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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 areas:
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 areas:
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 metabolism.
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 levels.
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 pregnancy.
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 specialist.
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