How to treat thyroid nodules

Thyroid nodules refer to one or more lumps of abnormal tissue structure in the thyroid gland due to various reasons. The causes of their formation are relatively complex, including: genetic factors, excessive or insufficient iodine intake, autoimmune imbalance, radioactive radiation, etc.

Clinically, thyroid nodules are relatively common. According to statistics, the proportion of palpable thyroid nodules in the population is 3%-7%, while the proportion of thyroid nodules found by high-definition ultrasound examination is 20%-67%, especially in women and the elderly.

Most thyroid nodules are benign, and malignant nodules only account for about 5% of thyroid nodules. Thyroid cancer is generally less malignant, grows slowly, and has a low probability of distant metastasis. Surgical treatment is more effective and is often jokingly called "lazy cancer" by doctors. As long as it is treated, it is generally not life-threatening.

You should be aware of the risk of thyroid cancer if you:

[History of radiation exposure to the head and neck or exposure to radioactive dust in childhood]

History of whole body radiation therapy

[A past or family history of differentiated thyroid cancer, medullary thyroid cancer, or multiple endocrine neoplasia type 2, familial polyposis, or certain thyroid cancer syndromes]

[Nodules grow rapidly]

[Accompanied by persistent hoarseness and dysphonia, and the possibility of excluding vocal cord lesions (inflammation, polyps, etc.) Accompanied by persistent hoarseness and dysphonia, and the possibility of excluding vocal cord lesions (inflammation, polyps, etc.)]

[With difficulty swallowing or breathing]

[Nodules are irregular in shape and adhere to and fixed to surrounding tissues]

【With pathological enlargement of cervical lymph nodes】

Evaluation of thyroid nodules

High-resolution ultrasound is the preferred method for evaluating thyroid nodules. The key to the diagnosis and treatment of thyroid nodules is to distinguish between benign and malignant nodules. Purely cystic nodules or nodules with spongy changes are mostly benign nodules.

The ultrasound report suggests possible signs of adverse lesions : solid extremely low echo nodules; invasion of the thyroid capsule and surrounding areas; unclear nodule boundaries and irregular shapes; sand-like calcifications; height>width; and significant abnormalities of cervical lymph nodes.

Ultrasound doctors will grade thyroid nodules and make follow-up recommendations based on the morphological and structural characteristics, diameter size, blood flow conditions, and other manifestations of the thyroid nodules. As the grade increases (≥grade 4), the risk of malignancy will gradually increase.

Follow-up and treatment of thyroid nodules

For most benign thyroid nodules, follow-up reexamination is recommended . A few thyroid nodules may have changes in thyroid function, and it is recommended to draw blood to complete the examination. If there is no abnormal thyroid function, no drug treatment is required. Individual thyroid nodules can be further examined with radionuclide and other imaging tests according to the doctor's advice. If the solid part of the thyroid nodule is found to be significantly enlarged in a short period of time or is suspected to be a malignant lesion, fine needle aspiration cytology should be considered to confirm the diagnosis.

Surgery may be considered for thyroid nodules if:

(1) Nodule diameter > 4 cm and local compression symptoms;

(2) Patients with concurrent hyperthyroidism who have not responded to medical treatment;

(3) The tumor is located behind the sternum or in the mediastinum;

(4) The nodule grows progressively and is clinically considered to be a malignant lesion;

(5) Those who strongly request surgery because their appearance or mental concerns affect their normal life.

【Lifestyle Guidance】

1. Maintaining a regular schedule , a stable mood and a happy spirit are important ways to prevent the occurrence of this disease.

2. A reasonable diet should be based on fresh vegetables and avoid fatty and spicy foods.

3. Exercise moderately and actively exercise your body to improve your disease resistance.

4. Stay away from radiation sources and ionizing radiation

With the improvement of living standards, people's awareness of regular health check-ups has gradually increased, and the detection rate of thyroid nodules has also increased accordingly. What we should do is to establish a correct understanding of thyroid nodules, maintain a healthy lifestyle, and follow up with standardized treatment under the guidance of professionals.