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What Type Of Thyroid Nodules Are Cancerous

Looking For More Of An Introduction

Thyroid Nodules, Cancers & Treatment

If you would like more of an introduction, explore this related item. Please note that this link will take you to another section on Cancer.Net:

  • ASCO Answers Fact Sheet:Read a 1-page fact sheet that offers an introduction to thyroid cancer. This free fact sheet is available as a PDF, so it is easy to print.

Thenext section in this guide is Statistics. It helps explain the number of people who are diagnosed with thyroid cancer and general survival rates. Use the menu to choose a different section to read in this guide.

How Are Thyroid Nodules Diagnosed

Fine Needle Biopsy

A thyroid fine needle biopsy is a simple procedure that can be performed in the physician’s office. Some physicians numb the skin over the nodule prior to the biopsy, but it is not necessary to be put to sleep, and patients can usually return to work or home afterward with no ill effects.

This test provides information that no other test can offer short of surgery. A thyroid needle biopsy will provide sufficient information on which to base a treatment decision more than 85 percent of the time if an ultrasound is used.

Use of fine needle biopsy has drastically reduced the number of patients who have undergone unnecessary operations for benign nodules. However, about 10-20 percent of biopsy specimens are interpreted as inconclusive or inadequate, that is, the pathologist cannot be certain whether the nodule is cancerous or benign.

In such cases, a physician who is experienced with thyroid disease can use other criteria to make a decision about whether to operate.

Thyroid Scan

A thyroid scan is a picture of the thyroid gland taken after a small dose of a radioactive isotope normally concentrated by thyroid cells has been injected or swallowed. The scan tells whether the nodule is hyperfunctioning . Because cancer is rarely found in hot nodules, a scan showing a hot nodule eliminates the need for fine needle biopsy. If a hot nodule causes hyperthyroidism, it can be treated with radioiodine or surgery.

Ultrasound

Physical Examination Maneuvers That Are Likely To Be Useful In Diagnosing The Cause Of This Problem

Examination should include inspection, auscultation, and palpation of the thyroid gland. Specifics including size of any palpated nodules and mobility should be noted. Nodules that are hard, fixed to adjacent structures, and with regional lymphadenopathy are associated with a higher risk for malignancy. Lymphadenopathy should be evaluated as well, including size, texture and mobility of any enlarged nodes.

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Fast Facts About Thyroid Nodules

  • Thyroid nodules are three times more common in women than in men
  • The incidence of thyroid nodules increases with age
  • At age 30, 30% of women will have a thyroid nodule, compared to one in 40 men the same age
  • 50% of 50-year-old women will have at least one thyroid nodule
  • 60% of 60-year-old women will have at least one thyroid nodule
  • 70% of 70-year-old women will have at least one thyroid nodule

Are Thyroid Nodules Cancer

How to Shrink Thyroid Nodules

The vast majority more than 95% of thyroid nodules are benign . If concern arises about the possibility of cancer, the doctor may simply recommend monitoring the nodule over time to see if it grows.

Ultrasound can help evaluate a thyroid nodule and determine the need for biopsy. A thyroid fine needle aspiration biopsy can collect samples of cells from the nodule, which, under a microscope, can provide your doctor with more information about the behavior of the nodule.

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Whats The Treatment For A Thyroid Nodule

Even a benign growth on your thyroid gland can cause symptoms. If a thyroid nodule is causing voice or swallowing problems, your doctor may recommend treating it with surgery to remove all or part of the thyroid gland.

If the doctor recommends removal of your thyroid , you may not even have to worry about a scar on your neck. Some patients are good candidates for a scarless thyroid procedure, where the surgeon reaches the thyroid through an incision made on the inside of your lower lip.

A newer alternative that the doctor can use to treat benign nodules in an office setting is called radiofrequency ablation . Radiofrequency ablation uses a probe to access the benign nodule under ultrasound guidance, and then treats it with electrical current and heat that shrinks the nodule. Its simple: Most people treated with RFA are back to their normal activities the next day with no problems.

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Our thyroid experts in the head and neck endocrine surgery team diagnose and treat patients with a variety of thyroid and parathyroid conditions. Learn about what we offer at our center.

Thyroid Cancer And Chemotherapy

Thyroid cancer is unique among cancers. In fact, thyroid cells are unique among all cells of the human body. They are the only cells that have the ability to absorb iodine. Iodine is required for thyroid cells to produce thyroid hormone, so they absorb it out of the bloodstream and concentrate it inside the cell.

The most common thyroid cancers are made up of cells that retain this ability to absorb and concentrate iodine. This provides a perfect “targeted” strategy.

Radioactive Iodine is given to the patients with certain types of thyroid cancers called differentiated thyroid cancers following complete removal of their thyroid gland. These differentiated thyroid cancers include the most common thyroid cancers of papillary thyroid cancer and follicular thyroid cancers. If there are any normal thyroid cells or any remaining thyroid cancer cells in the patient’s body , then these cells will absorb and concentrate the radioactive iodine.

Since most other cells of our bodies cannot absorb the toxic iodine, they remain unharmed. The thyroid cancer cells, however, will concentrate the poisonous radioactive iodine within themselves and the radioactivity destroys the cell from withinno sickness, hair loss, nausea, diarrhea, or pain. Some normal cells such as your saliva glands, tear glands, breast tissue and bone marrow also will absorb some iodine and receive some potential risk of damage.

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Symptoms Of Thyroid Nodules

Thyroid nodules usually do not cause symptoms. For this reason, theyre often found by a healthcare provider during a routine neck examination or an imaging test done for another reason .

When thyroid nodules do produce symptoms, the most common are a lump in the neck and a sense of mass while swallowing . In addition, larger nodules may cause difficulty breathing, hoarseness, and neck pain.

Rarely, the tissue in a thyroid nodule makes too much of the thyroid hormones triiodothyronine and thyroxine , which can lead to symptoms of hyperthyroidism . These include:

  • Anxiety
  • Missed or light menstrual periods

Papillary Thyroid Cancer Quick Facts:

Thyroid Nodules – Cancer Risk Factors and Radiation Exposure (Chernobyl, Fukushima)
  • Peak onset ages 30 through 50
  • Females more common than males by 3 to 1 ratio
  • Prognosis directly related to tumor size
  • Accounts for 85% of thyroid cancers
  • Can be caused by radiation or x-ray exposure
  • Spread to lymph nodes of the neck present in up to 50% of cases
  • Distant spread is very rare
  • Overall cure rate very high

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Can A Thyroid Problem Heal Itself

Occasionally, the condition may resolve without treatment. Follow-up appointments are important to monitor hypothyroidism over time, however. If hypothyroidism doesnt go away on its own within several months, then treatment is necessary. If left untreated, this condition eventually may lead to serious health problems.

What The Thyroid Gland Does

To understand why some types of goiter develop, it is first important to know what the normal function of the thyroid gland is and how it is regulated. The thyroid gland makes and releases into blood two small chemicals, called thyroid hormones: thyroxine and triiodothyronine . Each of them is comprised of a pair of connected tyrosine amino acids to which four or three iodine molecules, respectively, are attached.

The iodine needed for thyroid hormone production comes from our diet in seafood, dairy products, store bought bread, and iodized salt. Once absorbed, iodine in blood is trapped by a special pump in thyroid cells, called the sodium-iodide symporter. The thyroid also has several specialized biochemical ‘fastening machines,’ called enzymes, that then carry out the steps needed to attach iodine to particular parts of a very big protein called thyroglobulin, which is made only by thyroid cells.

Some of this thyroglobulin with iodine molecules attached is stored in the gland in the form of a gooey paste called colloid, which is normally located in the center of follicles, which are balls of thyroid cells with a hollow center.

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Who Is Most Susceptible To Thyroid Cancer

Children with a family history of thyroid cancer or a personal history of cancer are at a higher risk for thyroid cancer, as are children with an autoimmune thyroid disease. The greatest risk for childhood thyroid cancer is among adolescent girls, especially those of Hispanic descent. However, it occurs in all ages, races, and genders of children. Thyroid cancer in children is on the rise in certain populations.

How Big Is Too Big

Types of Thyroid Nodules

When it comes to thyroid nodules, the size matters quite a bit.

Studies have shown time and time again that larger thyroid nodules tend to turn into thyroid cancer at a higher rate compared to smaller thyroid nodules.

The magic number in terms of size is 1 cm or 10mm.

But size isn’t the only thing that matters.

For instance:

It has been shown that even small thyroid nodules can be cancerous if they have certain and specific findings on thyroid ultrasound.

The number of nodules and their size are not predictive of malignancy, as a nodule smaller than 1 cm is as likely as a larger nodule to harbor neoplastic cells in the presence of suspicious US features.

Thyroid Nodules by Popoveniuc and Jonklaas

For this reason, you never want to judge the risk of thyroid cancer based on the size of your nodule alone.

You will notice that while the size is certainly a risk factor, you should also look at other risk factors including whether or not the nodule is causing symptoms, your age, and what the nodule looks like on ultrasound.

As a patient, though, you can use the size of your nodule as a quick and dirty way to assess whether or not you should be worried.

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What Are The Risk Factors For Thyroid Nodules

Risk factors for developing thyroid nodules include:

  • Family history. Having parents or siblings who have had thyroid nodules or thyroid or other endocrine cancers increases your chance of developing nodules.
  • Age: The chance of developing nodules increases as you get older.
  • Gender: Women are more likely than men to develop thyroid nodules.
  • Radiation exposure: A history of radiation exposure to the head and neck increases your risk of developing nodules.

Risk factors for developing cancerous thyroid nodules include:

  • Family history of thyroid cancer
  • A nodule that is hard or is stuck to a nearby structure
  • Male gender

What Are The Risk Factors For Thyroid Cancer

Thyroid nodules and other thyroid conditions, such as goitre and inflammation of the thyroid, can increase the risk of thyroid cancer. Other risk factors include:

  • A history of significant radiation to the neck.
  • A personal history of thyroid cancer.
  • A family history of thyroid cancer.
  • Certain hereditary conditions, such as Multiple Endocrine Neoplasia type 2.

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When To Be More Proactive

Although most thyroid nodules are benign, some can harbor thyroid cancer. And some types of thyroid cancer are more aggressive than others. You should be more proactive in seeing an endocrinologist if you have any of the following symptoms:

  • A lump in your neck that appears to be growing
  • Swelling or pain in the neck
  • Hoarse voice
  • Persistent cough
  • Trouble breathing or swallowing

Also see an endocrinologist if you have been diagnosed with a thyroid nodule and have any of the following risk factors for thyroid cancer:

  • An immediate family member who was diagnosed with thyroid cancer
  • Any kind of radiation exposure, especially to the head and neck area

Preoperative Diagnosis Of Thyroid Carcinoma

Questions & Answers 194 – Thyroid Nodule, Blood Types, Electro Sensitivity

Two diagnostic procedures play a major role in the preoperative diagnosis of thyroid cancerthe ultrasound examination of the neck, revealing one or more thyroid nodules and the fine needle aspiration biopsy .With the discovery of a thyroid nodule, a complete history and physical examination focusing on the thyroid gland and cervical lymph nodes should be performed. Family history of thyroid carcinoma, prior head or neck irradiation, a growing or fixed nodule with neck lymphadenopathy, male gender as well as some age groups (< 18 and > 70 years of age are clinical factors that are associated with a higher risk of thyroid carcinoma .

The next diagnostic step is the clarification of thyroid function by obtaining a serum TSH. If the serum TSH is subnormal, besides serum levels of free T4 and T3, a radionuclide thyroid scan should be performed to document whether the nodule is hyperfunctioning , isofunctioning or nonfunctioning . Autonomously functioning thyroid nodules do not need further cytologic evaluation because the incidence of malignancy is exceedingly low . On the contrary, a higher serum TSH level, even within the upper part of the reference range, is associated with an increased risk of malignancy . Experimental studies have shown that thyroid cell proliferation is TSH dependent and that highly differentiated thyroid carcinomas retain this response to TSH. Suppressive thyroxine treatment for differentiated thyroid cancer is also based on this TSH dependence .

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What Are Thyroid Nodules

The thyroid gland is located in the lower front of the neck, below the voicebox and above the collarbones.

A thyroid nodule is a lump in or on the thyroid gland. Thyroid nodules are detected in about 6 percent of women and 1-2 percent of men they occur 10 times as often in older individuals, but are usually not diagnosed.

Any time a lump is discovered in thyroid tissue, the possibility of malignancy must be considered. More than 95 percent of thyroid nodules are benign , but tests are needed to determine if a nodule is cancerous.

Benign nodules include:

How Would You Know You Have A Thyroidnodule

Common reasons you can be referred to the endocrinology department for evaluation ofthyroid nodules include:

  • The nodule was discovered duringan imaging test for an unrelated reason, such as a carotid doppler ultrasoundor a CT scan that includes your neck.
  • Your primary care doctor felt alump in your neck during a routine physical examination .
  • You have symptoms such as swellingin the neck or front of the throat, trouble swallowing, or a hoarse voice.

A thyroid ultrasound is the best way toevaluate these nodules. We use an ultrasound machine to see if any nodules are present,their size, and whether there are signs that the nodule might be cancerous.

We do not usually worry about nodules that aresmaller than 1 cm in size or if we see a thyroid cyst , asthey are usually benign. Other nodules either should be followed on ultrasoundor evaluated further with a biopsy, depending on what they look like.

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A Quick Review Of The Thyroid Gland

The thyroid is a butterfly-shaped gland about two inches long located in the base of your neck. This gland plays a huge role in your body, as its responsible for releasing hormones that control metabolism the way your body uses energy. Hormones secreted by the thyroid regulate a host of body functions including your heart rate, breathing, body temperature, nervous system function, and much more.

When something is amiss with your thyroid, it can throw virtually every body system out of whack. Thankfully, nodules on your thyroid are often harmless, causing no change in how the gland functions. When they do cause problems, effective treatments are available.

Thyroid Cancer Symptoms Diagnosis And Treatments

Thyroid Nodule

According to the National Cancer Institute, there are over 56,000 new cases of thyroid cancer in the US each year, and the majority of those diagnosed are papillary thyroid cancerthe most common type of thyroid cancer. Females are more likely to have thyroid cancer at a ratio of 3:1. Thyroid cancer can occur in any age group, although it is most common after age 30, and its aggressiveness increases significantly in older patients. Approximately 1.2 percent of all men and women will be diagnosed with thyroid cancer during the course of their lifetime.

This article will highlight some common thyroid cancer signs and symptoms as well as thyroid cancer prognosis and treatments.

In this Article:

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From Causes And Symptoms To Diagnosis And Treatment The Information You Need About These Common Growths

Thyroid nodules are abnormal overgrowths of tissue in the thyroid gland that are most often benign, though in some cases they can be cancerous. Some people have one nodule, while others have many. Thyroid nodules may be solid tissue or filled with blood or other fluid.

Thyroid nodules are quite common, with as many as half of all people having at least one nodule by the age of 60. Theyre particularly prevalent in women, though men can get them too, especially as they age.

Is It Cancer Or Just A Benign Nodule

This page is written assuming you have read the introductory page on thyroid nodules first. If you have not, please do so because it will make this page easier to understand.

Thyroid nodules increase with age and are present in almost 10% of the adult population. Autopsy studies reveal the presence of thyroid nodules in 50% of the population, so they are fairly common. 95% of solitary thyroid nodules are benign, and therefore, only 5% of thyroid nodules are malignant.

Common types of the benign thyroid nodules are adenomas , thyroid cysts, and Hashimoto’s thyroiditis.

Uncommon types of benign thyroid nodules are due to subacute thyroiditis, painless thyroiditis, unilateral lobe agenesis, or Riedel’s struma. As noted on previous pages, those few nodules that are cancerous are usually due to the most common types of thyroid cancers that are the differentiated thyroid cancers. Papillary carcinoma accounts for 60%, follicular carcinoma accounts for 12%, and the follicular variant of papillary carcinoma accounts for 6%. These well differentiated thyroid cancers are usually curable, but they must be found first. Fine needle biopsy is a safe, effective, and easy way to determine if a nodule is cancerous.Thyroid cancers typically present as a dominant solitary nodule that can be felt by the patient or even seen as a lump in the neck by his/her family and friends. This is illustrated in the picture above.

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