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 is made up of 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.
Thyroid Nodules ClassificationThyroid nodules 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 nodule, multinodular goitre 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. Goitre occurs due to several nodules in the gland.
Diagnosis and treatment of thyroid nodulesSometimes, nodules get unnoticed and can be detected by primary physical exams after you experience some thyroid nodule symptoms. If the doctor notices any growth then he may inquire about the previous radiation treatment of neck, thyroid nodule history in the family and other problems of the thyroid gland. After this, other physical exams will be conducted for a proper treatment – to determine the thyroid-stimulating hormone (TSH) level, a blood test is conducted, ultrasound is done to detect the structure of the nodule, thyroid scanning for classification and needle test 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 thyroid nodules symptoms then it may not need any treatment at all. If the nodule is generating excessive hormones then thyroid nodules surgery or radioactive iodine treatment can be done. If this procedure helps eliminate nodules then synthetic hormones will be recommended regularly – other than thyroid nodules surgery, medications to check thyroid generation can also be prescribed.
Thyroid Lobectomy & ThyroidectomyThyroid lobectomy and thyroidectomy are performed for treating thyroid nodules. In thyroid lobectomy, the doctor removes one lobe and the tissue acting as the bridge between the two lobes. This method is useful in removing cancer-causing nodules. This thyroid nodules surgery is performed under local anaesthesia to avoid the pain. A cut is made in the wrinkle of the neck to prevent the visibility of the scar. After treatment, the doctor stitches the cut and recovery time is provided to the patient. In a thyroidectomy, the thyroid gland is removed. This is generally performed on the person with thyroid cancer and multinodular goitre. The production of thyroxine is reduced after thyroidectomy. The doctor prescribes synthetic hormones to fulfil the need. You have to stay overnight in the hospital and can be discharged after some days. Slight discomfort or pain is normal in lobectomy and thyroidectomy.
What are the conditions after surgery?General recovery time is 5-6 hours for the patient after surgery. You will be able to talk after surgery though soreness will be present. 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 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 of nerves and bleeding. To keep up the level of vitamin C, citrus fruits like lemon and orange juices are recommended.
Fine Needle BiopsyIn 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. Anaesthesia may or may not be given as per the requirement. Then with the help of needles samples are taken for observation. When 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 treated area will be sore for some days and in case of pain consult the doctor for medications. Certain foods should be avoided if you are diagnosed with thyroid nodules such as cauliflower, cabbage, sweet potatoes, broccoli, peaches, spinach, strawberry and peanuts.
Advantages of needle biopsy
- The major advantage of the needle biopsy is its accuracy; around 96% cases are accurate as other biopsies.
- The time needed for recovery is less and normal activities can be resumed after a few hours.
- To identify the cancerous or non-cancerous nature of thyroid nodules, it is a reliable technique.
- It is better than other biopsies as the cut made in the surgery is small.
- The procedure is less painful or not painful at all.
Disadvantages of the needle biopsyThe disadvantages are injury in the near area, infection in the operated area and sometimes bleeding can occur in the area of the biopsy.
Prevention of thyroid nodulesNot much can be done to prevent the thyroid nodule but intake of iodine in the diet can be increased as a preventive measure.
Some thyroid nodules symptoms are unnoticeable and not problematic. But if the size of the lump is large then pain in nodules occur, discomfort due to enlargement commonly called goitre, harsh voice and difficulty in breathing and swallowing. Hyperthyroidism can occur if the 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 which increases the risk of hypothyroidism, symptoms observed are incredible fatigue, dry hair, constipation, weight gain, cold sensitivity, dry skin and brittle nails.
Thyroid nodules 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 thyroid nodule can be a hereditary and genetic problem, often insufficient iodine is a major cause of thyroid nodule.
What are the side-effects or complications of the treatment of thyroid nodule?
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 your doctor.
What is the cost of the treatment?
The cost of the treatment differs according to the hospital. Though the basic cost of biopsy ranges between $4500 and $7000.
How should a patient prepare for the treatment?
The patient must clean the area beforehand, he should not eat anything before the surgery for at least 10 hours and should ask about activities to be done and precaution after surgery.
How long does the procedure take to be completed?
The fine needle surgery usually takes 30 minutes to be completed. But other biopsies or surgery can take 2 to 3 hours for completion. However, recovery requires 3-4 hours more.
Can the condition be cured?
Yes, the condition can be cured. The fine needle surgery and other biopsies are available for this purpose. Though they have their benefits and risks.