Most patients with benign thyroid nodules do not require any specific treatment and are usually followed up with ultrasound. If cancer is suspected, surgery would be recommended.
The treatment for thyroid nodules depends on the nature of the nodule, whether it is benign or malignant, and if it causes symptoms.
Cancer: Surgery is the treatment of choice. Depending on the size of the tumour, either half or the entire thyroid gland may need to be removed. Additional treatment with radioiodine may be necessary.
Benign nodules: Benign nodules may be observed if not causing any symptoms. Follow-up of the nodules is usually by ultrasound, and the interval will be decided by your doctor.
Surgery is an option if symptoms are present, including difficulty swallowing or breathing, or even just to remove the unsightly lump
Radiofrequency ablation (RFA): RFA treats benign thyroid nodules by delivering thermal energy to the targeted nodule, causing coagulative necrosis and shrinkage of the nodule. This minimally invasive procedure offers a low-risk alternative to surgery, providing symptomatic relief and cosmetic improvement for patients with benign thyroid nodules.
Indeterminate nodules: If the nature of the nodule is indeterminate on FNAB, your doctor will discuss with you the options of repeating the FNAB, close observation or surgery. The risk of your nodule being cancerous depends on the exact findings on ultrasound and FNAB
Thyroid surgery is performed under general anaesthesia and may be:
Hemithyroidectomy: Removal of half the thyroid gland, for benign nodules or small cancers.
Your surgeon will explain which operation you require and the reason for it.
In suitable patients, thyroid surgery can be performed without using a neck incision. The surgery may be endoscopic or robot-assisted, with skin incisions located in the axilla or armpit and less visible than a neck scar.
Some thyroid cancers can spread to the lymph nodes in the neck, and your doctor may need to remove some of the lymph nodes in your neck during the operation as well.
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