As soon as you notice a lump (nodule) on your thyroid, it is important to have it assessed by a doctor. If you have a thyroid nodule or lump, our VM-Med surgeons can quickly assess whether further treatment is required.
Once a diagnosis has been made, a treatment plan will be proposed either by your referring doctor, or by your VM-Med doctor, based on the examination and your test results. If surgery should be needed, one of our specialized surgeons can operate and remove the mass, usually within a week of when the decision to have surgery is made.
How We Diagnose Your Thyroid Mass
The diagnosis of a thyroid mass is made by reviewing your medical history and examining the neck. Your doctor may have you lift up your chin, extending your neck to make the thyroid gland more prominent. Your doctor may also ask you to swallow. This helps to distinguish a thyroid mass from other lumps and bumps in the neck.
Other tests that your doctor may order, all of which are available on-site during your visit include:
- Blood tests of thyroid function
- An ultrasound exam
- A CT scan
- A chest X-ray
- A thyroid scan
Based on the results of your physical examination, and on the results of any additional tests, your physician may recommend a fine needle aspiration (FNAC) which is a safe, relatively painless procedure whereby a fine needle is passed into the lump in the thyroid, ideally under ultrasound guidance, and samples of the tissues are taken.
Treatment of Your Thyroid "Lump"
Most thyroid ‘‘lumps’’ are benign. They can rarely be treated with thyroid medication known as ‘‘suppression’’ therapy. The object of this treatment is to see if the lump will shrink over time while on this medication. The usual time period for some improvement is three to six months. A repeat ultrasound or fine needle aspiration may be required during this time period. If the lump continues to grow most doctors will recommend removal of the thyroid lump. If the fine needle aspiration is atypical or suggestive of a malignancy, then thyroid surgery is required.
What Is Thyroid Surgery and What Should I Expect for My Recovery?
Thyroid surgery is an operation to remove part or all of the thyroid gland. It is limited to those patients who have potential problems based on pre-op tests. It is usually performed under general anesthesia. Usually the operation removes the lobe of the thyroid gland containing the ‘‘lump,’’ the isthmus and most of the other lobe. The pathology assessment will help determine if all of the thyroid gland should be removed. Sometimes, based on the operative findings, the surgeon may decide to stop and remove no more thyroid tissue, or proceed to remove the entire thyroid gland, and/or other tissue in the neck. This is a decision usually made in the operating room by the surgeon based on findings both before and at the time of surgery. Your physician will discuss these options with you before your surgery.
After surgery you may have a drain (a tiny piece of plastic tubing) inserted in the wound [for how long?]. This is removed if the fluid accumulation is minimal. Most patients do not need a drain and if admitted, are discharged a day or two after surgery is performed.
Complications after thyroid surgery are rare. They include bleeding, a hoarse voice, difficulty swallowing, numbness of the skin on the neck, and low blood calcium. Most complications go away after a few weeks. Patients who have the entire thyroid gland removed have a higher risk of low blood calcium post-operatively.
Patients who have thyroid surgery may be required to take thyroid medication to replace thyroid hormones after surgery. Some patients may need to take calcium replacement if their blood calcium is low. This will depend on how much of your thyroid gland remains, and what was found during surgery. In some cases where a malignant tumour is found, radioactive therapy might be recommended after surgery.
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