A goitre (pronounced goy-ter, sometimes spelled “goitre’) is an enlarged thyroid gland. This gives you a lump at the front of your neck. Some people with goitres have an underactive or overactive thyroid gland. This means that they make too much or too little thyroid hormone. There are various causes of goitre, and treatment depends on the cause.
A goitre is an enlarged thyroid gland. A goitre can mean that all or part of the thyroid gland is swollen or enlarged, or that one or more swellings or lumps develop in a part or parts of the thyroid gland.
The thyroid gland is in the lower part of the neck. It lies just in front of the windpipe (trachea). It has a right and left lobe, which are connected together by a narrow band of thyroid tissue. It is roughly the shape of a butterfly. You cannot usually see or feel a normal thyroid gland. If the thyroid gland enlarges, it causes swelling in the neck, which you can see as a goitre.
The thyroid gland makes thyroid hormones called thyroxine (T4) and triiodothyronine (T3). These hormones are carried around the body in the bloodstream. T4 and T3 help to keep the body’s functions (the metabolism) working at the correct pace. Many cells and tissues in the body need T4 and T3 to keep them working correctly.
Assessing the situation
When you have a goitre, a doctor will usually do some blood tests to check if you are making too much or too little thyroxine (T4) or triiodothyronine (T3). Blood tests may also help find out the cause of some goitres. Other tests may be done to find out the cause of the goitre. For example:
An ultrasound scan of the thyroid. This is the best test for thyroid swelling. An ultrasound scan is a safe and painless test that uses sound waves to create images of organs and structures inside your body. It can tell if a nodule is a cyst or a solid lump.
FNAC is a diagnostic procedure in which a small sample is collected by inserting a thin needle into the nodule and examining under the microscope. It is a simple and safe procedure. This procedure can be done under guidance of ultrasound where the specialist doing the procedure can see where they are inserting the needle by doing an ultrasound scan at the same time.
Occasionally, other specialist blood tests are needed to help establish the cause. Occasionally, a computerised tomography (CT) scan or a magnetic resonance imaging (MRI) scan is needed.
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Thyroid malignancies
Malignant thyroid disease
There are four main types of thyroid cancer. These are papillary, follicular, medullary, and anaplastic. Papillary is the most common type. The four types differ in how aggressive they are. Thyroid cancer that is found at an early stage can often be treated successfully.
Papillary thyroid cancer is the most common type, accounting for roughly 85 percent of all diagnoses, according to the NCI. If diagnosed early, the cure rates for this type of thyroid cancer are high.
Follicular thyroid cancer is the second most commonly diagnosed type of thyroid cancer, accounting for approximately 10 percent of diagnoses. It begins in follicular cells and usually grows slowly. This type of cancer is also highly treatable if diagnosed early enough.
Medullary thyroid cancer develops in the thyroid’s C cells, which make a hormone called calcitonin that helps maintain calcium levels in the blood. This rare cancer occurs in nearly everyone with a certain gene mutation. Blood testing can usually detect the presence of this altered gene.
Anaplastic thyroid cancer is a very rare and aggressive type of thyroid cancer that usually affects those over age 60. This type of cancer grows and spreads quickly, and is difficult to treat.
HOW WOULD I KNOW IF I HAVE THYROID CANCER?
At the early stages of thyroid cancer, there are very few discernable signs. This is why it’s essential to get a cancer screening after you reach an age where your risk increases. However, there are some early signs of cancer that you might be able to notice.
- Early signs of thyroid cancer
- Swelling or a lump on the neck
- Hoarse voice, or general changes to your voice
- Trouble swallowing
- Pain in the throat
- Neck pain
- Swelling in the lymph nodes
Thyroid cancer is evaluated in the same way as other thyroid lumps, with the help of blood tests, FNAC and Ultrasound examination.
If there is suspicion of cancer, your doctor would advice you to proceed with surgery.
TREATMENT FOR THYROID CANCER
Depending on the staging or progression of your cancer, your care team will present you with a few different options.
SURGERY
When it comes to surgical treatment for thyroid cancer, treatment typically consists of removing either part or all of the diseased thyroid. Typically, thyroid removal is open surgery and leaves a scar along the neck, but new minimally invasive techniques can help help you reduce scarring and reduce your recovery time.
THYROIDECTOMY
Your surgeon may recommend a total thyroidectomy if your issue can only be solved by total removal of the thyroid gland. When performing this surgery, your surgeon will usually leave a small peice of the thyroid gland to support the remaining parathyroid glands.
THYROID LOBECTOMY
Depending on the size of the tumor, your surgeon may recommend a lobectomy, which is partial removal of the thyroid gland. Specifically, with this procedure, the doctor removes half of the thyroid.
Usually, this is performed when patients have slow-growing forms of thyroid cancer on one side of the gland and no other nodules on the other side.
LYMPH NODE DISSECTION
This surgery focuses on removing lymph nodes on the neck that have been affected by thyroid cancer. To determine if this surgery is right for you, your care team will perform a ultrasound exam to reveal any signs of cancer spreading to the lymph nodes.
