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Some people who were treated for cancer during childhood may
develop hormone problems as a result of changes to a complex system of glands
known as the endocrine system. These glands include the thyroid, which makes
two hormones that are needed for growth and mental development and to help
regulate the body’s metabolism. Not enough or too much of these hormones can
cause various health problems.
Survivors who received radiation that may have affected the
thyroid gland are at risk for thyroid problems. Damage to the thyroid gland
after childhood cancer is most often the result of radiation to the following
Surgical removal of the thyroid gland, radioiodine
treatments, and high doses of MIBG (sometimes used to treat neuroblastoma) may
also cause thyroid problems.
In addition, those who received radiation that may have
affected the pituitary gland— which controls the thyroid gland—are also at
risk. Damage to the pituitary gland may occur after radiation to the following
Finally, these factors also are known to increase risk for
thyroid problems after childhood cancer:
Damage to the thyroid gland might not show up for years
after treatment. But, regular check-ups may help find thyroid problems early so
that treatment can be started. Several types of thyroid problems may develop.
When the thyroid gland is not active enough, it is called
hypothyroidism. It’s the most common thyroid problem in childhood cancer
survivors. When the thyroid gland is underactive, thyroid hormone levels are
low and your metabolism slows down.
Symptoms of hypothyroidism may include:
When the thyroid is too active it is called hyperthyroidism.
When this occurs, thyroid hormone levels are too high and speed up the body’s
Symptoms of hyperthyroidism include:
Growths on the Thyroid;
Many years after radiation, growths may occur on the
thyroid. Cancerous and non-cancerous growths usually begin as slow-growing,
painless lumps in the neck. Most growths don’t cause any symptoms.
If you are at risk for thyroid problems, you should have a
check-up every year that looks for thyroid problems. This annual visit should
include evaluation of growth in children and teens, examination of the thyroid
gland, and a blood test to measure thyroid hormone levels. During periods of
rapid growth your doctor may suggest more frequent monitoring of your thyroid
Female survivors who are at risk for thyroid problems should
have their thyroid levels checked before trying to get pregnant. This is
because mothers with thyroid disease have a higher chance of having babies with
developmental problems. It is also important to monitor thyroid levels during
Thyroid gland problems are easy to treat for the most part.
If your thyroid levels are too high or too low, you may be
referred to a doctor who specializes in hormones (an endocrinologist). If a
lump is found on your thyroid, you may be referred to a surgeon or other
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