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Thyroid Nodules Treatment Information
We use a variety of diagnostic tools to evaluate thyroid nodules, including:
- Blood tests. We check the levels of several substances in your blood, including thyroid-stimulating hormone (TSH) and the thyroid hormones thyroxine (T4) and triiodothyronine (T3). The results give us a sense of your thyroid’s functioning and how any nodules might be affecting it.
- Biopsy. We may take a sample of your thyroid cells, typically using a hollow needle in a technique called fine needle aspiration (FNA), to be examined under a microscope for signs of cancer. This procedure takes less than half an hour, and we use numbing medicine to limit any discomfort you might feel. After the procedure, a bandage at the biopsy site helps stop any bleeding. Our cytopathology experts provide highly accurate laboratory analysis of thyroid tissue samples and often give second opinions for physicians outside IU Health. In some cases, we order genetic testing on the tissue sample to help us determine whether a nodule is cancerous or benign (noncancerous).
- Ultrasound. In this imaging technique, we use high-frequency sound waves to check various characteristics of thyroid nodules, including their size and location and whether they are solid or fluid-filled. During the procedure, we move a wand (transducer) over your thyroid area as you lie on your back with your neck stretched a bit. Ultrasound does not hurt. If your thyroid nodule does not need surgery right away, we use ultrasound to see if it changes over time. Ultrasound also helps us guide the needle during a thyroid biopsy.
- Thyroid scan. This procedure evaluates the chance that a nodule is cancerous based on how well it absorbs a small amount of a radioactive substance, such as radioactive iodine. You take a small amount of radioactive iodine by pill several hours before the procedure. The amount of radiation you receive is similar to that of a typical X-ray. While you lie on a movable exam table, we take pictures of your thyroid using a special device that detects radioactive objects. Scanning time is typically less than an hour. Nodules that take up the radioactive substance are called “hot” and are unlikely to be cancerous. Nodules that do not absorb the substance are called “cold” and may be either cancerous or noncancerous.
Options for managing thyroid nodules include:
- Observation. If a thyroid nodule is small and shows no signs of cancer, and if you have no family history of endocrine cancers, then you might not need treatment. We continue to check the nodule for changes over the long term.
- Surgery. We recommend surgery to remove any nodules that could be thyroid cancer. Surgical removal is also an option for noncancerous thyroid nodules if they cause problems with swallowing or breathing. Depending on your specific case, your surgeon may remove either all of the thyroid gland (total thyroidectomy) or only part of it (partial thyroidectomy). You receive general anesthesia for the procedure, which often takes two to four hours. The most common operation involves a cut a few inches long across the front of your neck. Lifelong hormone replacement therapy is necessary if your entire thyroid gland is removed.
- Radioactive iodine. If you have a nodule that is producing too much thyroid hormone or you have a multinodular growth, we may use this substance to shrink the growth. You typically take the medicine one time by mouth. The treatment is safe in general, but pregnant women should not take it because it may damage the developing fetus. After you take radioactive iodine, you receive guidelines to avoid exposing other people to radiation. For example, you should avoid close contact with family members and keep your toilet especially clean for several days until most of the medicine clears from your system. Radioactive iodine often causes the thyroid to become underactive (hypothyroidism), so you may need hormone replacement therapy after treatment.
Thyroid Nodules Locations & Physicians
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Thyroid Nodules Support Services
More information on thyroid nodules is available at these websites:
A Sampling of Thyroid Nodules Support Services
American Thyroid Association
This nonprofit group offers a patient-friendly explanation of thyroid nodule symptoms, diagnosis and treatment.
This site, a service of the U.S. National Library of Medicine and the National Institutes of Health, provides an overview of thyroid nodules.