What type of hospital to choose? What department should I choose?
At present, most thyroid cancers are detected by physical examination. Usually the physical examination report will indicate: “thyroid nodule, not excluding malignant”, “thyroid nodule, further examination recommended at a general hospital”, etc. In a few patients, anterior cervical nodules are found unintentionally and are found to be growing faster.
The diagnosis of thyroid cancer relies on the experience of the physician, accurate ancillary tests, and even pathological biopsies. Therefore, it is recommended to visit a secondary or tertiary general hospital.
The general surgery department of a tertiary hospital is usually the best choice, and some hospitals have head and neck surgery departments that can also treat thyroid cancer.
What should I do to prepare for the visit?
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1. Consider whether you can accurately communicate your condition to the doctor, and if you have difficulty, you may need to inform a relative and ask them to accompany you to the appointment.
2. If you have access to a smartphone or the Internet, you can make an appointment online or by phone to register and reduce the time you have to wait in line at the clinic.
3. Bring the following information with you:
- Visit card, ID card;
- Outpatient medical records; make sure to bring your physical examination center report if you have one, preferably in paper form;
- Films and reports of previous relevant imaging examinations (ultrasound, CT, etc.);
- Recent laboratory test results: thyroid function, thyroid antibodies, etc.;
- If previous thyroid puncture was performed, be sure to bring the puncture report (including cytopathology results and molecular pathology results);
4. Fasting is not recommended for office visits. Most tests require an appointment and few can be done immediately on the same day, so fasting is not required; on the other hand, outpatient lines are quite large, waiting times are long, and hypoglycemia is likely to occur on an empty stomach.
What questions are doctors likely to ask when thyroid cancer is suspected?
The doctor may ask, “Where do you feel sick?” , “What is the purpose of your visit today?” , “What questions do you need my help with?” etc. You will then be asked to describe the discomfort and symptoms in as much detail as possible. Based on what you say, the doctor will ask further questions, such as:
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1. Is there a swelling or nodule in the front of your neck? Did you find it yourself, or did a family member or friend find it? Is the anterior neck nodule growing fast? How big is it to your own touch?
2. Are there any enlarged lymph nodes in the neck? Are the lymph nodes in the neck previously present or newly discovered? Have the lymph nodes recently grown rapidly?
3. Is there a fear of heat and excessive sweating?
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4. Have you had a recent cold or fever? What is your occupation and hobby? Is there exposure to radioactive substances? Is there a history of smoking and alcohol consumption? What is the amount of smoking and alcohol consumption?
5. Do you have any thyroid pain? Is the pain severe? Is the pain persistent? Is there any pain in the ear, occiput, shoulder, etc.?
6. Is there hoarseness of voice? How long has it been there? Is the hoarseness consistently worse or does it come and go?
7. Is there any difficulty swallowing? Is there difficulty breathing? Is there diarrhea, palpitations, flushing?
8. Has a relative had a thyroid tumor, or other tumors?
9. Are there any other endocrine tumors? Is there a history of other medical conditions?
How do you describe your condition to your doctor?
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Your doctor wants you to describe your discomfort concisely and correctly, with a focus on the characteristics of the discomfort, the timing, and the management of the discomfort. For example, where the discomfort exists; when it was uncomfortable; how it was uncomfortable; under what conditions it worsened and lessened; whether it was treated; what treatment; and how well it was treated.
The doctor will ask further questions based on your description.
Co-written by: China-Japan Friendship Hospital Dr. Peng Weizhao