Thyroid Conditions

The thyroid gland plays a crucial role in regulating metabolism and hormone production. When disorders develop, they can significantly affect overall health and quality of life.

Below is an overview of common thyroid conditions, their causes, symptoms, risk factors, and treatment options.

Overview

Thyroid nodules are abnormal lumps that form in the thyroid gland. They can be solid or fluid-filled and are often benign, but in some cases, they may be cancerous or cause hormonal imbalances.

Causes

  • Iodine deficiency
  • Overgrowth of normal thyroid tissue (thyroid adenoma)
  • Chronic inflammation of the thyroid (e.g. Hashimoto’s thyroiditis)
  • Thyroid cysts

Symptoms

  • Lump or swelling in the neck
  • Difficulty swallowing or breathing
  • Hoarseness
  • Hyperthyroid or hypothyroid symptoms (if the nodule affects hormone production)

Risk Factors

  • Family history of thyroid nodules or thyroid cancer
  • Radiation exposure, particularly to the head and neck
  • Female sex and increasing age

Treatment Options

  • Monitoring with ultrasound and fine-needle aspiration biopsy (FNAB)
  • Hormonal therapy in selected cases
  • Radiofrequency ablation in selected cases
  • Surgery if the nodule is large, symptomatic, or suspicious for malignancy
    • Isthmuectomy
    • Hemithyroidectomy
    • Total thyroidectomy

Overview

Thyroid cancer arises when cells in the thyroid gland grow abnormally. It is more common in women and has an excellent prognosis when detected early. In Australia, approximately 2,900 people are diagnosed with thyroid cancer each year.

Types

  • Papillary carcinoma – The most common type (about 80% of cases), slow-growing and highly treatable.
  • Follicular carcinoma – Accounts for around 10-15% of cases and has a slightly higher risk of spreading.
  • Medullary carcinoma – A rare form linked to genetic mutations.
  • Anaplastic carcinoma – A highly aggressive and rare form of thyroid cancer.

Causes

  • Genetic mutations
  • Radiation exposure
  • Iodine imbalance (deficiency or excess)

Symptoms

  • Asymptomatic, incidental finding on a scan for another reason
  • A painless lump in the neck
  • Hoarseness or voice changes
  • Difficulty swallowing
  • Enlarged lymph nodes

Risk Factors

  • Female sex
  • Family history of thyroid cancer
  • Previous radiation exposure

Treatment Options

  • Active surveillance for select patients
  • Surgery (isthmusectomy, hemithyroidectomy or total thyroidectomy)
  • After surgery, some patients may also require:
    • Radioactive iodine therapy
    • Thyroid hormone replacement therapy
    • Targeted systemical therapy
    • External beam radiation or chemotherapy for rare aggressive cases

Overview

Hyperthyroidism occurs when the thyroid gland produces excessive thyroid hormones, leading to an increased metabolic rate. In Australia, the most common cause is Graves’ disease.

Causes

  • Graves’ disease – An autoimmune condition that causes overactivity of the thyroid.
  • Toxic nodules – Single or multiple thyroid nodules that produce excessive hormones.
  • Thyroiditis – Inflammation of the thyroid gland, sometimes caused by viral infections.

Symptoms

  • Weight loss despite normal or increased appetite
  • Rapid or irregular heartbeat
  • Heat intolerance and excessive sweating
  • Tremors and nervousness

Risk Factors

  • Family history of thyroid disorders
  • Female sex
  • Other autoimmune diseases

Treatment Options

  • Antithyroid medications (e.g. carbimazole, propylthiouracil)
  • Radioactive iodine therapy to shrink the thyroid gland
  • Surgery (thyroidectomy) in severe or resistant cases

Overview

A goitre is an abnormal enlargement of the thyroid gland. It may be diffuse (uniform enlargement) or multinodular (multiple nodules).

Causes

  • Iodine deficiency (historically common in Australia before iodised salt)
  • Graves’ disease (overactive thyroid)
  • Thyroid nodules or cysts

Symptoms

  • Visible swelling in the neck
  • Difficulty breathing or swallowing
  • Hoarseness

Risk Factors

  • Iodine deficiency
  • Family history of thyroid disorders
  • Female sex

Treatment Options

  • Monitoring for small, asymptomatic goitres
  • Medications to regulate thyroid function
  • Surgery for large, symptomatic, or suspicious goitres

Overview

Thyroid cysts are fluid-filled sacs that develop within the thyroid gland. They are usually benign but may require treatment if they grow or cause discomfort.

Causes

  • Degeneration of thyroid nodules
  • Congenital abnormalities
  • Infections or inflammation

Symptoms

  • Lump in the neck
  • Sudden swelling
  • Pressure symptoms (difficulty swallowing or breathing)

Risk Factors

  • Previous thyroid conditions
  • Age (more common in adults)

Treatment Options

  • Fine-needle aspiration to drain fluid
  • Ethanol ablation
  • Surgery if the cyst is recurrent, large, or suspicious

Conclusion

Dr Laura Wang specialises in diagnosing and treating thyroid disorders. She has significant expertise in the management of locally advanced thyroid cancers and is happy to see patients with recurrent disease and those seeking a second opinion.

If you have concerns about thyroid nodules, cancer, hyperthyroidism, goitre, or cysts, a thorough assessment and personalised treatment plan can help restore thyroid health and overall well-being. Book a consultation today for expert care tailored to your needs.

Dr Laura Wang is a highly-experienced, fellowship-trained Endocrine and Head & Neck surgeon consulting and operating across Sydney.

Dr Wang holds both a Master of Surgery (MS) Degree and a Doctorate of Philosophy (PhD) in thyroid cancer surgery and performs a high-volume of thyroid and parathyroid surgeries. She was the first surgeon to be dual-trained in both head and neck cancer surgery (for benign and cancerous conditions), as well as microvascular reconstructive surgery at Memorial Sloan Kettering Cancer Centre in New York, which is the oldest cancer hospital in the world (founded in 1884).

Get in touch to book an appointment. Urgent appointments available for cancer patients.

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