A letter to parents of children with thyroid cancer

  If your child has thyroid cancer, you are worried and anxious, but you don’t know what to do, what tests your child should undergo and what treatment he/she should receive next. I hope this article can help you.  When you bring your child to the hospital, our doctor will first ask you about your child’s medical history in detail. We will ask about the onset of the anterior neck swelling, previous treatment, any hoarseness, dysphagia, dysphagia, saliva storage and choking on food, any pain and discomfort in the ear, occipital neck and shoulder, any cough, chest pain, any pain in the sternum, pelvis and vertebrae, any hyperappetite, weakness, irritability, insomnia, fear of heat and other symptoms of hyperthyroidism, any low-grade fever and night sweats, any loss of weight or weight loss. Any current or recent acute infections, etc. In addition, whether the child has any previous thyroid disease, any history of drug allergy, any relevant family history (differentiated thyroid cancer, medullary thyroid cancer, multiple endocrine adenomatosis type 2, familial polyposis, certain thyroid cancer syndromes, etc.), and whether the child is exposed to ionizing radiation in general, whether he/she has a high/low iodine diet, whether he/she is currently acutely infected, whether he/she is menstruating, whether he/she has a history of vaccination in recent months, etc. history of vaccination, etc. This information is necessary for us to make a clear diagnosis as soon as possible and to provide the necessary treatment for your child, so we hope that you will provide the above information in as much detail as possible when you bring your child to the clinic.  After the consultation, the doctor will give some necessary examinations, such as various thyroid examinations, electronic laryngoscopy (focusing on the movement of vocal cords), ultrasound of the thyroid and both necks and abdomen, and if the ultrasound suspects cervical lymph node metastasis, PET-CT examination and MRI scan and enhancement of the neck are recommended.  After the diagnosis of nail cancer in children is clear, active surgical treatment is the most necessary method to cure the disease in children. In order to have successful surgery, ideal treatment effect and reduce the child’s pain due to intraoperative or postoperative complications, the doctor will double check the outpatient nail function, TGAb, TMAb, PTH, PCT, Tg, laryngoscopy, ultrasound, MRI all within 3 months before surgery, after which you need to re-check.  In addition, I hope you understand that there are certain risks associated with surgery, which may result in injury to the child’s laryngeal return/supraglottis/facial nerve, bleeding, postoperative pneumonectomy, lifelong calcium supplementation and eugenol, and postoperative I131 radiation therapy. The doctors will do their best to avoid any of these situations, and in the unfortunate event that they do occur, they will do their best to save your child’s life.  We know that you will be particularly concerned about the diagnosis of your child’s benign and malignant nail cancer. Although the doctor will have a general judgment of your child’s lesion before the surgery, the benignity or malignancy of the lesion will only be clear after the pathological diagnosis after the surgery, I hope you can understand.  After surgery, antibiotics and drainage will be given at the doctor’s discretion to prevent infection and to help your child recover more quickly. Your child will usually be able to eat by mouth at the appropriate time after surgery.  After discharge from the hospital, you are expected to keep your child’s neck wound clean to avoid infection and contact the doctor in charge for stitch removal (with outpatient general number) 7-10 days after surgery. 1 week low/no iodine diet (buy non-iodized salt from supermarket, no soy sauce, seafood, pickles, etc.). 1 week later blood recheck, no fasting required. When your child’s blood is checked after 1 week with TSH > 30U/L, your doctor will contact 401 hospital for I131 radiotherapy for your child. After your child is discharged from the hospital, if you notice hoarseness, breath-holding or breathing difficulties, tingling or twitching symptoms in the hands and feet, fever, swelling, fluctuating sensation and pain in the neck and bilateral jaw area, please contact your doctor as soon as possible.  The treatment of thyroid cancer is a comprehensive treatment combining surgery, medicine and radiotherapy, which requires the long-term cooperation and joint efforts of the child, doctors and parents. Finally, we sincerely hope that our joint efforts can restore the child’s health at the fastest speed.