Most Neck Bumps Are Benign— But It’s Important to Check

by Victoria Lai, MD, MS, FACS, Endocrine Surgery
September 1, 2020

Of the prevalent diseases affecting patients today, we know that cancer is the deadliest. But thyroid cancer is a type of cancer that can be treated quite successfully—and it has a very high survival rate with treatment, as high as 97%.

Let’s look at some common questions concerning cancer of the thyroid gland:

What is thyroid cancer?

The thyroid is a butterfly-shaped gland in your neck. It’s responsible for many vital functions in your body, including regulating the body’s metabolic rate controlling heart, muscle and digestive function, brain development and bone maintenance. Thyroid cancer is related to abnormal cells in the thyroid gland that come from thyroid nodules.

Thyroid cancer affects more than 50,000 Americans each year—particularly women—and its incidence has risen over the last decade. It’s currently the fifth most common cancer in women (the second most common for women ages 30–39), and this year it is expected to be the most commonly diagnosed cancer in patients ages 15–29.

Who has the highest risk?

Although the causes of this disease are largely unknown, people with certain hereditary syndromes are at higher risk. Also, people who’ve had radiation therapy or treatment to the head and neck region—say, to treat lymphoma—may also be at risk to develop this illness. But that’s a very small percentage of the affected population.

What are the typical symptoms?

Thyroid cancer can affect men and women of all ages and the vast majority of people have no symptoms. The most common symptom, if someone has a symptom at all, is feeling a thyroid nodule—a mass inside the thyroid gland—that’s picked up coincidentally while the patient is undergoing tests for something else. At other times, people happen to feel a bump in their neck, which calls for imaging or a fine needle aspiration known as a biopsy.

Painless neck bumps may be benign or they may represent cancer. So it’s important to have them evaluated to help determine what they may be, and if a biopsy is needed, says Dr. Victoria Lai. https://bit.ly/2EOkg5F via @MedStarWHC.

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How is it diagnosed?

Thyroid cancer is usually diagnosed after a needle biopsy—a fine needle aspiration—is performed on a thyroid nodule. The nodule may have been found on an ultrasound or an imaging study, done either because a patient or their provider noticed swelling in the neck area, or sometimes because the imaging study was done for another reason and a thyroid nodule happened to be found.

Currently, we don’t advise routine thyroid screenings, as we do for breast or colon cancer. However, for patients who know their family has a specific predisposition such as the MEN2A genetic disorder, we may suggest a screening. Otherwise, it’s not generally recommended.

What is the typical treatment?

There are many different types of thyroid cancer, and we consider each case individually. For the most common types, the first line of treatment is surgery to remove the thyroid gland. In other cases, perhaps only half the gland is removed. We may choose to remove lymph nodes as well. If someone undergoes removal of their entire thyroid gland, supplemental thyroid hormone is an important part of the treatment arm. We may recommend something called radioactive iodine for selected patients who are at higher risk of having the thyroid cancer come back.

What are the success rate and long-term effects after surgery?

Patients tend to do very well post-treatment, although everyone’s recovery experience is a little different. With a survival rate of 95%–97%, it has essentially no impact on someone’s life span for the vast majority of patients.

In most cases, there are no long-term effects from the surgery. If the entire thyroid is removed, you will take thyroid hormone for the rest of your life. We work closely with endocrinologists to adjust dosage levels to suit your physiology.

Are there any potential complications?

Complications from surgery are low but not zero. We consider all risks before surgery, work hard to reduce those risks, and monitor for them after surgery. There could be a risk of infection, bleeding, or damage to the nerves that control voice and breathing, which occurs in 1%–2% of cases. There’s also a risk to the parathyroid glands, which control calcium metabolism, and the likelihood of needing long-term calcium supplementation is about 5%.

In a small percentage of cases with more aggressive sub-types of the illness, treatment and recovery may take a while longer.

At the Hospital Center, we make it our mission to follow up with our patients and monitor them long-term for any possible recurrence. This is done in concert with their endocrinologists, and we use a combination of physical exams, laboratory studies, and imaging studies.

What is the recovery process?

A typical recovery process depends in part on how extensive the surgery is. For some, it may be an outpatient surgery; for others, an overnight stay. In the U.S., the most common duration is a 23-hour observation period, after which you are released.

Most people find that the worst of any postoperative discomfort occurs in the first 24 hours after surgery, and improves after that. From the beginning, we ask patients to walk around if they are steady on their feet and to resume normal food shortly after surgery. For most people, most of the effects of general anesthesia wear off within the first two weeks.

The surgery’s high success rate, and patients’ typical quick recuperation, have given hope to many, including well-known figures like actress Sofia Vergara and musician Rod Stewart.

If you notice a painless bump in your neck, reach out to us. And if you are diagnosed with thyroid cancer, our team is here to diagnose, treat, and help you through a speedy recovery.

LISTEN: Dr. Lai discusses thyroid cancer in the Medical Intel podcast.

Feeling a neck bump?

Consult with one of our specialists.

Call 202-644-9526 or  Request an Appointment

Category: Healthy Living, Medical Intel     Tags: endocrine surgerythyroid cancer