Common Sense Health: You’ve discovered a thyroid lump, what does it mean?

By DR. GIFFORD-JONES AND DIANA GIFFORD-JONES on November 10, 2021.

Waking in the morning, the last thing you want is a health shock before you begin the day. If you are like most people, feeling a lump for the first time at the Adam’s apple, the thyroid gland, you will immediately jump to one conclusion, “I have a cancer.” But is this the right conclusion?

So, let’s report some good news that will decrease anxiety while you have your morning coffee. Fortunately, the majority of thyroid nodules are not cancers. Besides, the majority don’t even require removal.

Thyroid nodules are common in elderly people. In fact, a report from the University of California states that if you’re over the age of 60, there’s a 25-50% chance of developing a thyroid lump.

The older you are, whichever sex, the more likely that a nodule will develop in the thyroid. And the more likely the doctor is also going to tell you, “It’s not a cancer.”

You should also know these lumps are three times more common in women. But there’s a good possibility that neither women nor men will ever know that one or more nodules are present. This is because thyroid nodules do not always cause symptoms.

When symptoms do occur, patients may notice hoarseness, difficulty breathing, a voice change, the feeling there’s a lump in the throat, and sometimes discomfort in the throat.

The thyroid is a busy organ. It secretes the hormone that regulates metabolism. But its also responsible for heart rate, cardiovascular function, the central nervous system and bone remodeling.

If finding a nodule, the doctor will order thyroid tests of the blood to evaluate thyroid function. Usually, the test will show nothing wrong. The doctor will also order an ultrasound to obtain a general look at the gland.

The important test is what’s called a fine needle aspiration. A small needle is inserted into the thyroid gland to obtain tissue or fluid from inside the gland. This can be done in the doctor’s office. Usually, the doctor applies an anesthetic to the skin, then inserts the needle into the nodule. This takes only a few minutes. Thyroid nodules are 90% benign non-cancers. In general, if a nodule is under two centimeters (a little less than one inch), it’s less likely to be a malignancy.

If a cancer is found, surgical removal is done. This means hormone replacement medication may be required 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 gets smaller. Or it starts producing less of the hormone, an immune condition that damages the thyroid. Or, it may become more active with increased levels of hormone, a condition called Graves disease. This is why doctors are always feeling the neck for lumps.

Since prevention is always better than cure, there are tips to decrease the risk of a thyroid nodule. Researchers at the University of California report you are more likely to develop a thyroid nodule if you have a history of some type of cancer, such as a lymphoma, breast or kidney malignancy. Your risk also increases if you are obese, have had radiation to the neck or head during childhood, or have been exposed to nuclear radiation.

Finally, why do we have to keep saying it? Do not smoke.