Table of contents
- What are Thyroid Nodules?
- What is the classification of thyroid nodules?
- How are thyroid nodules diagnosed and treated?
- Thyroid Lobectomy & Thyroidectomy
- What is a fine needle biopsy?
- Can thyroid nodules be prevented?
What are Thyroid Nodules?
A thyroid nodule is a development of a lump in the cells of the thyroid gland. It is the part of the endocrine gland which secretes hormones in the blood. The thyroid gland is in the shape of a butterfly in the neck just below the larynx, commonly called Adam’s apple. The gland comprises the left and right lobes connected to the bridge, which produces thyroid hormones. These hormones control body temperature, digestion, functions of the heart, and process body metabolism.
What is the classification of thyroid nodules?
They are classified under three categories hot, cold and warm. A cold nodule is unable to produce hormones, warm nodules generate normal hormones, and hot nodules generate excessive hormones. This is a common problem and usually gets unnoticed. Almost 90% of these nodules are non-cancerous. There are different types of thyroid nodules, namely inflammatory nodules, colloid nodules, hyperfunctioning thyroid nodules, multinodular goiter, and thyroid cysts. Thyroid cysts are lumps that are partly fluid and partly solid. Inflammatory nodules are caused as a result of inflammation for a long time and swelling in the thyroid gland. Inflammatory nodules may cause pain. Goiter occurs due to several nodules in the gland.
Thyroid nodule causes are vague, but the biggest concern is that of cancer – though it is a rare condition, almost less than 5%. The lump in the thyroid gland is the reason for a thyroid nodule. In a study, it was found that this condition can be a hereditary and genetic problem. Often insufficient iodine is a major cause of thyroid nodules.
Some of the symptoms are unnoticeable and not problematic. But if the size of the lump is large, then pain in nodules occurs, discomfort due to enlargement, commonly called goiter, harsh voice and difficulty in breathing and swallowing. Hyperthyroidism can occur if a hot nodule is developed in the gland. Its symptoms are nervousness, insomnia or sleeping difficulty, weakness of muscles, weight loss and irregular and increased heart rate. Hashimoto’s thyroiditis occurs with thyroid nodules in special cases. It is a situation that increases the risk of hypothyroidism. Symptoms observed are incredible fatigue, dry hair, constipation, weight gain, cold sensitivity, dry skin and brittle nails.
How are thyroid nodules diagnosed and treated?
Sometimes, nodules get unnoticed and can be detected by primary physical exams after the patient experiences some thyroid nodule symptoms. If the doctor notices any growth, then the doctor may inquire about the previous radiation treatment of the neck, thyroid nodule history in the family, and other problems of the thyroid gland. After this, other physical exams will be conducted for proper treatment – to determine the thyroid-stimulating hormone (TSH) level. A blood test is conducted, an ultrasound is done to detect the structure of the nodule, thyroid scanning is for classification, and a needle test is for the sample.
Treatment depends on the type and size of the thyroid nodule. The doctor may resort to only regular inspections to check the growth of nodules. If it is non-cancerous with mild symptoms, then it may not require any treatment. If the nodule is generating excessive hormones, then surgery or radioactive iodine treatment can be done. If this procedure helps eliminate nodules, then synthetic hormones will be recommended regularly – other than surgery, medications to check thyroid generation can also be prescribed.
Thyroid Lobectomy & Thyroidectomy
Thyroid lobectomy and thyroidectomy are performed to treat thyroid nodules. In thyroid lobectomy, the doctor removes one lobe, and the tissue acts as the bridge between the two lobes. This method is useful in removing cancer-causing nodules. This thyroid nodule surgery is performed under local anesthesia to avoid pain. An incision(cut) is made in the wrinkle of the neck to prevent the visibility of the scar. After treatment, the doctor sutures (stitches) the incision, and recovery time is provided to the patient. In a thyroidectomy, the thyroid gland is removed. This is generally performed on a person with thyroid cancer and multinodular goiter . The production of thyroxine is reduced after thyroidectomy. The doctor prescribes synthetic hormones to fulfill the need. The patient has to stay overnight in the hospital and can be discharged after some days. Slight discomfort or pain is normal after the lobectomy and thyroidectomy surgeries.
What are the conditions after surgery?
General recovery time is 5-6 hours for the patient after surgery. The patient will be able to talk after surgery though soreness will persist. According to a study, life expectancy is normal for people less than 45 years, but it may shorten for people more than 45 years, especially those above 60 years. Other effects of the removal of the thyroid gland are low-level of calcium which leads to numbing, cramping, and tingling. Weak and hoarse voice due to damage to nerves and bleeding. Citrus fruits like lemon and orange juices are recommended to keep up the level of vitamin C.
What is a fine needle biopsy?
In a fine needle biopsy, a piece of tissue from the affected area is removed for microscopic observation. An image is formed on the screen for further assessment of the nodules. Ultrasound imaging is done to guide the needle in the nodule, & an antiseptic is used to clean the neck area. Anesthesia may or may not be given as per the requirement. Then with the help of needles, samples are taken for observation. When a biopsy is completed, a small amount of pressure is applied to reduce the risk of bleeding from the affected area. Sutures are not needed, and bandages can be applied. The patient can experience mild discomfort or pain – they are allowed to talk, eat, cough, or swallow during the procedure. The operated area will be sore for a few days, and in case of pain, consult the doctor for medications. Certain foods should be avoided if the patient is diagnosed with thyroid nodules, such as cauliflower, cabbage, sweet potatoes, broccoli, peaches, spinach, strawberry, and peanuts.
Advantages of needle biopsy
- The major advantage of needle biopsy is its accuracy; around 96% of cases are accurate as other biopsies.
- The time needed for recovery is less and normal activities can be resumed after a few hours.
- It is a reliable technique to identify the cancerous or non-cancerous nature of thyroid nodules.
- It is better than other biopsies as the incision (cut) made in the surgery is small.
- The procedure is less painful or not painful at all.
Disadvantages of the needle biopsy
The disadvantages are injury in the near area, infection in the operated area, and sometimes bleeding can occur in the area of the biopsy.
Can thyroid nodules be prevented?
Not much can be done to prevent the thyroid nodule, but the intake of iodine in the diet can be increased as a preventive measure.
The side effects include sore throat, difficulty in swallowing, hoarse voice, stiffness, hematoma and neck pain. These complications are common for 2-3 days but if the problem persists, consult the doctor immediately.
The cost of the treatment differs according to the hospital. However, the basic cost of a biopsy ranges between $4500 and $7000.
The patient must clean the area beforehand. They should not eat anything before the surgery for at least 10 hours and should ask about activities to be done and precautions after surgery.
Fine needle surgery usually takes 30 minutes to be completed. But other biopsies or surgery can take 2 to 3 hours to completion. However, recovery requires 3-4 hours more.
Yes, the condition can be cured. Fine needle surgery and other biopsies are available for this purpose. However, they have their benefits and risks.
The steps followed to do a thyroid self-test are:
Almost more than 95% of the thyroid nodules are benign (non-cancerous). In order to confirm the type of nodule, the doctor will advise the patient to undergo ultrasonography and FNAC (fine needle aspiration cytology) biopsy.
The risk factors of thyroid nodules are listed below:
1) Older age people (>60yrs)
2) Hereditary (family history of thyroid nodules)
3) Patients suffering from pre-existing thyroid conditions such as thyroiditis or Hashimoto’s thyroiditis.
4) Gender- The incidence is high in females compared to men.
5) Patients who are exposed to iodine radiation or iodine deficiency
6) Hormonal changes and pregnancy
Thyroid nodules are more commonly seen in today’s world. The doctor detects about 5-7% of the population of adults during a physical examination and detects about 20-76% of the adult population during ultrasonography . The incidence of a thyroid nodule is less commonly seen in children.