What is the Thyroid?
The thyroid is a butterfly-shaped gland located in your neck below the Adam’s apple. The thyroid produces hormones that regulate body temperature, metabolism, and energy use, with the two major hormones being T3 ( triiodothyronine) and T4 ( thyroxine). There are two possible thyroid malfunctions that can occur: hypothyroidism refers to an underactive thyroid gland, and hyperthyroidism refers to an overactive thyroid gland. Some causes of thyroid dysfunction include genetics, stress, poor nutrition, and iodine deficiencies. There are many possible symptoms of thyroid dysfunction. Hypothyroidism symptoms may include fatigue, weight gain, depression, and intolerance to cold, while those with hyperthyroidism may experience weight loss, heat intolerance, insomnia, and an increased heart rate.
Thyroid nodules are very common – almost 50% of the population has a thyroid nodule – although most people do not even know they have one. Thyroid nodules can be found by a healthcare provider, sometimes patients notice a mass on their neck and most often nodules are found when an imaging test is performed for another reason. Almost all thyroid nodules are caused by non-cancerous conditions.
Several tests are performed to determine if a thyroid nodule needs to be removed. Blood work is obtained to see if the thyroid is functioning normally. An ultrasound of the thyroid is often performed to determine if the nodule should be biopsied. Sometimes a fine needle aspiration (FNA) of the thyroid nodule is performed and the tissue is looked at under the microscope. If the FNA identifies cancer cells, then you will be referred for surgery. Sometimes the tissue sample cannot definitively say if there is cancer. In this case, you will also be referred for surgery. Some patients are referred to have a thyroid scan if the thyroid stimulating hormone is low on the blood work. This scan can help determine if the thyroid nodule is overactive.
If the nodule is not cancerous, then most people do not need surgery. Exceptions would include nodules that are large or those that impact breathing or swallowing. Only 5% of thyroid nodules are cancerous. If cancer is found then surgery is recommended.
How Can We Help?
There are different types of thyroid cancer. The most common type of thyroid cancer is papillary thyroid cancer. If this is found, we will recommend that your entire thyroid be removed. Some patients require treatment with radioiodine after surgery. All patients who have their thyroid removed require thyroid medicine for the rest of their life. This involves taking one small pill every day.
Sometimes the biopsy shows follicular cells that may be cancerous. In this case, we remove half of the thyroid. The specimen is then examined by a pathologist under the microscope to look for cancerous cells. This usually takes 3-5 days. If cancer is found, then we will recommend that the other half of the thyroid be removed. If only half of the thyroid is removed, only some people require daily thyroid medication.
Who to Contact
Dr. Charlie Jones and Dr. Susan Hagen are general, vascular and thoracic surgeons with over 30 years of experience. To make an appointment, please call 303-443-2123.