When certain conditions interfere with normal thyroid production, surgical removal of the thyroid gland is performed. This is usually done when thyroid cancer has been detected, an otherwise benign thyroid nodule grows so large it causes problems or hyperthyroidism (a disorder in which excess thyroid hormone is produced) does not respond to treatment with medications or radioactive iodine, though this is rare.
Thyroid surgery is known as a thyroidectomy. Two types of procedures are performed: a total thyroidectomy to remove the entire gland or a subtotal thyroidectomy, which removes part of the gland.
In a total thyroidectomy, the entire gland and surrounding lymph nodes are removed. The patient is given drugs to suppress thyroid hormone production, in addition to radioactive iodine. A subtotal thyroidectomy involves removal of one complete gland and part of the other, which is usually reserved for treating hyperthyroidism caused by Grave’s disease.
The effectiveness of any surgical thyroid procedure depends on the type of cancer present and how much it has spread. Overall, the surgery is considered safe, but may lead to complications that include injury to the vocal cords and larynx (which could cause hoarseness, changes in the voice and problems speaking or swallowing), injury to the parathyroid glands (which could cause hypoparathyroidism, a separate condition in which too little parathyroid hormone is produced), difficulty breathing and the usual risks associated with most surgical procedures (bleeding and infection).
Goiter
A goiter is caused by the swelling of the thyroid. While normally harmless, a goiter can lead to your thyroid producing an incorrect amount of hormones. Iodine deficiency is the most common cause of goiters worldwide. In the US, the most common cause of a goiter is an autoimmune condition called Hashimoto’s thyroiditis. This condition causes your own immune system to slowly destroy your thyroid, resulting in a decrease in hormone production. The pituitary gland senses this decrease and causes the thyroid to grow in order to compensate. A blood test and a physical exam are usually all that is necessary to diagnose a goiter.
Thyroid Cancer
The thyroid is a butterfly-shaped gland in the neck that produces hormones used to regulate your body’s metabolism. Though relatively rare, thyroid cancer occurs when abnormal cells multiply in the thyroid gland.
Fortunately, patients with thyroid cancer frequently do well because it is usually detected early and responds well to treatment. It is important to seek medical attention as soon as possible if you experience any symptoms of the disease.
Signs and Symptoms of Thyroid Cancer
There are several signs that might indicate thyroid cancer. These include a lump or swelling in the neck; neck, throat or ear pain; difficulty swallowing and/or breathing; hoarseness; chronic cough; swollen lymph nodes and wheezing.
These don’t necessarily indicate the presence of thyroid cancer, which is fairly uncommon, but a physician should investigate to be on the safe side. Your doctor may perform a biopsy in order to diagnose or rule out cancer.
There are different types of thyroid cancer.
- Papillary, the most common, forms in the follicular cells that produce thyroid hormone. It usually strikes people aged 30 to 50.
- Follicular thyroid cancer originates in the same region, but typically affects those over 50.
- Medullary thyroid cancer forms in the C cells that produce calcitonin.
- Anaplastic thyroid cancer is rare, but grows rapidly and is difficult to treat. It usually occurs in people over the age of 60.
Risk factors for thyroid cancer include being female, exposure to high levels of radiation and genetics – especially having family members who have experienced thyroid disease or cancer.
Thyroid Cancer Treatments
Treatment for thyroid cancer depends on the type and stage of your cancer, your age and your overall health. Surgery to remove all or part of the thyroid gland or the lymph nodes in the neck is the most common form of treatment. When this is done, you’ll have to take synthetic thyroid medication for the rest of your life.
You may also receive radioactive iodine treatment to destroy remaining cancerous tissue. Thyroid-stimulating hormone suppression therapy is used to reduce the levels of thyroid-stimulating hormone in your body, which can prevent future growth of cancerous cells. More advanced thyroid cancers may be treated with chemotherapy or radiation therapy.
Thyroid Nodules
Thyroid nodules are lumps in the thyroid gland that may be solid or filled with fluid. They are usually noncancerous and rarely cause problems. In some cases, they may enlarge to the point of causing breathing and swallowing difficulties or stimulating overproduction of thyroid hormone.
Thyroid Nodule Indications
Many times, you may be completely unaware that you have nodules growing on your thyroid gland. They may be discovered inadvertently during a routine examination by your physician. If they grow large enough, they may be visible to the naked eye and, in some cases, can be felt. When thyroid nodules press against your windpipe or esophagus, they can cause you to have trouble breathing or swallowing.
Nodules sometimes produce additional thyroid hormone, which causes an imbalance that leads to hyperthyroidism. Symptoms include rapid heartbeat, weight loss, anxiety, tremors, irritability, excessive perspiration and intolerance to heat. These are the result of a sped-up metabolism. In rare cases, thyroid nodules turn out to be cancerous.
Treatment for Thyroid Nodules
Thyroid nodules may develop due to a variety of conditions such as iodine deficiency, excess tissue growth, thyroid cysts, goiter (enlarged thyroid), Hashimoto’s disease (a thyroid disorder resulting in inflammation and reduced hormone production) and cancer. Heredity is also a factor; if thyroid nodules run in your family, you are more likely to have them.
Treatment depends on the size of the thyroid nodule and whether or not it’s cancerous. If a biopsy proves it’s benign and it isn’t causing any outward trouble, your doctor may suggest taking a wait-and-see approach. Unless it grows larger, treatment can be avoided.
Other times, it may be beneficial to remove benign nodules. This is usually accomplished through surgery or thyroid hormone suppression therapy. If nodules are causing hyperthyroidism, you’ll likely receive radioactive iodine or anti-thyroid medication. Surgery is the option of choice for malignant (cancerous) thyroid nodules.
Call Mid-Valley ENT & Allergy at (541) 967-0404 for more information or to schedule an appointment.
