On this page you can find:

• Who is at risk for thyroid function problems?
• What thyroid function problems might occur?
• What surveillance modality should be used and at what frequency should it be performed?
• What other advice should be given?
• What should be done if abnormalities are identified?

Who is at risk for thyroid function problems?

CAYA cancer survivors treated with

• radiotherapy to a volume exposing the thyroid gland, including TBI
• radioiodine therapy (I-131 ablation therapy)
• MIBG therapy (I-131 MIBG therapy) ^b
• allogeneic HSCT
• total thyroidectomy ^c

What thyroid function problems might occur?

• Hypothyroidism (after radiotherapy to a volume exposing the thyroid gland, including TBI, radioiodine therapy, MIBG therapy, allogeneic HSCT or total thyroidectomy)
• Hyperthyroidism (after radiotherapy to a volume exposing the thyroid gland, including TBI, or allogeneic HSCT)

What surveillance modality should be used and at what frequency should it be performed?

• A history with specific attention to hypothyroidism and/or hyperthyroidism
• Measurement of TSH and fT4
  every year in survivors ≤ 18 years of age, and at least every 2-3 years in survivors > 18 years of age

What other advice should be given?

• For female CAYA cancer survivors at risk for hypothyroidism, discuss the importance of measuring TSH and fT4 prior to attempting pregnancy and periodically during pregnancy
  at least every 5 years, starting at entry into long-term follow-up

What should be done if abnormalities are identified?

Disclaimer

While PanCare strives to provide accurate and complete information that is up-to-date as of the date of publication, we acknowledge that the sequence of referral and diagnostic tests might vary according to the local and national healthcare system logistics.

It is recognised that survivors and their healthcare professionals have the final responsibility for making decisions concerning their long-term follow-up care. As such, they may choose to either adopt these recommendations or not to do so after individual informed discussion. It is good practice to document this decision.

In addition to regular surveillance, real-time awareness and prompt reporting of new symptoms and signs is essential to the early detection and timely treatment of late effects.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information.

The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.