nódulos tiroideos en el cuello cómo entenderlos y reducir la ansiedad

Title: Understanding Thyroid Nodules in the Neck and Reducing Anxiety Author: Healthcare Writer Reviewer: Medical Expert Commissioner: Healthcare Organization Production Information: Health Daily Section Profile: Thyroid nodules are mostly benign, but they require monitoring and proper management to alleviate anxiety.

The term "thyroid nodule" in a medical report often causes concern for many people: is it cancer? Is surgery necessary? In fact, a thyroid nodule is simply a "lump" that grows on the thyroid, similar to moles on the skin, and the vast majority are benign. There is no need to panic, but neither should it be ignored.

The thyroid is a butterfly-shaped gland located at the front of the neck, responsible for secreting hormones that regulate the body's metabolism. Nodules are small protrusions that appear on this "butterfly". In our country, the detection rate of thyroid nodules in adults ranges from 20% to 76%, indicating that 1 in 5 people may have this condition, although the malignancy rate is only 5% to 10%. Nodules are more common in women, with an incidence ratio of about 1:3-4 between men and women, particularly affecting those aged between 40 and 60 years. There are not only benign and malignant nodules, as more than 90% are benign and only a small percentage corresponds to thyroid cancer.

Thyroid nodules have complex causes, and benign nodules often arise from various conditions: multinodular goiter, which is the most common, is related to iodine intake abnormalities and hormonal disorders; thyroid adenomas are small benign tumors associated with genetics and hormone levels; inflammatory nodules are caused by Hashimoto's thyroiditis, viral infections, among others; and there are special types such as cysts and hematomas. Risk factors for malignant nodules mainly include family history of thyroid cancer, iodine intake imbalance, radiation exposure in the head and neck during childhood, and hormonal fluctuations in women.

To distinguish between the benignity and malignancy of the "small lumps", ultrasound is the most visual "gold standard". Benign nodules generally have well-defined margins, regular shapes, homogeneous echoes, and do not show abnormal blood flow or only have coarse calcifications; in contrast, malignant nodules present diffuse margins, abnormal shapes, heterogeneous echoes, and abundant blood flow, with minimal calcifications being an important red flag. Regarding symptoms, benign nodules are typically asymptomatic, and only large nodules may cause discomfort due to compression; malignant nodules may also show no obvious symptoms in the early stages, but in advanced stages, they could present symptoms such as changes in voice or swelling of lymph nodes in the neck. In terms of growth rate, benign nodules typically remain unchanged for many years, while malignant nodules may increase in size over a short period.

Upon discovering a nodule, scientific diagnosis is divided into three steps: first, a thyroid ultrasound is performed, where the doctor assesses the risk via the TI-RADS grading system; grades 1-3 are generally benign, while grade 4 and above are suspicious for malignancy; the second step involves blood tests to examine thyroid function, assessing for hyperthyroidism, hypothyroidism, or autoimmune inflammation; the third step involves fine-needle aspiration biopsy of suspicious nodules, which is the ultimate 'gold standard' for determining benignity or malignancy.

When facing nodules, it is crucial to avoid a one-size-fits-all approach and to follow an individualized principle: for low-risk benign nodules, regular follow-ups are recommended, with ultrasound checks every 1-2 years for nodules smaller than 1 cm, and every 6 months to 1 year for those measuring between 1-2 cm; for benign nodules causing pressure, hyperthyroidism, or inflammatory symptoms, targeted medication or surgery may be required to relieve discomfort; and for suspicious malignant or confirmed malignant nodules, surgical treatment is preferred, as the 5-year survival rate after early thyroid cancer surgery exceeds 95%, indicating an excellent prognosis.

Special groups such as children, pregnant women, and the elderly must take special care: children have a higher risk of malignancy in nodules, thus active screening is necessary; pregnant women should prioritize ultrasound, with low-risk nodules being monitored during pregnancy, while suspicious nodules should be treated in a scheduled manner; in elderly patients, their physical condition must be considered; if they can tolerate surgery, active treatment should be pursued, while those with weakened constitutions should be followed conservatively.

Regarding thyroid nodules, it is essential to dispel these myths: nodule ≠ cancer; over 90% are benign and do not require surgery; nodule size is not related to malignancy risk, as small nodules can also be malignant; even if there is no pain or discomfort, regular monitoring is necessary to avoid delayed diagnosis; not all surgeries will leave scars, as minimally invasive techniques and ablations can be aesthetic; after total thyroidectomy, lifelong medication is required, but the medications are safe with minimal side effects; there is no need to eliminate iodized salt, as balanced intake is key; thyroid cancer has a low degree of malignancy and is not a death sentence.

The "lumps" in the neck should never be seen as a "verdict" on health, but rather as a "reminder" of thyroid health. After discovering a nodule, it is important to promptly visit an endocrinologist or thyroid surgeon, follow medical advice for check-ups, monitoring, or treatment, maintain a balanced iodine intake, avoid radiation, and maintain a regular schedule. By doing so, uncertainty about the "lumps" can easily be alleviated, protecting thyroid health.