How are thyroid nodules treated?
Treatment depends on the type of thyroid nodule you have. Treatment options include: • No treatment. If you have a noncancerous nodules, you and your doctor may simply choose to monitor your condition through timely check-ups. • Thyroid hormone suppression therapy. Some doctors treat noncancerous nodules with levothyroxine, a synthetic form of the thyroid hormone thyroxine. The theory is that this drug signals the pituitary to produce less of another thyroid hormone responsible for thyroid tissue growth. The goal of this treatment is to shrink the nodules. Debate continues in the medical community whether the evidence consistently shows that this treatment actually works to shrink the nodules. • Radioactive iodine. Your doctor may use radioactive iodine to treat hyperfunctioning thyroid nodules and multinodular goiters. The radioactive iodine is absorbed into the thyroid gland, causing the nodules to shrink. Pregnant women and women trying to become pregnant should not undergo this tre
Treatment depends of the type of thyroid nodule. Surgical removal of the thyroid is recommended for thyroid nodules that are cancerous or suspicious. After surgery, radioactive iodine therapy may be used to destroy any remaining thyroid cells. Other types of nodules, even when they are not cancerous, may need to be removed when they get too big and cause problems with swallowing or breathing. Hyperfunctioning nodules are almost never cancerous, but they may produce too much thyroid hormone and cause hyperthyroidism. These nodules may be surgically removed or treated with radioactive iodine. Any thyroid nodule not removed needs to be monitored by your doctor every 6 to 12 months. This follow-up may involve a physical examination or a thyroid ultrasound or both. If the nodule gets larger, you may need to have a repeat fine needle biopsy (even if you already had one previously). Even if this biopsy is benign, surgical removal may be recommended for a nodule that is getting bigger.
The primary treatment options for thyroid nodules include surgery and medical therapy. Nodules that are suspicious for cancer, growing, present in an enlarged gland, or found to be hyperfunctioning should be immediately treated by surgical removal. Thyroid nodules that are felt to be benign or low-risk for cancer can be monitored instead. This involves an examination of the nodule every 6 to 12 months with a physical examination by a doctor, a thyroid ultrasound, or both.
All thyroid nodules that are found to contain a thyroid cancer, or that are highly suspicious of containing a cancer, should be removed surgically by an experienced thyroid surgeon. Most thyroid cancers are curable and rarely cause life-threatening problems (see Thyroid Cancer brochure ). Any thyroid nodule not removed needs to be watched closely, with an examination of the nodule every 6 to 12 months. This follow-up may involve a physical examination by a doctor or a thyroid ultrasound or both. Occasionally, your doctor may want to try to shrink your nodule by treating you with thyroid hormone (see Thyroid Hormone Treatment brochure) at doses slightly higher that your body needs (called suppression therapy). Whether you are on thyroid hormone suppression therapy or not, a repeat fine needle biopsy may be indicated if the nodule gets bigger. Also, even if the biopsy is benign, surgery may be recommended for removal of a nodule that is getting bigger.
If your nodule is not cancer and is not causing problems, your doctor may watch your nodule closely. If your thyroid nodule is causing hyperthyroidism, your doctor may recommend a dose of radioactive iodine, which usually comes in a liquid that you swallow. Your doctor may have you take medicine (antithyroid pills) for a few weeks to slow down the hormone production. Your thyroid hormone level needs to be normal before you can be treated with radioactive iodine. If your nodule is cancer or is so large that it causes problems with swallowing or breathing, you’ll need surgery to remove the nodule. You may also need treatment with radioactive iodine to destroy any leftover cancer cells. After surgery, you may need to take thyroid medicine for the rest of your life.
