Thyroid Nodule or Goitre: When Is Surgery Needed?

Finding a lump in the neck or being told that you have a thyroid nodule can be frightening. The first thing to know is that most thyroid nodules are benign (not cancer) and many do not need an operation. Only a proper examination and tests can tell what is right for you.

How a nodule or goitre is checked

• Examination of the neck and thyroid blood tests (TSH, T3, T4)
• Ultrasound of the thyroid and neck
• FNAC, a needle test of the nodule, when the ultrasound shows it is needed

When is surgery usually advised?

• The needle test shows cancer or is suspicious for cancer
• The nodule or goitre is large, keeps growing or presses on the windpipe or food pipe, causing difficulty in swallowing or breathing
• An overactive thyroid (hyperthyroidism) that is not controlled with medicines or keeps coming back
• A goitre that extends behind the breastbone
• A visible swelling that troubles the patient, after other causes have been checked

When is surgery usually not needed?

A small benign nodule that causes no symptoms is often just watched with regular check-ups and ultrasound. Your doctor will tell you how often to repeat the tests.

Questions to ask your surgeon

1. What is my exact diagnosis, and is surgery really needed now?
2. Are there any alternatives, or can I wait and watch?
3. Will the whole thyroid or only one half be removed?
4. Which approach is best for me – open, endoscopic or robotic – and why?
5. What are the risks, such as voice change or low calcium?
6. Will I need thyroid tablets afterwards, and for how long?
7. How long will I stay in hospital, and when can I return to work?

Consult a thyroid surgeon in Varanasi

If you have a thyroid nodule, a goitre or a thyroid cancer diagnosis, you can meet Dr. Om Prakash Prajapati, endocrine and breast cancer surgeon, at Delta Clinic & Hospital, Varanasi. Read about goitre and thyroid nodule, or start with an online video consultation. Please bring your earlier reports and scans.