I have a neck lump which moves when I swallow!

If you clicked on this post, chances are that you are experiencing a phenomenon known as a thyroid nodule which sometimes presents itself as a painless lump in your neck that is easily viewable or can be felt by pressing against it.

But what exactly are thyroid nodules?

Thyroid nodules are lumps or growths that are either filled with liquid or solid in nature. They are formed within the thyroid gland itself which is situated at the bottom of the neck. They are often discovered during routine physical examinations or when they present themselves outwardly on the neck. It is important to note that thyroid nodules tend to be painless to the touch and usually move when people ingest food and drink. 

There are several reasons why a thyroid nodule may be formed. Some causes include an overgrowth of thyroid tissue, thyroid inflammation or  the development of a tumour. Thyroid nodules are also common amongst older individuals, specifically females. Iodine deficiency and a family history of thyroid cancers and autoimmune diseases are among other risk factors. 

Symptoms Of Thyroid Nodules

One obvious symptom of thyroid nodules is the appearance of a thyroid nodule in your neck. In some cases, larger nodules may even add pressure against your trachea and oesophagus making everyday actions like breathing and swallowing food difficult. These can also cause a whole host of other symptoms known as compressive symptoms which include but not limited to:

  1. Difficulty breathing especially when exercising 
  2. Difficulty swallowing 
  3. Loud and noisy breathing when sleeping at night 
  4. A sense of tightness in the neck 
  5. A sense of discomfort when lying down especially when adopting certain positions when lying down

How Are Thyroid Nodules Evaluated? 

When you visit a thyroid specialist in Singapore, the first step is to identify if the nodules are cancerous. The first step is usually an ultrasound which is able to pinpoint the thyroid nodule with targeted accuracy. The doctor will make an informed decision to move forward with a biopsy based on the results of the ultrasound. Ultrasounds are incredibly helpful in helping the doctor to determine the size, shape and make-up of the nodules. 

There are usually two scenarios that follow the ultrasound. First, the ultrasound indicates if the thyroid nodule is filled with liquid or is cystic in nature. If it is a purely cystic nodule, it means that it does not have a solid component and the chances of it being benign are fortunately very high. 

In such cases when the thyroid nodule is purely cystic or fluid-filled, the ultrasound will show that the nodule is completely black. This is a good sign that the nodule is not malignant and does not pose a severe threat to the patient’s life. On the other hand, if the ultrasound reveals the nodule is marked with little white spots, it could signal the presence of thyroid cancer. 

When this happens, the  thyroid specialist in Singapore will usually proceed with the biopsy. Using a fine-needle aspiration, the doctor will carefully insert a needle into the nodule in order to collect some thyroid cells for laboratory analysis. It is a minimal procedure with no downtime whatsoever and can be completed within half an hour. 


Treatment Options For Thyroid Nodules

Thyroid treatment for thyroid nodules include invasive procedures like thyroid surgery which is usually required to remove suspicious nodules, medical prescriptions and close monitoring. Listed below are more details about the various treatment methods which are usually determined based on the severity of the thyroid nodule. 

1.  Surgery

Generally, Invasive methods like thyroid surgery are only recommended if the patient’s thyroid nodule turns out to be cancerous. In such cases, the thyroid specialist in Singapore will surgically remove about half of the thyroid gland. However, the doctor will determine how much of the thyroid gland to remove as it is dependent on the spread of the cancer. This treatment method is also recommended if the thyroid nodule presses against your windpipe or oesophagus making essential activities like breathing or swallowing difficult. 

2. Hormone Therapy

If the thyroid nodule is producing thyroid hormones, this could cause an overproduction of thyroid hormones which are naturally generated by the thyroid gland. In such cases, the doctor recommends treating this issue with two distinct types of medication. The first is anti-thyroid medication like methimazole which makes it difficult for the body to produce hormones and helps to reduce the effects of the overactive thyroid nodule. 

Another option is when the attending doctor prescribes radioactive iodine which is either ingested orally as a tablet or as a liquid. When absorbed by the thyroid cells, the radioactive iodine helps to decrease the size of the thyroid nodule. When the thyroid nodule becomes smaller, it reduces the overproduction of thyroid hormones. 

3. Close Monitoring

Another common alternative is for the doctor to closely monitor the growth of the thyroid nodule. If it does not increase in size and is non-cancerous, then the thyroid specialist in Singapore would recommend close monitoring instead. The patient may be required to come down for regular physical examinations by a thyroid specialist in Singapore and frequent biopsy testing to ensure that the thyroid nodule does not become malignant. 

Schedule A Consultation With Our ENT Doctors at Amandela ENT Head and Neck Centre

Make an appointment with our doctors at Amandela ENT Head and Neck Centre if you need treatment for thyroid-related issues or if you suspect that a thyroid nodule has developed in your neck. Our doctors are determined to deliver patient-centric care so that you receive the right help to ease any potential compressive symptoms and ensure that the thyroid nodule is not malignant. Click here to arrange a consultation session with our team of ENT doctors at Amandela ENT Head and Neck centre.