Thyroid Nodules - Treatments

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What is the treatment for thyroid nodules?

Follicular adenomas are difficult to distinguish from follicular cancers. Follicular nodules, other nodules highly suspicious for cancerous and definite cancer should be treated by surgery. Most thyroid cancers are curable and rarely cause life-threatening problems. Any nodule not removed needs to be watched closely by follow-up with the physician every 6 to 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. 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 causes hyperthyroidism, it is usually noncancerous. Treatment is aimed at preventing the signs, symptoms, and complications of hyperthyroidism, such as heart failure, osteoporosis,, and rapid heart rate. Treatments include destroying the gland using radioactive iodine (131-iodine), blocking production of thyroid hormone with medications, or conservatively following the patient with mild hyperthyroidism. "Subclinical hyperthyroidism" refers to an adult patient with a hyperfunctioning nodule, but TSH is minimally suppressed and the blood levels of thyroid hormones are normal. Treatment is individualized based on age, presence of other medical conditions, and patient preference.

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See what others are saying

Comment from: Blue, 55-64 Female (Patient) Published: December 30

I just had the right half of my thyroid and isthmus removed a week ago. All in all, the surgery was not bad. I had a large nodule on the right and 3 small ones on the left. I had the choice of having half or whole of the thyroid removed. I agonized over this decision; asking other medical people, researching medical information. There was no clear decision one way or the other. I wanted to hopefully avoid having to take medication. Anyway, I chose to have half removed. The pathology results are benign; so no more surgery. The biggest surprise for me was that the nodule growth was so gradual, I did not realize that my breathing, sleeping, snoring were influenced. I am amazed that I no longer snore; I can breathe in more air without perceived restriction on the right side. My wheezing has all but disappeared. This whole issue was not really addressed with me with the nodule issue. I still have the feeling of something "heavy" on my left thyroid side. I thought that my breathing and wheezing were just allergy problems. Before surgery, I could not lay on my back flat without feeling I was being smothered in my neck. Now that I have had this realization, I wanted to make sure other thyroid patients are aware.

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Comment from: melwrona, 35-44 Female (Patient) Published: May 28

I went in for a routine sinus check because I was snoring and they found some thyroid nodules. I had a needle biopsy done and they said I had some cancer cells. I had surgery for right side thyroid and a week later another surgery for the rest of the thyroid because they said they found cancer cells, and then 3 months later another surgery because they said they did not get it all out (go figure). Well, I was told I needed a 4th surgery because they still did not get it all out because my levels were still a little high for radioactive iodine treatment. I at that point said, you are crazy. I went to a cancer center and unbelievably I never had thyroid cancer. Pathology was wrong all 3 surgery times. I am furious. I now take calcium supplements because they damaged my parathyroid, and levothyroxine. Please if anyone is told they have thyroid cancer and needs surgery, please get a second and third opinion. If I would have had the 4th surgery they would have damaged my vocal cords permanently. As for the medicines it is awful. I have wheezing, snoring still, tiredness, foggy head, restlessness, low calcium numbness, and you name it, I got it. Good luck to you guys.

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