Most types of thyroid cancer can be curable when caught early, but often may require aggressive treatment using surgery and/or chemotherapy and radiation.  

The two types of nodules are:
Malignant nodules, or thyroid cancer, which can grow and spread to other organs if not treated. 

Benign nodules, which represent more than 95 percent of the cases, are non-cancerous, and can grow and cause symptoms but do not spread, and often do not need to be removed. 

Diagnosis: We can determine what kind of nodule you have using these tools:

Physical Exam: Your doctor will feel your neck to identify the presence of nodules.

Blood Tests:  Your doctor will test your blood for elevated or low levels of thyroid stimulating hormone (TSH).

Thyroid Scan:  Your doctor will give you an oral radioactive substance to track its path through the bloodstream.  Nodules absorbing more radioactive substance than the surrounding thyroid tissue are considered to be “hot,” or non-cancerous. 

Diagnosis: We can determine what kind of nodule you have using these tools:

Thyroid Ultrasound:  With an ultrasound, your doctor will see the thyroid nodules.  Ultrasounds help doctors find nodules too small to detect in other ways.  Ultrasounds also help doctors see the size and shape of nodules, and determine whether they are non-cancerous, liquid-filled cysts. 

Fine-needle Aspiration: In an FNA, a very fine, thin needle is inserted into the thyroid, and aspirates (or "suctions") cells and/or fluid from a thyroid nodule or mass into the needle. The sample obtained can then be evaluated for the presence of cancerous cells.

Thyroid Nodule

Thyroid nodules are extremely common. The chances are 1 in 10 that you or someone you know will develop a thyroid nodule. Although thyroid cancer is the most important concern of the thyroid nodule, fortunately it occurs in less than 10% of nodules. This means that about 9 of 10 nodules are benign (noncancerous). The most common types of noncancerous thyroid nodules are known as colloid nodules and follicular neoplasms. If a nodule produces thyroid hormone without regard to the body’s need, it is called an autonomous nodule, and it can occasionally lead to hyperthyroidism. If the nodule is filled with fluid or blood, it is called a thyroid cyst.

We do not know what causes most noncancerous thyroid nodules to form. A patient with hypothyroidism may also have a thyroid nodule, particularly if the cause is the inflammation known as Hashimoto’s thyroiditis. Sometimes a lack of iodine in the diet can cause a thyroid gland to produce nodules. Some autonomous nodules have a genetic defect that causes them to grow.

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FNA- Frequently Asked Questions.

How Does FNA Differ From Needle Core Biopsy?
In a needle core biopsy, a thicker, large needle is used to obtain a "core" tissue sample for analysis, and the larger sample that can be recut for smaller samples that can be sent out for further analysis. Needle biopsies are typically done using local anesthesia, and these procedures have slightly greater risk of bleeding associated with them, so they are more often done by a surgeon in outpatient or ambulatory surgical facilities.

What is an Ultrasound-Guided FNA?
When a nodule is palpable - meaning, you can feel it with your hand - most practitioners don't need to use ultrasound to guide the FNA process.

Some nodules are very low lying or can only be felt when you are swallowing, or can't be felt but were picked up by ultrasound, cat scan or MRI. In these cases, a practitioner may use ultrasound to ensure that the FNA is accurately performed.

Is FNA Risky?
Thyroid FNA is generally considered safe, and almost never results in any complications.

Why do I need a biopsy?

While the great majority of lumps are not malignant, the treatment of the nodule will depend upon its exact nature.  Fine needle aspiration is a simple biopsy procedure that can provide the necessary information on which to guide your treatment. About 90 percent of the time, biopsy results can determine the exact nature of the nodule so that the correct treatment can be determined.. Dr. Metchick has performed 1000's of biopsy's and feedback from our patients are posted for your review.

What are the risks associated with fine needle aspiration biopsy?

Fine needle aspiration poses no significant risk to you.  Some patients report a mild, dull, throbbing sensation in the area of the biopsy, which usually subsides within 30 to 60 minutes.  This minor discomfort does not bother most patients and requires no medication.  If you experience any soreness in the area, simply apply an ice pack and take Tylenol.  Some patients have expressed concern that passage of a needle through a tumor might cause the tumor to spread.  This concern has been examined by physicians at several universities and such tumor spread has never been reported. You may experience some discomfort for several days following the procedure. This is normal. If you are concerned about excessive discomfort, redness, swelling or signs of infection – call our office immediately

There are 4 primary types of thyroid cancer:

Papillary thyroid cancer is the most common form, occurring in more than 80 percent of diagnosed cases.    It appears as a dense, uneven mass within healthy thyroid tissue.  Cure rates are 80-90 percent.

Follicular thyroid cancer is second to papillary in frequency, but is more aggressive.  Like papillary, follicular cancer occurs within thyroid tissue, but carries a greater risk of spreading to the blood channels and then metastasizing to other major organs.  Nevertheless, cure rates are generally high.

Medullary thyroid cancer is the third most common type, accounting for about five percent of diagnosed cases.  This type develops from a particular kind of thyroid cell called “C cells.”  Medullary cancer can spread quickly to lymph nodes, lungs or liver, and is most effectively treated before this occurs.

Anaplastic thyroid cancer accounts for about two percent of diagnosed cases.  Anaplastic cancer cells look very different from normal thyroid cells, and often derive from a pre-existing papillary or follicular cancer.  This cancer can quickly spread throughout the body and is very difficult to treat and cure.