Thyroid cancer on rise among younger patients

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SOUTH BEND, Ind.--- The McCarthy kids are always moving, especially four-year-old Chloe.

That's why her parents never suspected something was wrong until two years ago.

"Well actually, my husband was playing with her, like you do a normal one-and-a-half-year-old,” said Lauen McCarthy, Cloe’s mother. “He would dip them upside down, bring them back, and when he pulled her up her head was back and he saw the lump in her neck.”

Images showed Chloe’s one thyroid gland was three times its normal size. It was caused by cancer.

Doctors eventually had to remove all of the thyroid tissue.

Thyroid cancer is the fastest growing cancer in the United States, and it is being diagnosed more often in younger patients.

Dr. Andrew Bauer, a pediatric endocrinologist at the Children’s Hospital of Philadelphia, says thyroid cancer in kids under 10 is rare, about five cases per every million, but at age 15 those numbers jump to 18 per million.

Previous data found the age group seeing the largest increase was white, teenage girls, but the most recent study shows it crosses all genders and races.

"In adolescents it's actually quite similar to non-Hodgkin’s lymphoma, which many people have heard of before," said Dr. Bauer.

Experts say most parents aren't aware that thyroid cancer can, and does, strike kids.

"They don't have any pain,” said Dr. Bauer. “They don't have weight loss."

Since this is a cancer that has few early symptoms, experts say it's especially important that parents know what to look out for.

Doctors say parents should check kids for swelling or lumps in the neck. Don't skip routine check-ups, where doctors will examine neck glands.

Dr. Bauer says with early diagnosis, and treatment, kids have a 95 percent chance of surviving thyroid cancer.

Chloe McCarthy is now cancer-free, and her parents are happy they can put this behind them.

"It's not something that we thought to look for,” said Lauren. “It's nice to keep an eye on everything on your child."

Experts aren't sure why there has been an increase in thyroid cancers, but they say previous exposure to radiation is a risk factor.

Blood tests or ultrasound can sometimes detect changes in the thyroid, but experts say those are not recommended unless the physical exam is abnormal, or a patient is at high risk, possibly because another family member has had thyroid cancer.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY

TOPIC: Thyroid Cancer in Kids
REPORT: MB #3869

BACKGROUND: Thyroid cancer is the third most common solid tumor malignancy and the most common endocrine malignancy in children. The two most common types of pediatric thyroid cancer are differentiated thyroid cancer, which includes papillary and follicular thyroid cancer and their variants. Papillary thyroid cancer is the most common type in both children and adults. The second is medullary thyroid cancer in which approximately 30-percent to 35-percent are familial tumors transmitted by a gene from either the mother or father. Risk factors that can cause pediatric cancer can include occurrences in family history, radiation treatment, or radiation fallout, as discovered in increased thyroid cancer rates after the 1986 Chernobyl disaster. Although not fully understood, females tend to develop thyroid cancer more than males after puberty; the risk is equal for children, male and female, under the age of 10.
(Source: http://www.entnet.org/content/pediatric-thyroid-cancer, http://www.thyca.org/pediatric/about/, http://www.everydayhealth.com/thyroid-cancer/pediatric-thyroid-cancer.aspx)

TREATMENT: Because children have a much greater chance of having thyroid cancer spread to other parts of the body, a removal of the thyroid, or total thyroidectomy, is the standard-of-care. If there is suspicion that the cancer has spread to the lymph nodes in the neck, these may be removed surgically as well. If there are any cancerous cells remaining after surgery, radioactive iodine therapy may be utilized. Thyroid hormone therapy may also be needed to replace normal hormones needed for a child's growth. These hormones include: thyroxine and triiodothyroxine, which help with growth and metabolism, and calcitonin which decreases calcium in the blood and increases it in the bones. Chemotherapy and radiation are also options depending on the type of thyroid cancer, or may be used as treatments to shrink tumors.
(Source: http://www.entnet.org/content/pediatric-thyroid-cancer)

FOR MORE INFORMATION ON THIS REPORT, PLEASE CONTACT:

Ashley Moore
(267) 426-6071
Moorea1@email.chop.edu