Thyroid Nodules (cont.)
Ruchi Mathur, MD, FRCP(C)
Ruchi Mathur, MD, FRCP(C) is an Attending Physician with the Division of Endocrinology, Diabetes and Metabolism and Associate Director of Clinical Research, Recruitment and Phenotyping with the Center for Androgen Related Disorders, Department of Obstetrics and Gynecology at Cedars-Sinai Medical Center.
In this Article
- Introduction to thyroid nodules
- What is the prevalence of thyroid nodules and cancer?
- What are the symptoms of thyroid nodules?
- What are the types of thyroid nodules?
- How are thyroid nodules diagnosed?
- What is the treatment of thyroid nodules?
- Thyroid Nodules At A Glance
- Find a local Endocrinologist in your town
What is the treatment for thyroid nodules?
Because of the difficulty in distinguishing follicular adenomas from follicular cancers, patients with either of these two types of nodules, other nodules that are highly suspicious for cancerous, and, of course, with definite cancer, should undergo surgery if they are healthy enough to withstand surgery. Most thyroid cancers are curable and rarely cause life-threatening problems. Any nodule not removed needs to be watched closely with an examination and follow-up with the physician every 6-12 months. This follow-up may involve a physical examination, ultrasound examination, or both. Occasionally, a physician may attempt to shrink the nodule by using suppressive doses of thyroid hormone. Some physicians believe that if a nodule shrinks on suppressive therapy, it is more likely to be benign, and if the nodule continues to grow regardless of suppressive therapy, surgery should be considered strongly. The value of suppressive therapy, however, is controversial.
If a nodule is causing hyperthyroidism, it is usually benign. Treatment is aimed at preventing the signs and symptoms of hyperthyroidism such as heart failure, osteoporosis, and rapid heart rate. Treatments include destroying the gland using radioactive iodine (this time with the iodine isotope 131), blocking the production of thyroid hormone with medications, or just following a patient if the hyperthyroidism is mild.
In cases where a nodule is hyperfunctioning and the TSH is minimally suppressed, but the level of thyroid hormones in the blood is not elevated (these patients have "subclinical hyperthyroidism"), treatment is individualized based on the patients' age, the presence of other medical conditions, and patients' preferences.
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