Caring for the Thyroid, Understanding Thyroid Nodules and Thyroid Cancer

  The thyroid gland is the largest endocrine organ in the human body and its main role is to synthesize, store and secrete thyroid hormones and regulate the body’s metabolism. Adequate amounts of thyroid hormones are needed for the growth and development of fetuses, young children and adolescents. Therefore, the thyroid gland should be an organ that deserves our care.  However, in reality, people do not pay enough attention to the thyroid gland, and it is not included in the general physical examination. Hyperthyroidism or hypothyroidism is a common and prevalent condition, often with obvious symptoms and easy access to medical care. However, thyroid nodules and early thyroid cancer are also common and often asymptomatic. According to domestic and international statistics, the prevalence of thyroid nodules obtained by palpation is 3% to 7%, while the prevalence of thyroid nodules obtained by high-resolution ultrasound examination is 20% to 76%. The prevalence of thyroid cancer among thyroid nodules is 5%-15%. (2012 China Guidelines for the diagnosis and treatment of thyroid nodules and differentiated thyroid cancer) Therefore, physical examination of the thyroid gland is necessary even if there are no uncomfortable symptoms. In particular, physical examination by a thyroid specialist and high-resolution ultrasound are significant in assessing thyroid nodules (distinguishing benign from malignant) and contribute greatly to early detection and diagnosis of thyroid cancer. More than 90% of thyroid cancer is differentiated thyroid cancer. Early detection, early diagnosis and standardized treatment have good prognosis and high survival rate of 10 years or even 20 years (some up to 90%).  The following medical history and physical examination findings are risk factors for thyroid cancer: 1) history of head and neck radiation exposure or radioactive dust exposure during childhood; 2) history of systemic radiation therapy; 3) presence of differentiated thyroid cancer, medullary thyroid cancer or multiple endocrine adenomatosis type 2 (MEN2), familial polyposis, certain thyroid cancer syndromes (e.g. Cowden syndrome, Carney syndrome, Werner syndrome); 4) presence of differentiated thyroid cancer, medullary thyroid cancer or multiple endocrine adenomatosis type 2 (MEN2), familial polyposis, and certain thyroid cancer syndromes (e.g. Cowden syndrome, Carney syndrome, Werner syndrome). 4, male; 5, rapid growth of nodules; 6, persistent hoarseness, dysphonia, and exclusion of vocal cord pathology (inflammation, polyps, etc.); 7, dysphagia or dyspnea; 8, irregular shape of nodules and adhesion to surrounding tissues; 9, pathological enlargement of lymph nodes in the neck.  It is recommended to take care of your thyroid gland during the physical examination. First, a physical examination (visual and palpation) of the thyroid gland by a thyroid specialist; then, a thyroid function check and a specialist ultrasound of the thyroid gland (or lymph nodes in the neck). High-resolution ultrasound examination of the thyroid gland has the following advantages: clear and accurate, economical, and non-radioactive. (Better than CT, MRI, PET).