Is surgery necessary for nodular goiter?

Patients with nodular goiter generally have a long-term history of simple goiter. The disease usually occurs in people over 30 years old, and is more common in women than in men. The degree of thyroid enlargement varies and is generally asymmetrical. At the beginning, there is only one nodule, which later develops into multiple nodules. The nodules are generally hard or soft. So, is surgery necessary for nodular goiter?

Sometimes the boundaries of the nodules are unclear, and the surface of the thyroid gland only feels irregular or lobed when touched. The disease progresses slowly and most patients are asymptomatic. Larger nodular goiters may cause compressive symptoms, including difficulty breathing, dysphagia, and hoarseness. Acute bleeding into a nodule may cause a sudden increase in size and pain; symptoms may subside within a few days, and an enlarged mass may decrease in size over a few weeks or longer.

If nodular goiter is not treated in time, as the disease progresses, it is very likely to become cancerous. This is because nodular goiter is actually a late manifestation of the natural evolution of simple goiter. Some nodular goiters can form embryonal adenomas or papillary adenomas, or thyroid cancer, due to excessive proliferation of epithelial cells. Moreover, the tumor will compress the patient's trachea, esophagus, and recurrent laryngeal nerve, causing discomfort to the patient and greatly increasing the difficulty of treating the disease. Therefore, once you suffer from this disease, you should go to a regular hospital for treatment as soon as possible. Surgery is the treatment of choice for nodular goiter. It can quickly remove non-functional nodules and fibrotic and calcified lesions in the thyroid gland. But it should be noted that iodine-131 treatment is ineffective for this disease.

So in what cases must patients with nodular goiter undergo surgical treatment?

If patients with nodular goiter have the following 6 conditions, they must undergo surgical treatment, otherwise the condition may worsen at any time, or even become cancerous, endangering the patient's life!

1. Accompanied by symptoms of airway, esophagus, and recurrent laryngeal nerve compression: The most common symptom is tracheal compression. In the early stage, the patient may feel shortness of breath during strenuous activities. In severe cases, the patient may also have difficulty breathing during rest or sleep. Compression of the esophagus may manifest as difficulty in swallowing. Compression of the recurrent laryngeal nerve may manifest as hoarseness. However, the latter two conditions are relatively rare in benign nodular goiter. If they occur, be aware of the possibility of thyroid cancer.

2. Retrosternal goiter: It is a special type of nodular goiter, in which the lower pole of the thyroid gland extends behind the sternum. Since this type of goiter is prone to symptoms of airway and large blood vessel compression, it should be treated with surgery as soon as possible.

3. Huge goiter affects people’s lives and work.

4. Patients with nodular goiter and secondary hyperthyroidism: Patients usually have symptoms such as palpitations, irritability, anger, increased appetite, and weight loss. Blood tests for thyroid function may show elevated T3 and T4.

5. Cystic changes occur in the later stage and fibrosis and calcification form locally.

6. Patients with nodular goiter suspected of malignant transformation.

Patients should eat more vegetables, such as purple cabbage, broccoli, spinach, etc. These foods can help suppress the production of hormones by the thyroid gland. Don't drink coffee, tea, soda, and don't eat irritating foods such as stinky tofu. Eat more fresh fruits, such as pears, peaches, apples, lemons, bananas, etc., and eat more dried fruits.