Should a thyroid nodule be treated or not? What can be done to shrink the nodules? The methods to shrink nodules are: 1. TSH suppression therapy, but it is not effective and has some side effects. 2, ablation: including thermal ablation, anhydrous ethanol injection, etc. 3.Surgical excision, but there is a possibility of recurrence, and it is generally not recommended. It should be emphasized that for benign thyroid nodules, unless the nodules are very large or have recurrent bleeding, they usually do not need to be treated and patients can be followed up with regular review. What kind of nodules require surgical treatment? Surgical treatment should be considered in the following cases: 1. Nodules that are proven to be malignant on puncture biopsy. 2.Nodules that are growing rapidly and are highly suspicious of malignancy. 3. Nodules that are very large and have symptoms of pressure. 4.Nodules with combined hyperthyroidism (can be operated or treated with iodine 131). 5. Nodules with recurrent bleeding. Treatment of thyroid nodules: 1. Substantial single nodules. A single thyroid nodule with a hot nodule on a nuclide scan is less likely to be cancerous. Cold nodules mostly require surgical treatment. Any single nodule with rapid development and hard texture, or with enlarged lymph nodes in the neck or in children should be operated early because of the high possibility of malignancy. 2.Multi-nodular goiter (MNG). Traditionally, it is believed that MNG has less chance of developing cancer than a single nodule. However, many people diagnosed with single nodule by high resolution ultrasonography are actually multinodular nodules, and it is now believed that there is little difference in the incidence of cancer between the two. Therefore, the first step in the management of MNG is to exclude malignancy. If sTSH is decreased, hyperthyroidism is indicated. If FNA cytology is diagnosed as malignant or suspected malignant, surgery should be performed. 3.Nodules that cannot be palpated. In recent years, due to the development of ultrasound, CT, and MRI, small, non-palpable thyroid nodules can be found unexpectedly during other examinations. These nodules are usually found in elderly people without a history of thyroid disease or risk factors for thyroid cancer. If the nodule is smaller than 1.5 cm, it only needs to be followed up and observed. If the nodule is larger than 1.5 cm, FNA can be done under ultrasound guidance, and then further treatment can be done according to cytological results.4. Radiation nodules. Those who received radiation therapy to the head and neck are prone to thyroid cancer, as early as 5 years after radiation and as late as 30 years after radiation. FNA should be performed to confirm the diagnosis of thyroid nodules after radiation therapy to the head and neck.