Two pediatric endocrinologists recommend a more conservative, or "individualized," use of certain therapies to treat thyroid cancer in children and teens. In the journal Expert Review of Endocrinology and Metabolism, authors Gary Francis and Steven Waguespack write that children with differentiated thyroid cancer (DTC) rarely die from the disease.
However, they note that these kids often experience serious and sometimes fatal complications from treatments used to battle DTC.
While only 2% of thyroid cancer diagnoses occur in children and teens, the American Cancer Society has stated that this rate may be on the rise. The researchers analyzed data collected on children with thyroid carcinomas. They found that even though children with thyroid nodules are more likely than adults to have a malignant form of the disease, their survival rate is quite high.
The team specified that almost all children with DTC survive at least 10 years and that after 40 years, just one in 50 children will have died of the disease. Nearly every case of childhood DTC was found to be either papillary or follicular thyroid cancer.
The Columbia University Department of Surgery reports that these are the two most common, and most treatable, forms of differentiated thyroid disease. The study's authors said that a thyroidectomy was the treatment commonly recommended for children with DTC. This operation tends to have positive results, they said.
The team added that radioactive iodine therapy may not always be necessary as a follow-up treatment. They reasoned that children who have Stage I thyroid cancer, the least advanced form, may not exhibit a high enough risk of dying from the disease to require such an aggressive treatment.
While it is an effective therapy - in which cancerous thyroid cells absorb radioactive iodine and are destroyed - it can have life-long complications. The group concluded that the potential for secondary cancers is something to consider when prescribing radioactive iodine therapy for children.
In the U.S., thyroid nodules are ten times more common in teens than in prepubescent children, according to a study in the journal Endocrine-Related Cancer.