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Late Effects of Treatment for Childhood Cancer (PDQ®): Treatment - Patient Information [NCI] - Endocrine System

Thyroid gland

Thyroid late effects are more likely to occur after treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause thyroid late effects:

Radiation therapy to the head and neck increases the risk of thyroid late effects.

The risk of thyroid late effects may be increased in childhood cancer survivors after treatment with any of the following:

  • Radiation therapy to the brain and spinal cord or head and neck.
  • Total-body irradiation (TBI) as part of a stem cell transplant.
  • Chemotherapy.
  • Radioactive iodine therapy for neuroblastoma.

The risk also is increased in females, in survivors who were a young age at the time of treatment, in survivors who had a higher radiation dose, and as the time since diagnosis and treatment gets longer.

Late effects that affect the thyroid may cause certain health problems.

Thyroid late effects include the following:

  • Hypothyroidism (not enough thyroid hormone): The most common thyroid late effect. It usually occurs 3 to 5 years after treatment ends but may occur later. It is more common in girls than boys.
  • Hyperthyroidism (too much thyroid hormone): It usually occurs 3 to 5 years after treatment ends.
  • Goiter.
  • Lumps in the thyroid: Usually occur 10 years after treatment ends. It is more common in girls than boys.

Signs of thyroid late effects depend on whether there is too little or too much thyroid hormone in the body.

These symptoms may be caused by thyroid late effects:

Hypothyroidism (too little thyroid hormone)

  • Feeling tired or weak.
  • Being more sensitive to cold.
  • Pale, dry skin.
  • Coarse and thinning hair.
  • Brittle fingernails.
  • Hoarse voice.
  • Muscle and joint aches and stiffness.
  • Constipation.
  • Menstrual periods that are heavier than normal.
  • Depression or trouble with memory or being able to concentrate.

Hyperthyroidism (too much thyroid hormone)

  • Feeling nervous, anxious, or moody.
  • Trouble sleeping.
  • Feeling tired or weak.
  • Having shaky hands.
  • Having a fast heartbeat.
  • Having red, warm skin that may be itchy.
  • Having fine, soft hair that is falling out.
  • Having frequent or loose bowel movements.
  • Weight loss for no known reason.
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