When you wake up, the last thing you want is a health shock before starting the day. If you’re like most people, if you first experience a lump in your Adam’s apple, the thyroid gland, you’ll immediately jump to a conclusion: “I have cancer.” But is this the right conclusion?
So, let’s report some good news that will reduce anxiety while you’re having your morning coffee. Fortunately, the majority of thyroid nodules are not cancers. Besides, the majority doesn’t even need to be removed.
Thyroid nodules are common in the elderly. In fact, a University of California report states that if you’re over 60, there’s a 25-50% chance of developing a thyroid mass.
The older you are, regardless of gender, the more likely it is that a nodule will develop in the thyroid. And the more likely it is that the doctor will also tell you, “It’s not cancer.
You should also know that these lumps are three times more common in women. But chances are that neither women nor men will ever know that one or more nodules are present. Indeed, thyroid nodules do not always cause symptoms.
When symptoms appear, patients may notice hoarseness, difficulty breathing, voice change, a feeling of a lump in the throat, and sometimes throat discomfort.
The thyroid is an active organ. It secretes the hormone that regulates metabolism. But it is also responsible for heart rate, cardiovascular function, central nervous system and bone remodeling.
If he finds a nodule, the doctor will order thyroid blood tests to assess thyroid function. Usually the test will show nothing wrong. The doctor will also order an ultrasound to get a general look at the gland.
The important test is what is called a fine needle aspiration. A small needle is inserted into the thyroid gland to remove tissue or fluid from inside the gland. This can be done in the doctor’s office. Usually, the doctor applies anesthetic to the skin and then inserts the needle into the nodule. This will take only few minutes. Thyroid nodules are 90% non-benign cancers. In general, if a nodule is less than two centimeters (just under an inch), it is less likely to be a malignant tumor.
If cancer is discovered, surgical removal is performed. This means that hormone replacement drugs may be needed for the rest of the patient’s life. Fortunately, the 30-year survival rate for the most common type of thyroid cancer is 95%.
As we age, the thyroid becomes smaller. Or it begins to produce less hormone, an immune condition that damages the thyroid. Or, it may become more active with increased hormone levels, a condition called Graves’ disease. This is why doctors always feel the neck for lumps.
As prevention is always better than cure, there are tips to reduce the risk of thyroid nodule. Researchers from the University of California report that you are more likely to develop a thyroid nodule if you have a history of a type of cancer, such as lymphoma, malignant breast or kidney tumor. Your risk also increases if you are obese, had radiation to your neck or head as a child, or were exposed to nuclear radiation.
Finally, why do we have to keep saying it? No smoking.
Dr. W. Gifford-Jones is a graduate of the University of Toronto and Harvard Medical School. For more than 40 years, he specialized in gynecology, devoting his practice to the formative issues of women’s health.