Thyroid Cancer
Thyroid nodules are a common abnormality and their incidence is increasing, partly due to incidental findings in patients undergoing examinations for other abnormalities in the neck and chest area. In the past 2-3 years, the incidence of new thyroid cancer cases has increased.
How to know if it is a thyroid nodule
The thyroid gland is located at the front of the neck. When abnormal, it enlarges and can be seen as a lump. Sometimes it appears as a single nodule, sometimes as multiple nodules clustered together. Importantly, nodules on the thyroid gland move up and down when swallowing saliva.
Toxic and Non-toxic Thyroid
An enlarged thyroid gland can be classified into two major groups: toxic and non-toxic. Toxic thyroid is a condition or disease caused by abnormal thyroid gland function, producing excessive thyroid hormones, which disrupt the function of various body systems. Symptoms include palpitations, irritability, heat intolerance, excessive sweating, increased appetite without weight gain or even weight loss, some have moist skin, diarrhea, and some have protruding eyes, etc. In the case of non-toxic thyroid, these symptoms are absent, and only thyroid enlargement is found. Often, there is confusion between toxic thyroid and thyroid cancer. Toxic thyroid is not cancer, and it is usually found that people with toxic thyroid rarely have thyroid cancer.
What diseases can thyroid nodules be?
The most common thyroid abnormality is a single abnormal nodule, which can be various diseases, including thyroid cancer. Therefore, it is very important for doctors to diagnose and differentiate the disease to plan appropriate treatment.
Patients with a single thyroid nodule may have the following diseases:
- Benign thyroid tumor (thyroid adenoma), found in about 20-30%
- Benign toxic thyroid tumor
- Thyroid cancer (thyroid carcinoma), found in 10-15%. In the early stage, it is a single small nodule that gradually grows before spreading to multiple nodules within the thyroid or metastasizing to other areas such as lymph nodes or bones, etc.
- Goiter or nodular goiter, 50-60% of single thyroid nodules are abnormalities in the group of nodular goiter
What are the symptoms of thyroid cancer nodules?
Thyroid cancer is a disease where cells in the thyroid gland become malignant. It usually starts as a simple nodule in the thyroid gland that gradually grows. As it enlarges, the cancer may spread, forming lumps on the side of the neck or nodules in other parts of the body such as the head, ribs, hips, etc. Some patients may experience hoarseness or difficulty breathing due to a large nodule.
How to know if it is thyroid cancer
Thyroid cancer usually has no symptoms initially except for a nodule in the thyroid gland. Therefore, when a lump is found in the front of the neck that moves up and down with swallowing, a doctor should be consulted. The doctor will perform a fine needle aspiration biopsy to collect cells from the thyroid gland for examination, which can help diagnose the disease. This method has about 90% accuracy. However, if no cancer cells are found, it may be a benign thyroid tumor or goiter. In such cases, the doctor will prescribe medication to treat the goiter and schedule follow-up examinations. If it is a goiter, the thyroid nodule will shrink and eventually disappear. If the nodule does not resolve, other diseases such as tumors or thyroid cancer should be considered, and surgery is usually recommended.
Normally, ultrasound examination shows that everyone can have thyroid nodules, but if the size is larger than 1 cm, a specialist should be consulted to confirm whether the nodule is cancerous. Usually, nodules found in people over 60 years old or under 16 years old are more likely to be cancerous. Therefore, doctors recommend that anyone with abnormal symptoms or over 60 years old should have a thyroid ultrasound examination.
Thyroid examination
Currently, the examination of thyroid nodules using high-resolution ultrasound is the most appropriate and effective method. High-frequency ultrasound provides detailed information about lesions in the thyroid, which is a superficial organ, such as size, echogenicity texture, details of surrounding organs, and can also be used to locate the site for pathological cell biopsy.
Differential diagnosis of thyroid nodules may require multiple ultrasound features combined to assess the likelihood of cancer. Additionally, high-frequency ultrasound helps locate the best site for thyroid cell biopsy. CT scans or MRI are used for further examination to assess cancer spread to nearby organs.
Symptoms indicating a high likelihood of cancer
- Rapidly growing nodule
- Hoarseness, difficulty breathing
- Difficulty swallowing, choking
- Palpable enlarged lymph nodes on the side of the neck
- Family history of cancer or previous radiation exposure
- Age under 16 or over 60 with thyroid nodules
Even mild illness requires seeing a doctor
“From my experience treating patients, I always tell everyone that whenever you are ill, even slightly, you should see a doctor because unexpected things can happen. For example, one patient came to see me for a cold, but I noticed an abnormal lump in the neck. Further examination revealed thyroid cancer. This patient had annual health check-ups but never had a thyroid ultrasound, so the abnormality was not detected.”
