At Western E.N.T we understand thyroid lumps exceptionally well. With the appropriate clinical and radiological information we are able to counsel our patients as to the best management according to local and international guidelines. We use cutting edge technologies and modern surgical techniques in our approach to surgical diseases of the thyroid. All cancer cases are discussed at a Tumour Board where a group of specialists are involved in decision making, resulting in the best treatment for our patients.
Thyroid nodules are very common and it is totally unnecessary to remove them in every patient. The majority (90%) of nodules are not cancerous but either simple swellings of fluid (cysts) or benign growths of thyroid tissue with no tendency to spread or invade structures.
Approximately 10% of thyroid nodules are cancerous, and require appropriate surgical management.
A thyroid goitre is a visible swelling of the thyroid gland. Goitres may cause enlargement of the entire gland, or there may be a solitary or multiple nodules which cause a large thyroid. Goitres can become very large and cause pressure on the windpipe (trachea) and swallowing tube (oesophagus). This can result in shortness of breath, voice change, cough, increased pressure, sensation in the neck and sometimes difficulty swallowing.
Surgery to remove the thyroid gland is usually necessary to treat large goitres that are causing symptoms. Surgery is also necessary where there is a suspicion of thyroid cancer in an enlarged thyroid gland and where the swelling is causing cosmetic deformity.
These tumours are caused by an abnormal growth of thyroid follicle cells. They have no capacity to spread or cause destruction of tissue but they usually cannot be differentiated from a type of thyroid cancer on FNA (biopsy). Surgery is usually recommended for diagnosis. The lobe of the thyroid that has the nodule is usually removed.
Thyroid cancer is the most common endocrine cancer. It is more common in women, and the average age of onset is early to middle-age. Most thyroid cancer is well differentiated and has an overall survival of greater than 98%.
There are however some rare and more aggressive thyroid cancers which have a worse outcome. One form can be part of a syndrome of hormonal tumours, and is a genetic disease (Medullary cancer). The other is Anaplastic cancer, which is a very aggressive tumour and often untreatable.
The mainstay of treatment for thyroid cancer is surgery. This involves removal of the entire thyroid gland in most instances, however in some low risk cases, removal of only half of the thyroid may be undertaken. Removal of some glands from the neck may also be performed at the same time.
Frequently radioactive iodine is used following surgery to kill small amounts of thyroid tumour that may have spread to other areas of the body, or that remain in the thyroid bed. The radioactive iodine is taken as a drink and has very few side effects. You become radioactive for a short period, so your doctor may advise you to stay in hospital for 2-3 days.