Health Day

Do you have hidden lumps in your neck?

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World Thyroid Day, observed on the 25th of May every year, calls out for increasing awareness about the increasing number patients suffering from thyroid related health issues.

The phrase, “She/he is suffering from a “thyroid problem” is something we hear quite often in India these days. A thyroid problem implies any abnormality that one may experience within the thyroid gland. Thyroid gland is a butterfly-shaped gland located just below the voice box in the neck and secretes hormones which regulate the body’s metabolism.
Sometimes, this gland becomes underactive (hypothyroidism — weight gain, lethargy, cold intolerance, etc.), overactive (hyperthyroidism — weight loss, palpitation, heat intolerance, etc.) or may develop cancerous or non-cancerous lumps.

A large number of people over 40 years of age may have lump in their thyroid gland. In Western countries, majority of them are picked up on screening ultrasound done for thyroid or non-thyroidal illness. In Indian scenario, these are usually picked up late, till it cause some symptoms to patients. About 10 per cent of these nodules are cancerous and can have undesirable outcome if not treated at appropriate time.

Dr Naval Bansal, consultant endocrine and breast surgeon at Fortis Hospital, Mohali, shares situations in which a doctor may recommend one to undergo thyroid surgery (removal of part or whole of thyroid). These are:

When cancerous growth is present or is suspected.

When a noncancerous (benign) nodule is large enough to cause problems with breathing or swallowing.

Hyperthyroidism that cannot be treated with medicines or radioactive iodine.

He states that thyroid cancer can be detected at an early stage by a simple neck examination (in front of mirror). This may be done at regular intervals and any nodule or fullness in anterior aspect of the neck should be looked for; as this is the most common manifestation of thyroid cancer.

Dr Bansal further suggests that voice change, difficulty in breathing or difficulty in swallowing are other presentation of thyroid cancer. In case of suspicion of any of these symptoms, neck ultrasound along with needle aspiration from the nodule should be done for confirmation of this disease.

Dr Bansal suggests that surgical intervention, i.e. thyroidectomy (removal of thyroid gland), is the mainstay of treatment in most cases of thyroid cancer. As per literature high volume/dedicated thyroid surgeon (endocrine surgeon, etc.) can deliver the best results in terms of post-thyroidectomy complications like voice change or low calcium levels. Newer modalities like endoscopic or robotic thyroid surgeries are also been practiced these days for the treatment.

Early detection is the key to a chance of successfully battling cancer. Reassuringly Dr Bansal says, “Thyroid cancer if detected in early stages can be cured in more than 90% of the cases given that appropriate treatment is sought at the right time.”

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