Evaluating Nodules
Some nodules cause pain. Others may cause swelling. Still others cause no symptoms but can be felt by an experienced physician. In any case, if a nodule is detected in your thyroid gland, it's critical to get a thorough evaluation of the nature of the nodule and whether it's cancerous or not.
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Statistically speaking, malignant nodules are more likely to occur in children, adolescents, and men than they are in women. You're also at greater risk if you received radiation treatments in the 1940s and 1950s for conditions such as acne or tonsillitis. In addition, a single lump is more likely to be malignant than are several nodules.
Several tests can help your doctor determine whether the nodule is benign or malignant, active or inactive. These include:
Fine Needle Aspiration (FNA):Aside from surgery, an FNA is the only way to determine whether a nodule is cancerous or not. Doing an FNA involves retrieving cells from the nodule, which are then studied closely for cancer. Sometimes, a diagnosis cannot be made after an FNA, and the procedure must be repeated.
Ultrasound: An ultrasound of the nodule can reveal its size and whether it is solid or a cyst. Over time, ultrasound can reveal whether the nodules are getting bigger.
RAIU and Scan: An RAIU and scan may be done to see whether your nodule is hot. A hot nodule appears brighter on the scan, showing that the nodule is taking up iodine for the autonomous production of thyroid hormone.
TSH Test: Measuring the level of TSH in your blood can reveal whether a hot nodule is causing hyperthyroidism. When the level of TSH is suppressed, it confirms that you have a toxic adenoma.
Sometimes, in spite of all these tests, a physician cannot say for sure whether a nodule is benign or malignant. Some may be benign, but others may be precancerous, meaning they'll eventually become cancer if they're left untreated. Still others may actually be cancer. The problem is that no test can definitively prove that the nodule is benign, and nothing can demonstrate that the nodule is positively cancerous. In these cases, the nodules are deemed suspicious, and treatment usually involves surgery.
