The thyroid gland is one of the larger endocrine glands in the body and also one of the most susceptible to disease. From a surgical point of view, thyroid disorders are classified as thyroid adenoma, nodular goiter, hyperthyroidism, chronic lymphatic thyroiditis and thyroid cancer. The high incidence of thyroid disease is concentrated in the age group of 30-50 years old, with a predominance of women, roughly seven times that of men. Although the incidence of thyroid disease is high, it has a good prognosis. With early detection and standardized treatment, the cure rate of thyroid cancer is high, with a ten-year survival rate of about 95.2%. Which thyroid nodules should be alerted to cancer The incidence rate of thyroid nodules is 7%, which is a very high incidence rate (for example, the incidence rate of stomach cancer is 50/100,000). This nodule may be benign or cancerous, and it is thought that one quarter of solid, solitary thyroid nodules are thyroid cancer. A thyroid nodule is a nodular growth on the thyroid gland. It may be a nodular goiter, a sarcoidosis, thyroiditis, thyroid adenoma or thyroid cancer, all of which are collectively called thyroid nodules until they are characterized. Size is not the only indicator of whether a thyroid nodule requires surgery. Some nodules may be as small as 0.8 cm in diameter, but if they have a malignant tendency, they need to be cut out as soon as possible. If the nodule appears benign on ultrasound, then we will consider removing it only when it is 3 to 4 cm in diameter. If the ultrasound suggests a thyroid adenoma, it is also best to remove it surgically because 10% of thyroid adenomas become cancerous as they grow. How do I know that a nodule is malignant? A single nodule is more dangerous than multiple nodules; 2. A single nodule is hard, fixed and painless; 3. It grows quickly; 4. The ultrasound indicates that the nodule has tiny calcification points; 5. The ultrasound indicates a hypoechoic nodule, and a hypoechoic nodule is more likely to be malignant than a medium or high echogenic nodule; 6. A solid nodule is more dangerous than a cystic or cystic nodule; 7. The adjacent cervical lymph nodes are enlarged; 8. The nodule may cause pressure symptoms or hoarseness. Not all thyroid nodules require surgery Many hospitals now take a one-size-fits-all approach to thyroid nodules, as long as they are diagnosed as nodules, regardless of whether they are single or multiple, benign or malignant, they all take surgery. This is not a desirable approach. Some nodular goiters, which are multiple nodules and hardly ever cancerous, can do more harm than good if they are removed at about 1 or 2 cm. Multiple goiter nodules generally require surgery only if they are large enough in diameter to cause unsightly neck, or to compress the trachea, or to cause hyperthyroidism. If a woman develops a nodule at age 40, she may not need surgery until she is in her 50s because of the slow growth of the nodule, so that even if the nodule grows again after surgery, most will not need to be operated on again in their lifetime. Due to post-surgical adhesions, the chance of reoperation causing damage to the recurrent laryngeal nerve increases significantly, resulting in hoarseness; for example, the probability of damage to the recurrent laryngeal nerve is about 0.1% for the first surgery and 3% for the second. Thyroid cancer is a malignant tumor with a high cure rate In recent years, the incidence of thyroid cancer has shown a significant increase, with the incidence rate being almost 300% of that in the past. The reasons for this are firstly, due to the increasing attention to health and more emphasis on medical check-ups, especially the updated examination techniques such as neck ultrasound and CT, which have led to the detection of previously neglected and asymptomatic cases. Secondly, other factors such as environment, diet and personal emotions may also be triggering the increased incidence of thyroid cancer. Thyroid cancer is not sensitive to chemotherapy. Generally speaking, patients with intermediate to advanced stage need radiotherapy after surgery, while early stage, and even some intermediate stage patients can be treated without radiotherapy. The prognosis of thyroid cancer in early stage is good, and after surgery, the survival rate is about 95% in 10 years. If thyroid cancer is not detected and diagnosed early, the prognosis of late stage thyroid cancer will be affected if it is not treated in time. In addition, it is not uncommon that some cancers, even though small, may invade the laryngeal nerve at an early stage and cause hoarseness if they grow close to the nerve. Nodules based on Hashimoto’s disease have a high rate of cancer Chronic lymphatic thyroiditis, also called Hashimoto’s disease, is one of the most common types of thyroiditis. Simply put, it is a type of autoimmune disease in which the body produces lymphocytes that attack its own thyroid gland. The onset of Hashimoto’s disease is slow and the patient usually has no special sensation. The enlarged thyroid gland is often found unintentionally and is usually diffusely and symmetrically enlarged, or it can be enlarged on one side more significantly. As the disease progresses, when the thyroid gland reaches a certain level of destruction, more than half of the patients may develop symptoms of hypothyroidism, such as fear of cold, weakness, weight gain, etc. The nodules that grow on top of Hashimoto’s disease are prone to cancer, and some studies suggest that the percentage of cancer is as high as 23%. Therefore, for people with thyroiditis combined with thyroid nodules, the indications for surgery need to be relaxed appropriately. It is best to have your thyroid checked once a year. With the increase in social competition and work pressure, thyroid disease has been on the rise in recent years. Because this disease has a certain insidious nature and is not easily detected in the early stages, early detection and prevention is more important. For patients who have been diagnosed with benign thyroid nodules, it is also best to see a specialist every six months for a formal checkup and appropriate treatment.