Thyroid nodules are common. Here’s what to do after you check your neck.

Written by: Julie Cole Miller
Media contact: Yvonne Taunton

Thyroid nodules are common, and while simply having irregular thyroid growths does not mean a person has cancer, everyone should check their neck on occasion and let their medical team know of any concerns. Physicians at the University of Alabama at Birmingham’s O’Neal Comprehensive Cancer Center are advancing the field of thyroid care with cutting-edge, patient-specific procedures and collaborative research investigations.

The thyroid, a small, butterfly-shaped gland at the base of the front of the neck, is part of the endocrine system. Small lumps or bumps, called nodules, are often present — and may or may not be anything to worry about.

“Thyroid nodules are present in anywhere between one-third and one-half of the population,” said Brenessa Lindeman, M.D., a surgeon at the O’Neal Comprehensive Cancer Center and associate professor in the UAB Marnix E. Heersink School of Medicine’s Department of Surgery. “Nearly 90 percent of those are benign.”

The thyroid gland produces hormones that regulate metabolism and impact other essential functions such as heart rate, blood pressure and body temperature. Thyroid cancer occurs when cells grow out of control; these cancerous cells may spread to other areas of the body. Patients who note abnormal growths or feel pressure inside the neck should contact their physician, who will check thyroid function and evaluate next steps.

If a biopsy reveals a cancerous tumor, the multidisciplinary care team at the O’Neal Comprehensive Cancer Center will help a patient determine the best path forward, which could include surgery, radioactive iodine, radiation and hormone therapy. Treatment plans depend on the stage and type of cancer detected.

Researchers from the UAB Department of Radiology are working with researchers in the Department of Surgery to determine new ways of targeting thyroid cancer that has spread to other areas of the body.

“Preliminary studies show that certain markers may be over-expressed in radioiodine refractory thyroid cancer,” said Suzanne E. Lapi, Ph.D., co-leader of the Experimental Therapeutics Program at the O’Neal Comprehensive Cancer Center. “This may represent a new targeting strategy for both imaging and therapy with novel radiopharmaceuticals.” 

Working together with Renata Jaskula-Sztul, Ph.D., associate professor in the UAB Department of Surgery, the team aims to develop methods of patient-specific treatment, including highly targeted delivery of localized radiation doses to cancer sites. 

For nodules that are benign but bothersome — maybe they are producing too much hormone, maybe they are unsightly, or they create an irritating pressure — UAB’s physicians may recommend a new non-invasive ultrasound-guided procedure that shrinks the nodule. Radiofrequency ablation is an alternative to surgery for nodules that leaves no scar and requires little down time.

“We see patients who are back to work the next day,” Lindeman said.

Though thyroid cancer occurs in both women and men, women are three times more likely to develop it. However, when thyroid cancer is detected in men, it tends to be more advanced. In 2022, the American Cancer Society estimates that there will be more than 43,000 new cases of thyroid cancer. Of the more than 2,000 deaths estimated, nearly half of those are men.

Increased detection with more sensitive diagnostic procedures has led to an uptick in new cases over time.

“The incidence of thyroid cancer is increasing, but it is easily treatable,” Lindeman said. “It is good to catch this early, and when we do, we see amazing survival rates.”