How do you diagnose thyroid cancer?

The doctor will ask about your medical history and will do a careful physical exam, with special attention to feeling your thyroid and checking for lumps in the neck. You may also be asked to have a blood test or special scans.

The best screening test for a thyroid nodule is a good examination of the neck by your primary care physician.  Most internists, family doctors and obstetricians/gynecologists perform examination of the neck during routine checkups, and nodules can often be found in this way.

Sometimes people will notice a lump in their neck when they look at themselves in the mirror, or something will be noted by a spouse or close friend.  This may be nothing, but it usually should be checked further – particularly if it is asymmetrical (not even on both sides).  The thyroid and most thyroid nodules move easily when you swallow, so if a lump in the neck moves, it most likely involves the thyroid gland.  If there is a lump that does not move, this would be concerning and should be evaluated by a physician capable of performing a good neck exam.  The combination of a lump and a change in the voice is very concerning and should be evaluated by a specialist right away.

If a lump is thought to involve the thyroid gland, it should be evaluated by a specialist soon, and a needle biopsy done on the nodule.  This is an outpatient procedure typically done in the office and causes about the same amount of discomfort as drawing blood from the arm.  The doctor removes a small sample of tumor tissue, which is examined under a microscope by a pathologist to determine if cancer cells are present.

If nodules are detected early, even if they are cancer, there is a very good chance for a cure.  The larger the nodule, the less likely it is that the entire tumor can be removed before it spreads.