The National Cancer Institute reports that while thyroid cancer remains rare in children overall (10.7 cases per 1 million people aged 0 to 19), it “accounts for approximately 14 percent of all cancers” in 15- to 19-year-olds. With the incidence of thyroid cancer on the rise nationally and across the globe, Nicklaus Children’s Hospital is positioned to provide comprehensive, multidisciplinary care for children facing this growing concern.

Charting a Course for Better Outcomes

Today, pediatric thyroid cancer care makes frequent use of molecular studies. In fact, Carmen Bustamante Escobar, MD, pediatric endocrinologist and director of the Thyroid Cancer and Obesity Programs for Nicklaus Children’s Health System, states that all diagnoses of thyroid cancer within Nicklaus Children’s Division of Pediatric Endocrinology and Diabetes receive molecular testing in an effort to identify a tumor’s genetic makeup.

Through molecular studies, clinicians gain insight into the individual cancer affecting a young child. With this data, providers can make optimal treatment planning decisions, ensuring a therapy experience that is tailored to meet the specific needs of each individual patient.

To further pediatric cancer research for improved care options, Nicklaus Children’s clinicians are actively involved in the Child and Adolescent Thyroid Consortium (CATC). CATC consists of 21 North American health institutions with the shared goal of providing pediatric thyroid cancer-related research, improving patient care and enhancing collaboration between the various specialists providing care for the pediatric thyroid cancer population.

Our Current Approach to Care

In addition to improving the future of pediatric thyroid cancer care, Nicklaus Children’s remains a leader in diagnosing and optimizing care today. When thyroid cancer is suspected, our team performs advanced diagnostic screenings, including high-definition ultrasound and fine needle aspiration biopsy.

Once we determine a specific diagnosis, treatment planning may include one or more of the following:

• Thyroidectomy. “For this rare type of cancer, it's important to have a high-volume surgeon with the ability and experience required for the best outcomes,” Dr. Bustamante Escobar says. “The Thyroid and Endocrine Surgery Center at Nicklaus Children’s has the highest number of pediatric thyroid patients of any facility in South Florida.”

• Hormone therapy. Whether the patient’s hormone gland underperforms or undergoes surgical excision, hormone therapy helps aid in proper hormone production.

• Radiation therapy. When indicated, radiation therapy is provided through a partnership with Miami Cancer Institute at Baptist Health South Florida. Radiation therapy and radioiodine therapy serve to eradicate thyroid tissue persisting after surgical removal of the thyroid.

• Chemotherapy. Though rarely applicable to pediatric thyroid cancer patients, chemotherapy is available for thyroid use, when appropriate.

Connecting All Members of the Care Team

Through the patient journey, children receive care from a multidisciplinary team that includes interventional radiologists, pathologists, pediatric surgeons, psychologists and others. These varied specialists hold a conference each month to consider complex cases and promote the use of newly established best practices. Team members also maintain open lines of communication with referring physicians and engage caregivers in every decision, providing education and updates to reduce the anxiety and fear that typically accompany a pediatric cancer diagnosis. This ongoing communication continues until the patient ages out of the program and transfers to adult care.

“Families start meeting specialists right away, and they stay in contact with all providers at the same time,” Dr. Bustamante Escobar says. “They receive updates from our multidisciplinary team on the day we meet or the day after. We also make ourselves easily accessible by phone. Every patient gets a roadmap, so families know exactly what they need to do as well.”

To refer a patient to Nicklaus Children's thyroid cancer program, email our physician liaison.