Treatment depends on the findings
In the case of larger thyroid nodules and those that cause symptoms, the treatment depends on whether the nodules produce thyroid hormone (“hot” nodules) – or whether they are possibly malignant and a thyroid carcinoma is involved. We will proceed as follows:
Benign thyroid nodules
Treatment is usually only necessary if the benign lump presses on the esophagus or windpipe or is cosmetically disturbing because it is clearly visible on the outside of the neck, for example. The treatment of choice is then surgery, whereby the lump is gently removed. In specially selected cases, thermal ablation, in which the lump is obliterated with heat, is also an option.
Hot thyroid nodules
If the lump is not too large, it can be treated with radioiodine therapy. For this purpose, we administer radioactive iodine with a capsule. The radioactive iodine accumulates in the particularly active thyroid nodule and destroys it. However, if the nodule is very large or if multiple nodules have developed in the thyroid gland, surgery is the treatment of choice. Depending on how extensive the changes are, only part of the thyroid gland is removed, sometimes even the entire gland.
It is almost always operated on, and in some forms of this cancer radioiodine therapy is also used after the operation.
Cooperation between different specialist disciplines
Today, determining and carrying out the best possible treatment for a thyroid nodule requires cooperation between various specialist disciplines. All important specialist disciplines work closely together at the Thyroid Center of the USZ. The respective form of therapy is worked out individually for each patient in a weekly meeting of the various specialists.
Thyroid surgery and the consequences
Anyone who has had thyroid treatment or surgery must check their thyroid values carefully in future and take appropriate countermeasures. Especially if the entire organ had to be removed, it is important to take thyroid hormone for the rest of your life, i.e. hormone replacement therapy.
Incision for thyroid surgery
However, in addition to this indirect consequence of thyroid surgery, there are also direct consequences: In the past, thyroid surgery left clearly visible marks. The organ was removed through a large incision in the lower neck area, leaving a long scar. Today there are ways of making small incisions in natural skin folds, for example. In this way, there are usually no noticeable scars.
Side effects of thyroid surgery
Like all surgical procedures, thyroid surgery carries the risk of side effects. This can potentially lead to an impairment of the voice. There is a risk of damage to the vocal cord nerves. Constant hoarseness would then be the side effect. However, this risk can be reduced if those affected go to a specialized center for treatment. There, the risk of this surgical consequence is less than one percent.
Another possible side effect of thyroid surgery is that the parathyroid glands no longer function properly. These are four glands, about the size of a lentil, which are located next to the thyroid gland. They produce parathyroid hormone, which regulates calcium levels. Dysfunction of the parathyroid glands can lead to cramps or tingling of the skin. The failure of the parathyroid glands after the operation is usually only temporary and can be treated well by administering calcium and active vitamin D.