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Pediatric Surgery for Endocrine Tumors
Pediatric, Adolescent and Young Adult (AYA) Surgery for Endocrine Tumors
General questions and answers
What is AYA?
AYA is a general title used to describe cancers among the
dult population ages 15 – 39.
Currently 65,000 – 70,000 AYA cancers are diagnosed each year in the U.S.
Thyroid cancer one of the top five AYA cancers. First for female ages 15-29 and second for females 30-39.
Thyroid cancer numbers are increasing.
What are some of the challenges and unique needs of AYA cancers and patients?
Life transitions, such as:
Shifts in family and peer groups
Changing and evolving sexual health and relationships
New found Independence, self-awareness and feelings of invincibility and invulnerability
Reduced adherence to treatment and follow-up
Challenges in communication, such as:
AYA – family
AYA – physician
AYA – peers
Family - physician
Unique needs, such as:
Disruptions in education, employment, and social life
Questions about future fertility
Establishing financial independence
Navigating the health care system.
Very premature confrontation with mortality
Changes in physical appearance
“Long-term follow-up” is really long-term
Pregnant or a new parent
Survivorship – AYA cancer survivors, and especially AYA thyroid cancer survivors, will hopefully have a LONG life of follow-up care
What is special about AYA thyroid cancers?
Mean age at presentation for all thyroid cancers is in the third decade
Younger patients (less than age 20)
present with more extensive disease.
ONLY cancer where age (less than 45) is part of staging
most AYA thyroid cancer patients are classified as having Stage 1 disease and therefore potentially undergo less extensive treatment depends on the specifics of the cancer.
Excellent overall survival
What is the typical workup of a pediatric thyroid nodule?
Like adults, a neck ultrasound is the best initial test for a thyroid nodule. Occasionally, fine needle aspiration (FNA) or diagnostic thyroid lobectomy (surgery) will be required for a diagnosis.
Is thyroid cancer a common pediatric cancer?
Thyroid cancer is the most common endocrine cancer in the pediatric population, representing about 1 percent of all pediatric malignancies in pre-pubertal children to 7 percent in adolescents, with the incidence increasing by 1.1 percent per year.
What if I am a pediatric or AYA cancer survivor? Do I need to be screened for thyroid cancer?
Young cancer survivors that received head and neck radiation are at an increased risk of developing thyroid cancer.
At a minimum, patients should have a physical exam of their neck every year by a clinician. There is debate over if and how frequent a neck ultrasound should be performed for screening.
I am a pediatric or AYA patient and I have….