Most thyroid nodules (90-95%) are benign, so finding one doesn't require panic. A thyroid ultrasound is the main diagnostic tool; if it shows suspicious features like irregular borders or microcalcifications, a fine-needle biopsy follows. Small, asymptomatic nodules are monitored with annual ultrasounds, while larger or symptomatic ones may be treated with radiofrequency ablation to shrink them without removing the thyroid.
Take me through. If people do a self neck check or they get an ultrasound, something's found, let's say it's a nodule. Talk to me about what happens after that. What are next steps? And are all nodules cancer? Like, does it need to be so terrified about this?
And so that's the first thing. If you find a nodule, if it's in the center of your neck or a lump on the side of your neck, don't panic. Take a deep breath. Most thyroid nodules are benign, but don't go and get a CT scan and a full body PET scan. People just jump down that road. The best test for the thyroid is actually an ultrasound. And then on ultrasound, if it has suspicious characteristics, so things that we look for, irregular borders, microcalcifications, that increased blood flow or vascularity. So those are some key buzzwords that you might see on an ultrasound report. If there's anything like that on the report, then the next step is a biopsy. So just take the proper steps if you find a nodule.
And then if it's a nodule and it doesn't have concerning characteristics, right, doesn't mean they necessarily have to get it out, their thyroid removed, etc. What can those people who don't fall under the umbrella of thyroid cancer, what does their next steps look like?
So it depends on size and it depends on symptoms. So if it's a smaller nodule, it's 1.5 centimeters, you're not having symptoms, it looks benign, or you had the biopsy and it's benign, okay, so you monitor it. That's the majority of patients. And so every year you get an ultrasound, and if it's— if there's no changes, you don't even repeat a biopsy unless there's changes. If you have a nodule that's larger and it's causing you symptoms, and when we talk about symptoms, we talk about compressive symptoms like trouble swallowing or an increased effort to swallow or clearing your throat a lot when you're not sick, things like that, then there's non-operative interventions like radiofrequency ablation. And so you maintain your thyroid, you just shrink the nodule using a heated probe. So it's not always— it means surgery. It could be monitoring, it could be non-surgical interventions.
Right. And what percentage of nodules, in your experience or in the data, are benign versus cancerous? So it's 90 to 95% of thyroid nodules are benign.
And then if it's worst case scenario, it's a cancer, again, don't panic. You know, take a deep breath. It's still curable for the most, for most cases. And I could potentially just take out half your thyroid, and you may not even need thyroid medication. So just take the proper steps if you find a nodule.
