Have you had the feeling in the past two years that more and more people around you are developing thyroid nodules, and some of them are even diagnosed with thyroid cancer! Yes, this is the era of massive invasion of thyroid cancer! I remember when I was a postgraduate surgeon, I wanted to attend a thyroid cancer surgery, but after waiting for a long time, I attended countless surgeries for liver cancer, stomach cancer, colon cancer, etc., but I just couldn’t see a single patient with thyroid cancer. So much so that in my little book of surgical skills, the two pages reserved for “thyroid cancer” were always blank. To this day, for example, the Breast and Thyroid Surgery Department of Beijing Friendship Hospital, where I work, performs many radical thyroid cancer operations every day! The data shows that thyroid cancer is the most rapidly growing malignant tumor in recent years, bar none! Thyroid cancer is a disease that often has no symptoms and is only discovered by chance during a physical examination, so it is often not easily taken seriously. The best way to detect it is by palpation and ultrasound of the thyroid gland by a doctor. Therefore, many organizations are now adding thyroid ultrasound to their regular physical examinations. When a thyroid nodule is detected by ultrasound, there are several pieces of information that will suggest the possibility of thyroid cancer: hypoechoic, larger longitudinal than transverse diameter, poorly defined borders, irregular morphology, nodule with blood flow signal, and sand-like calcifications within the nodule. The above features may not appear at the same time, and the doctor needs to combine several indicators to make a judgment whether it is thyroid cancer or not. When the nature of thyroid nodules cannot be determined by ultrasound, final diagnosis is often obtained by needle aspiration cytology or hollow core needle puncture. This is also the “gold standard” for thyroid cancer diagnosis. If there are no other indications for surgery (e.g. secondary hyperthyroidism, symptoms of pressure, aesthetics, thyroid gland behind the sternum, etc.), the nodular goiter can be reviewed periodically without medication or “minimally invasive” treatment such as radiofrequency ablation. However, if thyroid cancer is clearly identified, surgery is almost always required (except for rare pathological types such as undifferentiated thyroid cancer). Surgery for thyroid cancer often requires removal of the entire thyroid gland, because this type of cancer is characterized by the presence of more than one lesion, which means that only the tumor itself is removed and the remaining thyroid gland may still have cancerous lesions that are not visible to the naked eye; in addition, removal of the entire thyroid gland is also beneficial for postoperative follow-up treatment and testing. Thus, for patients who have been diagnosed with thyroid cancer, radiofrequency ablation, which can only eliminate one tumor found so far, is a cover-up and should not be adopted as it is against the current treatment convention and consensus. Almost all thyroid cancers do not require radiotherapy and chemotherapy after surgery, but only oral levothyroxine, which can play a role in preventing tumor recurrence while supplementing the function of the removed thyroid gland. For some patients, radionuclide therapy is required in order to further reduce the recurrence rate. Finally, regarding one of the most frequently heard questions from patients, “How long will I survive?” Depending on the type of pathology, the majority of thyroid cancers have an excellent prognosis. In a recent clinical study, 6.5 years after surgery, nearly 95% of patients were recurrence-free. So, my answer to this question from patients is often, “I don’t know – because you would have survived as long as you probably will!” So, while being alert to this oncoming disease, timely detection and standardized treatment is a reason to have the confidence to fight and win!