”Once a thyroid nodule is found, there is no need to be overly nervous. This is because most thyroid nodules are benign. However, at the same time, the rising trend of thyroid cancer incidence should not be ignored.” Recently, Professor Liu Yuewu, chief physician of basic surgery at Peking Union Medical College Hospital, said in an interview with China Science News that with the enhancement of public health awareness and the gradual popularization of medical checkups, many people are found to have thyroid nodules during medical checkups. According to statistics, nodules in the thyroid gland can be found in about 20 percent of normal people during ultrasound examinations. The incidence is seven times higher in women than in men, and among women, it is more common in women of childbearing age and young and middle-aged women. The thyroid gland is the largest endocrine gland in the body and is responsible for synthesizing thyroid hormones, regulating body metabolism and playing an important role in human growth and development. ”When thyroid hormones are produced in excess, the body’s metabolism is accelerated and symptoms such as rapid breathing and heartbeat and profuse sweating are likely to occur, called hyperthyroidism; conversely, when its supply is insufficient, the body’s metabolism slows down and symptoms such as coldness, drowsiness and rough skin occur, called hypothyroidism or hypothyroidism.” Liu Yuewu said. Usually no symptoms in the early stage In fact, the inside of the human thyroid gland is originally uniform in texture and has no nodules. But if a nodule grows, it could be a cancer or adenoma, or it could be a hyperplastic nodule, but until it is characterized, it is collectively called a nodule. ”It’s like when we look at a person, assuming the light is bad and we don’t see clearly what kind of person he is, we just know it’s a person, and only when we get closer can we be sure it’s a man, woman, old man or child.” Liu Yuewu introduced that thyroid nodules can be divided into single nodules and multiple nodules according to ultrasound findings; and hot nodules, cool nodules and cold nodules according to isotope findings. Early nodules, which are just single or multiple lumps of varying sizes on the body of the thyroid gland, are round or oval in shape, have a smooth surface, can move up and down with swallowing, are slightly harder in texture than the normal gland, and lumps without pressure can maintain their original shape for a long time or grow slowly. ”Patients usually do not have any symptoms at this time.” Liu Yuewu said that as the nodules increase or grow larger, some patients may experience facial flushing, diarrhea, and invasion of adjacent tissues and organs by the masses, causing hoarseness, breathing difficulties, and swallowing disorders. However, once a thyroid nodule becomes malignant, patients may experience discomfort such as neck swelling and pain, a sense of urgency, and rapid lump enlargement. What exactly causes the high incidence of thyroid disease? According to Liu Yuewu, this is mainly related to the accelerated industrialization and increased radiation. Work environment with radiation, long-term emotional depression, or repeated and violent mood swings; life patterns are obviously upside down and disrupted, can cause abnormalities in endocrine and thyroid metabolism, and the appearance of thyroid nodules. In addition, studies have also shown that iodine deficiency and excessive iodine intake may also lead to thyroid nodules. It must be determined comprehensively So, once a thyroid nodule is found during a physical examination, what should we do? Liu Yuewu suggests first going to a more specialized medical institution, especially for the first visit, and it is best to get a confirmed diagnosis. “The size and nature of the thyroid mass is determined by thyroid ultrasound, thyroid function, and fine needle aspiration biopsy. Of these, ultrasound is nearly 85% accurate in identifying the benignity or malignancy of nodules.” If the ultrasound shows a nodule is a substantial mass, punctate with microcalcifications, irregular borders, abundant blood flow within it, infiltration of surrounding tissues or with lymph node metastasis, it is highly suspected to be thyroid cancer. Secondly, the function of thyroid gland should be checked. Blood sampling for thyroid hormone is a quantitative indicator to determine the function of thyroid gland. In addition, nuclear imaging is also valuable to determine the function of thyroid gland. Liu Yuewu told reporters that as long as the nodule is more than 1 cm, it should be taken seriously. Once the ultrasound suggests any hint of malignancy such as hypoechoic, microcalcifications or irregular margins, puncture can be performed if necessary. In many cases, however, the test results often suggest that the thyroid nodules are multiple and not too regular in size, but are functioning normally. ”The management at this point can be somewhat hesitant, and ultrasound is needed to check the status of the nodules regularly.” Liu Yuewu said that for some multiple benign nodules, it is best to wait a bit before surgery, until the nodule is more than 4 cm or has symptoms of neck compression. If the nodules are removed as soon as they are present, it is likely that some people will have to undergo 3 to 4 such surgeries in their lifetime, which is obviously not worth it and can easily damage the nerves leading to complications such as hoarseness. Regular checkups are indispensable It seems that regular checkups for thyroid nodules are essential. Liu Yuewu feels that regular checkups can observe changes in the size as well as the nature of the thyroid nodules. ”There are some nodules that grow large but may be benign. But there are also some nodules that may grow very slowly, but over time, if calcified spots appear in the middle of the nodule, they are likely to show features of cancer.” Liu Yuewu said, if there is no nodule, a yearly check is enough; if there is already a nodule and it is benign, a half-yearly or semi-annual check is enough; if the nodule overall looks like a benign one but has some cancerous features, it is better to review it once every 3 months. After all, the high incidence trend of thyroid cancer is not to be taken lightly. According to Peking Union Medical College Hospital, the annual number of thyroid cancer surgeries in the hospital was only 8 cases in 1986, while the annual number of thyroid cancer surgeries in the hospital was 1,125 cases in 2012, which is 140 times of 1986. Most of them are curable. “Once it is confirmed that the nodule is a malignant tumor, there is no need to talk about cancer. Because common thyroid cancer is mostly papillary cancer, its cure rate is high.” Liu Yuewu said frankly. Even some patients have recurrence after surgery, but as long as it is detected and operated in time, it does not have much impact on the quality of life and life expectancy, so there is no need to be too nervous and afraid of delaying the treatment. It is understood that thyroid cancer can be divided into four categories: papillary, follicular, medullary and undifferentiated carcinoma. The most common is papillary carcinoma, which accounts for more than 85% of thyroid cancer, followed by about 10% of follicular carcinoma, 5% of medullary carcinoma and 1% to 2% of undifferentiated carcinoma. Among the four types of thyroid cancer, papillary carcinoma has the highest incidence and the best treatment effect, followed by follicular carcinoma, but it can metastasize to other organs, such as bones, lungs and brain, through blood vessels at an early stage; while medullary carcinoma metastasizes both through lymphatic and blood, which is more tricky to treat. ”The worst treatment is undifferentiated cancer, for which there are almost no good treatments, and it is about three months to six months from discovery to death.” Liu Yuewu feels that early detection, early diagnosis and early treatment are still indispensable for effective treatment of thyroid cancer. As for some people’s concern that the lack of thyroid hormones will affect their metabolism after thyroid removal, Liu Yuewu said in a firm tone: it is not necessary at all. Because the purity of synthetic thyroxine is already very high now, it is very convenient to take.