Thyroid nodule and Thyroid Cancer

Thyroid nodules are round or oval-shaped growths in the thyroid gland. 

Thyroid nodules are common and are not usually harmful to a person’s health. But sometimes, thyroid nodules are caused by a serious condition, such as cancer.

Most thyroid nodules do not change the amount of thyroid hormone in the body. But some cause the thyroid gland to make too much thyroid hormone. This can cause symptoms.

Some people do not have any symptoms. They might find out that they have a thyroid nodule incidentally when their doctor feels it during a routine check-up. Or a doctor might find nodules on an imaging test that was done for another condition. 

Eg: sonography/CT/MRI of neck

Some people have symptoms. For example, they might feel or see a lump in their neck. Or they have symptoms from having too much thyroid hormone, such as:

• Feeling worried, upset, or having trouble sleeping
• Feeling weak or tired
• Losing weight without trying
• Having a fast heartbeat
• Having frequent bowel movements

Tests usually include blood tests and an imaging test of the thyroid called an ultrasound. Sometimes, people need more tests. These include:

• Fine needle aspiration – For this test, a doctor uses a thin needle to remove a small sample of cells from the thyroid nodule. The cells are sent for other tests. These tests can help doctors decide which nodules should be removed by surgery and which nodules can be watched.  
• Thyroid scan – People get this test only if they have too much thyroid hormone in the body.

Thyroid nodules are treated in different ways, depending on their cause and how much thyroid hormone is in the body. Different treatments include:

• Watching and waiting – Doctors don’t always treat thyroid nodules right away. Your doctor might watch a thyroid nodule if it is small and doesn’t look serious. But he or she will follow it closely to see if it grows bigger or needs to be treated. This means you might have another thyroid ultrasound and sometimes another fine needle aspiration.

• Surgery to remove one or both sides of the thyroid.

• A procedure to drain fluid from the thyroid nodule, if it is filled with fluid.

If you want to get pregnant, talk with your doctor as the plan is to be individualised from case to case basis depending on multiple variables including patient preferences.

Thyroid cancer occurs when cells in your thyroid undergo abnormal changes (mutations). The mutations allow the cells to grow and multiply rapidly. The cells also lose the ability to die, as normal cells would. The accumulating abnormal thyroid cells form a tumour.

Several types of thyroid cancer exist. Some grow very slowly, and others can be very aggressive. 

Thyroid cancer typically doesn’t cause any signs or symptoms early in the disease. As thyroid cancer grows, it may cause:

• A lump (nodule) that can be felt through the skin on your neck
• Changes to your voice, including increasing hoarseness
• Difficulty swallowing
• Pain in your neck and throat
• Swollen lymph nodes in your neck

Depending on the type, extent and staging of the disease there are various modalities of treatment.

• Thyroidectomy/Surgery of thyroid gland
• Chemotherapy
• Palliative care
• Radiation therapy