August 01, 2019

Thyroid nodules

When to act, when to relax

It's always been a part of your routine physical exam. Your doctor feels your throat area quickly, then moves on. But this time, there's a pause. Your doctor feels a lump in your thyroid gland — located just under the skin by your swallowing tube (esophagus) — and asks if you've had any difficulty swallowing.

Lumps in the thyroid — called thyroid nodules — are common. The likelihood of having one is higher in women and increases with age. It's estimated that up to 50% of adults older than 50 may have one.

Thankfully, around 90% to 95% of thyroid nodules are noncancerous (benign). Still, follow-up to determine whether they're benign or cancerous is important. When cancer is caught early and confined to the thyroid gland, treatment is usually very successful.

Making the find

A thyroid nodule is often discovered by feel or during an imaging scan of the neck area done for another reason (incidental finding). Occasionally, a nodule may first be noticed if it causes swelling in the neck or if it's large enough to make swallowing uncomfortable or difficult. In rare cases, nodules can cause changes in thyroid hormone levels (hyperthyroidism). This can cause unexplained weight loss, nervousness or heart rhythm issues.

An initial exam of a thyroid nodule can help point the way for additional testing. This may include:

  • A physical exam and discussion of factors that may increase the risk of finding cancer — such as previous head or neck radiation or family history of thyroid...