Thyroid cancer is currently the most rapidly growing solid tumor in the world, with the incidence in women twice that of men. With increasingly advanced screening tools, many microscopic thyroid cancers can be detected early. Patients usually lack specific clinical symptoms and most are unintentionally found to have painless nodules in the neck or an enlarged neck. Most thyroid nodules are benign, however, if you meet one of the following high-risk factors, then please be vigilant because your thyroid nodule is most likely malignant: 1. male; 2. elderly; 3. rapid growth of the mass; 4. previous history of thyroid cancer; 5. history of radiation exposure. How can we determine whether the nature of the thyroid nodule is good or bad? The doctor will usually ask the patient to take a CT film, and based on the imaging performance of the mass, the doctor will have a basic judgment. If malignancy is suspected, it is best to perform a fine needle aspiration biopsy, i.e., to obtain a small piece of thyroid mass tissue by fine needle aspiration, and after a special pathological section test procedure, most patients can clarify the nature of the tumor before surgery. Of course, fine-needle aspiration biopsy has a certain rate of misdiagnosis. If you are unwilling to undergo the test or cannot do so due to potential risks such as bleeding, you can also have a frozen pathology test done immediately during the surgery to confirm the diagnosis. What should I do if I have thyroid cancer? Should we undergo surgery? Should I undergo radiotherapy or chemotherapy? Or should I take Chinese herbal medicine for conservative treatment? The current medical opinion is that surgery is the only and the most effective treatment for differentiated thyroid cancer. It can be completely removed by surgery, and the recurrence rate of the tumor after complete removal is extremely low. After surgery combined with I131 nuclear scan and drug treatment, the efficacy is very satisfactory, I am many patients after surgery after years of follow-up, are no tumor recurrence and metastasis, good quality of life. Radiotherapy alone is almost ineffective for thyroid cancer. As for Chinese medicine treatment, it should be said that it has some auxiliary effect on controlling malignant tumor, but it should not be relied on completely, otherwise it will lead to tumor spreading and metastasis and miss the best treatment time. What are the risks of thyroid cancer surgery? 1. Injury to the recurrent laryngeal nerve: The recurrent laryngeal nerve is the nerve that governs the movement of the vocal folds, which is closely related to the thyroid gland and is very weak, so if the recurrent laryngeal nerve is damaged during surgery, it may lead to vocal fold paralysis. Patients with vocal fold paralysis on one side will feel the effort of pronunciation and hoarseness. Over time, this phenomenon will be gradually relieved by the compensatory movement of the contralateral vocal folds, and the voice will gradually return to near normal, with little impact on the quality of life. If there is bilateral damage to the recurrent laryngeal nerve, the problem is more serious. Bilateral vocal fold paralysis will lead to fixation of the vocal folds and narrowing of the vocal fissure, and the patient will have difficulty breathing, requiring tracheotomy, rerouted breathing, or even lifelong tube, which is a more serious complication of thyroid surgery. However, for some thyroid cancers that are very extensive and have severe adhesions and invasion of the surrounding tissues, this kind of injury may be inevitable, and the surgeon will have a proper estimation before surgery and will fully explain and communicate with the patient. 2. Hypothyroidism or parathyroidism: In the past, in order to prevent tumor recurrence and metastasis and to eliminate microscopic cancer foci, total thyroidectomy was advocated for all thyroid cancers, but this, although complete, could easily lead to bilateral posterior retrograde nerve damage and acquired hypothyroidism and parathyroidism, and patients need to take thyroxine tablets for hormone replacement therapy for life. The parathyroid glands, on the other hand, are tiny glands located on the back of the thyroid gland that secrete parathyroid hormones vital to maintaining the body’s blood calcium levels. If the parathyroid glands are hypoparathyroid, patients will suffer from hypocalcemic twitching of the hands and feet, requiring lifelong intravenous calcium supplementation, which is also very painful. In view of the above problems, after the research of evidence-based medicine, the surgery is now more scientific and reasonable. Doctors will make the surgical plan according to the scope and size of the patient’s lesion and the presence of metastasis, etc. For relatively limited thyroid cancer, partial thyroidectomy can also achieve satisfactory results and maintain the patient’s endocrine function to the maximum extent. In conclusion, early detection and treatment will significantly reduce the risk of surgery and greatly improve the treatment effect, while it is unwise to refrain from treating the disease, deceive oneself or take the initiative to refuse formal treatment with a fluke mentality!