When someone gets emotional, it's said that they have a lump in their throat. While that kind of lump is harmless, you may have a reason for concern if you actually see or feel a lump.
The symptoms of something more serious are not always obvious. They can mimic other diseases. But if you have a lingering sore throat, a sinus infection that won’t go away, neck pain, voice changes, breathing difficulties, coughing or trouble swallowing, all of these symptoms can be indicators of thyroid cancer.
"A lump on your thyroid that might be of concern will show up right under the area that's considered the Adam's apple for a man," explains Hugh Willcox, MD, with Roper St. Francis Physician Partners General Surgery. He specializes in thyroid and parathyroid surgeries. "If you feel or see one, the first thing you should do is see your primary care doctor for an examination and blood tests to see if your thyroid gland is functioning normally."
The thyroid gland is a small, butterfly-shaped gland at the base of the throat that produces hormones that regulate the body's metabolic rate which controls your heart, muscle and digestive functions as well as brain development and bone maintenance. Thyroid hormones affect every cell in your body and having too much or too little of the hormones can cause organ damage.
"When your thyroid is overactive, you can have hyperthyroidism," said Dr. Willcox. "Hypothyroidism is when the gland isn't making enough thyroid hormone, which is needed to make the body run normally.”
If you do not see a nodule, but are experiencing other symptoms such as dry skin, constipation, feeling colder, tiring more easily, or feeling forgetful or depressed, having your thyroid checked is still a good idea.
Dr. Willcox explains that a thyroid nodule should also be examined by ultrasound. "Depending on the size of the lump, whether or not it's hard or soft, and how it looks on the ultrasound, it may need to be biopsied," he said. "A biopsy is when a thin needle is inserted into your thyroid gland, so a piece of tissue can be removed and examined. The biopsy will help determine if the lump is benign (which is non-cancerous) or malignant."
Benign nodules can be removed if the lump is large enough to obstruct your throat. Otherwise your doctor may advise a wait-and-see attitude. If the lump is malignant, the side of the thyroid that had the lump will need to be surgically removed. "How much of the thyroid will be removed will depend on the tumor’s size and the type of thyroid cancer the patient has," said Dr. Willcox.
Two of the most common types of thyroid cancer are papillary thyroid cancer and follicular thyroid cancer. Both are slow-growing but can spread to lymph nodes. Both are also very curable, starting with the removal of the thyroid.
The surgeon performs a lobectomy, which removes the thyroid lobe that contains the cancer and the isthmus, the bridge between the left and right lobes.
"If the biopsy shows that one lobe is suspicious for cancer, but it’s not clear, we can remove it and leave the other side," said Dr. Willcox.
The lobe is sent out for testing and if it comes back cancerous, the surgeon might choose to remove the remaining lobe.
"If the cancer has spread to include the lymph nodes in the neck, the lymph nodes will also be removed at the same time of the thyroid surgery," explains Dr. Willcox. "If the entire thyroid is removed, called a thyroidectomy, the patient will require thyroid hormone replacement with levothyroxine."
It's important to note that having a lump or having thyroid cancer might not cause any symptoms at first. Make sure you have an annual check-up with your primary care doctor so they can examine your neck regularly and check the progress of any benign lumps you may have had.
The American Cancer Society estimates that 52,890 people in the United States will be diagnosed with thyroid cancer in 2020. Compared with other common types of cancer, thyroid cancer occurs more frequently in younger patients, with about 65 percent of cases occurring in people under the age of 55. Women are also two-and-a-half times more likely to develop thyroid cancer than men.
For more information on Dr. Hugh L. Willcox, MD, General Surgery, visit http://www.rsfh.com/partners/surgery, Roper St. Francis Physician Partners, 300 Callen Blvd., Ste. 330 Summerville, SC 29486 or call (854) 529-3001.