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Concerns About Thyroid Cancer
Phillip R. Stevens, M.D.
Tri-State Otolaryngology - Head and Neck Surgery
Q: I have a lump in my neck. It's been there for a few weeks. I was convinced it was nothing until a friend brought up thyroid cancer. What should I do?
A: The Thyroid gland is located low in the middle of the neck. It makes thyroid hormone, which helps the body burn energy. Enlargements of the thyroid gland, also called goiters or nodules, are quite common. The majority of these nodules are not cancerous, but cancers of the thyroid gland do occur. For this reason, any lump in the neck that develops and then persists for more than a few weeks should be evaluated.
The work-up for a thyroid nodule initially involves blood tests to check hormone levels and an ultrasound study. The ultrasound study shows how large the nodule is and whether it is solid or filled with fluid.
Fluid-filled cysts are less likely to be cancerous. A type of biopsy called a fine needle aspiration is also frequently ordered. This involves sticking a very thin needle into the nodule. Cells are then drawn into the needle with a vacuum. The needle is removed, and the cells placed on a slide and examined. If they are not cancerous, then the nodule can be followed at regular intervals, usually six months to a year. Frequently, hormone therapy is started to try to shrink the nodule. If the fine needle biopsy shows suspicious or cancerous cells, then a portion of the gland should be removed. This involves a surgery called a thyroidectomy and is done to confirm the diagnosis.
If the thyroidectomy confirms that a cancer is present, then other treatments may be needed. But the bottom line is that the vast majority of thyroid cancers are completely curable with the correct treatment. If you have any lumps in your neck, have your doctor check them.
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