When to Worry About Thyroid Nodules?
Many patients worry when they hear they have thyroid nodules. The good news is that they are usually not cancerous or require surgery. Usually doesn’t mean never, though. This is why it’s important for you to know when there is something to worry about with your thyroid nodules.
About Thyroid Nodules
Thyroid nodules are lumps on a thyroid. The thyroid is a butterfly shaped gland that produces hormones to regulate the body’s metabolic rate. This controls major organs and bodily functions:
Muscle and Digestive Functioning
In most cases, thyroid nodules aren’t bothersome to thyroid functioning UNLESS they become too large or they are cancerous.
Nodules are either solid or contain fluid in them. The fluid ones are referred to as thyroid cysts.
Thyroid nodules seem to run in families, and more women than men have them. It’s still unclear what causes them.
How to Know You Have Thyroid Nodules
People often find out they have thyroid nodules one of three ways:
An imaging test for an unrelated matter is one of the most common ways thyroid nodules are discovered.
A primary care doctor may feel them during a physical exam.
Difficulty swallowing, swelling and a hoarse voice often prompt people to visit a doctor who then decides to perform an ultrasound on the throat.
A thyroid ultrasound will check to see if there are any nodules, how big they are and if there are any signs they may be cancerous. Nodules smaller than a centimeter or filled with fluid are usually benign and left untreated. Bigger nodules that are solid are evaluated further with a biopsy.
What Happens When You Have Thyroid Nodules
An ENT specialist will use a blood test to check the functioning of the thyroid gland. If the gland is producing too much of the hormone, the patient is diagnosed with hyperthyroidism, if too little hormone they they are diagnosed with hypothyroidism. If there are thyroid hormone irregularities found, then your ENT specialist will refer you to an endocrinologist who specialized in hormone disorders.
For suspicious nodules, your ENT surgeon may recommend a fine needle aspiration under ultrasound guidance to biopsy the worrisome nodule and aspirate some cells from it. These cells are evaluated in a lab for cancer. Two tests can be performed - first with a pathologist. If it is unclear whether the cells are cancerous, a molecular test can be performed.
When to Worry About Thyroid Nodules
Only 5% of thyroid nodules are cancerous. While that seems small, there’s still a chance. You should worry about thyroid nodules when:
The ENT receives the results of a biopsy and tells you the nodules are malignant.
The lump in your neck actively grows.
Pain and swelling in the neck increases.
You become hoarse from the thyroid mass or nodule.
You have trouble breathing or swallowing from the thyroid mass or nodule.
Contact an ENT doctor immediately if you have any of the above symptoms AND you have a family member who was diagnosed with cancer or have been exposed to radiation.
Thyroid Nodules Treatment
Keep in mind that thyroid nodules grow slowly. You don’t want to wait too long to have it treated, but it’s not an emergency situation. Simply make an appointment with an ENT doctor near you, like ones at C/V ENT Surgical Group.
Your ENT surgeon will perform one of the following treatments:
Remove large nodules surgically. If the thyroid must be removed with the nodules, the surgeon will usually only take half of it so you don’t have to rely on thyroid medication.
For hot nodules, those that are affecting hormone production, radioactive iodine therapy may be used. This is a single dose of oral medication that kills overly active thyroid cells. Surgery is an option for hot nodules but not the preferred option. Often your ENT will refer you to an endocrinologist to manage hot nodules.
Remove the entire thyroid (thyroid goiter) or half of it. For cancerous nodules, the ENT surgeon has to remove the thyroid completely, if the cancer cells have attacked both sides or are at risk of being bilateral. Radioactive iodine therapy might follow if necessary as deemed by an endocrinologist.
Thyroid cysts are drained with a thin needle. If the fluid comes back (as it usually does), a percutaneous alcohol ablation may be performed. This drains the cyst and then injects alcohol into it. The alcohol keeps the cyst from filling up with fluid again.
The above thyroid nodule treatments are usually only needed in extreme cases. Many people live with thyroid nodules without any problems at all. The only time you should worry about thyroid nodules is when they start to interrupt your daily life because you can’t swallow, breathe, or suffer from some of the other symptoms of thyroid cancer.
Contact Us When You’re Worried About Thyroid Nodules
If you’re worried about thyroid nodules and live in West Hills or Encino, contact C/V ENT Surgical Group. We know this is a scary time for you and we want to make you feel better. Our experienced team of ENT specialists will evaluate the nodules with an ultrasound and perform a biopsy, if necessary. Again, please remember most cases of thyroid nodules are not cancerous or require surgery. If there are thyroid hormone or function issues then you will be referred to an endocrinologist, as ENTs don’t manage thyroid hormone issues.