By Timothy Kelly, MD, FACS
Thyroid nodules can come in all sizes. Often they are quite small, but they can affect your health in different ways. Therefore, it is important to have them evaluated and treated by someone who has experience in this regard. But what is a thyroid nodule?
What is a thyroid nodule?
A thyroid nodule is a growth of cells on or within the thyroid gland. They are often felt on physical examination before becoming visible. Larger nodules may look like a bump or swelling in the lower midline neck. Thyroid nodules are quite common. Five to 10 percent of people have noticeable nodules, and are detected through ultrasound or other x-rays in up to 60 percent of people. Nodules are often found during an evaluation of the neck for other purposes, such as CAT scans or MRIs. After detection, a biopsy is sometimes necessary to determine if a nodule is potentially malignant (a cancer).
Fortunately, approximately 85-90 percent of thyroid nodules are benign. However, benign nodules can still cause problems. If they become too large, they can compress structures in the lower neck and upper chest, causing symptoms of difficulty swallowing or breathing, and can affect one’s voice. On the other hand, thyroid nodules rarely affect the function of the thyroid gland.
If a thyroid nodule is benign or asymptomatic, observation may be the only treatment necessary. If a nodule is greater than 4 centimeters (almost 2 inches), removal is usually suggested. Surgery – either removal of a portion or all of the thyroid gland – may be needed if cancer is suspected. Luckily, thyroid cancer is very treatable and is often cured with surgery alone. This may be done as an outpatient procedure. The mortality rate for most thyroid cancers is very low, especially in young women.
For reasons that are not completely understood, the number of thyroid cancer cases has tripled in the past 30 years. There is an increased risk of cancer if the nodule grows rapidly, if you have a history of radiation exposure, or if you have a family history of thyroid cancer. There is also an increased risk if you are male, have symptoms of trouble swallowing or hoarseness, and if you are younger than 20 or older than 70 years of age.
The cause of most thyroid nodules is not known. They may have a genetic or familial cause and can be associated with inflammation of the thyroid, known as thyroiditis. Otherwise, they are simply one of the many changes that our bodies go through as we age. Evaluation by an experienced surgeon is relatively straightforward. It’s important to note, though, that whatever the cause of the nodule, they are very treatable and should not cause undue concern.
This blog is for informational purposes only. For specific medical questions, please consult your physician. Dr. Kelly is an otolaryngologist who specializes in comprehensive pediatric & adult ENT, pediatric airway, and thyroid surgery. He practices out of our Rock Hill and Fort Mill offices.