Thyroid Cancer in Children

Thyroid cancer often starts quietly with no symptoms — at least, at first. Then, maybe your child’s pediatrician finds a lump (thyroid nodule) in your child’s neck during a routine checkup. Or maybe your child noticed one themselves.

At your first appointment, we’ll spend time going over your child’s health history. We’ll want to know if there’s anything that could have increased their risk of developing thyroid cancer — like prior radiation treatments or a family history of thyroid problems.

If your child has already had a thyroid cancer diagnosis, we’ll take a look at any prior test results and notes from the provider who referred you.

We may order more tests to confirm a diagnosis and prepare us for designing a personalized treatment plan that focuses on your child. We might do:

• Blood tests: Blood tests can show us how well your child’s thyroid works by looking closely at the hormone levels in their blood.
• Ultrasound: We use ultrasound to check the number of thyroid nodules, how big they are and if they’re solid or filled with fluid.
• Fine-needle aspiration biopsy: After numbing the area with medicine, we use a thin needle to take a small thyroid tissue sample (biopsy). Our experienced pathologists examine the sample under a microscope and can tell us for sure whether the nodule is cancerous.
• CT scan or MRI: We use these imaging tests to make sure your child’s thyroid cancer hasn’t spread to other parts of their body.

Second opinions for thyroid cancer in children

When you hear your child may have pediatric thyroid cancer, it’s natural to wonder if you’ve chosen the right healthcare team. You want to be 100% sure that the providers taking care of your child are the best there are.

That’s why, at Cleveland Clinic Children’s, we encourage second opinions. Our pediatric cancer specialists will meet with you and your child (either in person or virtually) and go over their diagnosis and treatment plan. They’ll take the time to answer your questions and listen to your concerns. And they’ll offer their expertise in a kind and caring way. We also know that cancer doesn’t wait. So, we’ll always try to get your child an appointment with us as soon as possible.

Second opinions can give you peace of mind knowing that your child — and you — are in the most capable and compassionate hands.

Meet Our Thyroid Cancer in Children Team

At Cleveland Clinic Children’s, you and your child will have the support of a team of skilled pediatric healthcare providers who are experts in diagnosing and treating thyroid cancer in children. Your child’s care team could include:

• Pediatric endocrinologists.
• Pediatric radiologists.
• Pediatric oncologists.
• Pediatric otolaryngologists (ear, nose and throat specialists).
• Pediatric anesthesiologists.
• Pathologists.
• Pediatric nurse practitioners.
• Pediatric physician assistants.

Next, our team will look at all of your child’s test results and other information to design a treatment plan that’s right for them. We’ll keep you and your child in the loop throughout the entire process, so you know what to expect.

We’ll create this plan based on several important things — the type of thyroid cancer, its aggressiveness (how fast it grows) and your child’s health history. Often, we recommend a combination of several treatments that work together to help your child feel their best.

Thyroidectomy

Surgery to remove the thyroid gland — a thyroidectomy — is the most recommended treatment for children with pediatric thyroid cancer. We’ll give your child general anesthesia, so they’re asleep and won’t feel any pain during the procedure.

Your child’s experienced surgeon will make a small incision (cut) in their neck to remove the cancerous gland. During surgery, we’ll use a special nerve monitoring device to avoid damage to your child’s important recurrent laryngeal nerves, which help them speak and also keep their airways clear. Your provider will decide if your child can go home that same day or if they’ll need to stay in the hospital overnight.

Radioactive iodine therapy

Your provider may recommend radioactive iodine therapy after a thyroidectomy to get rid of any remaining cancerous thyroid cells in your child’s body. We’ll give them this single-dose oral therapy in pill or liquid form. Typically, your child can return home the same day as treatment.

Hormone replacement therapy

The thyroid gland makes hormones that are important to your child’s growth and development. Following a thyroidectomy, your child will need artificial hormones to help them continue to grow. Hormone replacement therapy can be physically and emotionally challenging for teenagers who have had thyroid cancer. We’re here to walk your young adult through these changes, adjust their medications as needed and offer resources to you and your child.

Follow-up care

Kids who’ve had pediatric thyroid cancer need lifelong follow-up care. We’ll see your child every three to six months for ultrasound screenings. Regular check-ins help us catch any cancer that’s come back (recurred) right away and respond to any changes in your child’s health. And as they become an adult, we’ll help your child make the transition to new providers who specialize in adult thyroid cancer treatment and follow-up.

Taking the Next Step

When you heard your child might have pediatric thyroid cancer, you probably didn’t know what to do or say. We understand how frightening this diagnosis can be, and it’s natural to worry about your child’s future. At Cleveland Clinic Children’s, your child’s future means a lot to us, too. That’s why we’re here to give them excellent cancer care — and you, the hope and peace of mind you need — so your entire family can move forward together.