Thyroid Nodule Clinic
Finding out you have a thyroid nodule can be stressful. You may wonder if it is cancer or whether you need more tests.
The Thyroid Nodule Clinic at UT MD Anderson helps answer those questions. Our team specializes in evaluating and treating thyroid nodules. We use ultrasound, biopsy, molecular testing and other advanced tests to learn more about your nodule and recommend the right next steps.
What are thyroid nodules?
The thyroid is a small, butterfly-shaped gland in the front of your neck. It makes hormones that help control how your body uses energy.
A thyroid nodule is a lump that forms in the gland. Most thyroid nodules are not thyroid cancer. Many do not need a biopsy or surgery. After a careful evaluation, many can be safely watched over time without treatment.
Even if a nodule is not cancer, it can cause symptoms that may need to be treated. These include:
- A visible lump in the neck
- Trouble swallowing
- Pressure in the neck
- Changes in thyroid hormone levels.
Thyroid nodules are very common. They are often found during an imaging test done for another reason. Other times, people notice a lump in their neck. Others learn they have a nodule during a routine exam.
Who should come to the Thyroid Nodule Clinic?
The Thyroid Nodule Clinic evaluates people with:
- A thyroid nodule
- Multiple thyroid nodules (multinodular goiter)
- A thyroid nodule that is growing
- Biopsy results that are unclear
- Thyroid cysts
- Questions about treatment options
- A need for a second opinion
Our team can help determine whether a nodule needs monitoring, additional testing, a biopsy or treatment.
What to expect on your first visit to the Thyroid Nodule Clinic
At your appointment, we will:
- Review your medical history and test results
- Examine your neck and thyroid
- Perform an ultrasound if needed
- Decide whether a biopsy is needed
- Discuss your results and next steps
- Create a follow-up or treatment plan
Patients leave their first visit with a clearer understanding of their thyroid nodule and what happens next.
What treatments does the Thyroid Nodule Clinic offer?
Many patients do not need treatment for their thyroid nodule. Instead, doctors recommend regular follow-up visits and ultrasound exams to watch for changes over time.
When treatment is needed, there are several options. One is surgery to remove part or all of the thyroid gland. Doctors recommend surgery for nodules based on their size, symptoms or biopsy results.
There are also minimally invasive procedures that can shrink some thyroid nodules without removing the thyroid gland. These procedures may help reduce symptoms without surgery. Our clinic offers advanced treatment options for selected patients, including:
- Radiofrequency ablation (RFA)
- Nanosecond pulsed field ablation (nsPFA)
If the nodule is making too much thyroid hormone, doctors may recommend medications to reduce hormone levels.
If testing shows thyroid cancer, your care will continue with specialists in UT MD Anderson’s Endocrine Center. Those experts provide treatment for all types of thyroid cancer.
Meet Our Team
The Thyroid Nodule Clinic brings together physicians from the Endocrine Center and surgeons with the Head and Neck Center. These providers include oncologic endocrinologists, surgeons, radiologists and pathologists who specialize in thyroid disease. We work as a team to review your imaging, biopsy results and treatment options so you receive coordinated care.
Clinical Leadership
Steven P. Weitzman, M.D., FACE
Clinic Medical Director
Thyroid Nodule Clinic advanced practice providers
Care providers with the clinic also include advanced practice providers who specialize in conditions of the thyroid.
- Samina Asfandiyar, DNP, APRN
- Elizabeth "Beth" Schacht, DMSc, MSPAS, PA-C
- Malini Thomas, MSN, APRN, FNP-C
- Jennifer Tran, APRN, FNP
Thyroid nodules: 8 questions, answered
The thyroid is a butterfly-shaped gland in your lower neck that produces hormones which control your metabolism, heart rate and body temperature.
Sometimes, a nodule forms in the thyroid gland. You may be able to be feel it or see it as a lump in your neck. However, many nodules are found during imaging tests done for other reasons. While discovering a lump can be concerning, thyroid nodules usually aren’t cancerous.
Oncologic endocrinologist Steven Weitzman, M.D., leads UT MD Anderson’s Thyroid Nodule Clinic. Here, he’ll answer eight common questions about thyroid nodules.
What is a thyroid nodule?
A thyroid nodule is a growth in your thyroid gland. These growths are very common, especially as people age.
Most nodules don't cause symptoms. They’re often found accidentally during imaging tests for another condition or during a routine physical exam.
When thyroid nodules do cause symptoms, you may notice hoarseness, difficulty swallowing, pressure in your neck, or a visible lump or enlargement of your thyroid gland.
What causes thyroid nodules?
While the exact cause of most thyroid nodules is not known, several factors increase your risk of developing thyroid nodules. These include:
- Increasing age: The risk of developing thyroid nodules steadily increases as you age. And they’re three times more common in people in their 60s compared to younger people.
- Being female
- Family history of thyroid disease
- Iodine deficiency
- Prior radiation exposure to the head or neck
- Certain inherited conditions, such as familial adenomatous polyposis (FAP), multiple endocrine neoplasia type 2 (MEN2), Carney complex, DICER1 syndrome, and PTEN hamartoma tumor syndromes, including Cowden syndrome
How are thyroid nodules diagnosed?
Once a nodule is found, it’s important to have it evaluated to determine if you need further testing or treatment.
An ultrasound is the best test for evaluating a thyroid nodule.
“Ultrasound is an excellent tool, but it is operator-dependent,” explains Weitzman. “In UT MD Anderson’s Thyroid Nodule Clinic, our dedicated head and neck ultrasonographers evaluate the thyroid and surrounding lymph nodes every day. They make sure we thoroughly examine the thyroid and the surrounding lymph nodes.”
Are thyroid nodules cancerous?
Only about 5% of thyroid nodules are cancerous.
“The goal is to identify which nodules need additional evaluation or treatment while avoiding unnecessary procedures for people who are unlikely to have cancer,” says Weitzman.
Specialists look at several features on ultrasound, including the nodule’s size, shape, appearance and borders. Based on these features, the nodule receives a risk score that helps determine whether a biopsy is needed.
No single feature alone determines whether a nodule is cancerous. “If a nodule scores above a certain threshold, we recommend a biopsy,” says Weitzman. “If it's below that threshold, we can often monitor it with follow-up imaging.”
Depending on the nodule, another ultrasound may be recommended within six to 12 months to check for any changes.
“The longer a nodule remains stable, the more confident we become that it's benign,” he says. “In some cases, we can eventually stop monitoring nodules that clearly don't pose a risk.”
Do nodules affect thyroid function?
The role of your thyroid gland is to produce thyroid hormone. If your body produces too much thyroid hormone, this is called hyperthyroidism. It can make you feel shaky, have a fast heartbeat, or experience unintentional weight loss. If you have too little thyroid hormone, it’s called hypothyroidism. This can make you feel tired, have a puffy face or gain weight.
Most people with thyroid nodules have normal thyroid hormone levels. Sometimes, a nodule can produce extra thyroid hormone on its own. These overactive thyroid nodules are called ‘hot nodules.’ The overactive nodules are usually not cancerous and often can be treated without a biopsy or surgery.
“Thyroid nodules that make too much thyroid hormone are almost never cancer,” says Weitzman. “Because of that, a needle biopsy is usually not needed. Sometimes, though, a biopsy may still be done if the nodule looks concerning on an ultrasound. If a biopsy is needed, doctors take extra care because an overactive nodule can release more thyroid hormone.”
Do thyroid nodules require treatment?
Most thyroid nodules never require surgery, and many don’t even need a biopsy.
If a biopsy is needed, doctors perform a fine needle aspiration to collect cells from the nodule. The procedure is guided by ultrasound and often takes less than 30 minutes.
If treatment is needed, there are a few options. Surgery may involve removing all or part of the thyroid gland, depending on the location and size of the nodule. If the thyroid is overactive, treatment may also include daily medicine or radioactive iodine to treat the overactive nodule.
What is active surveillance?
Active surveillance means watching the nodule closely with regular ultrasounds and follow-up visits instead of treating it right away.
Given their expertise in monitoring thyroid nodules, UT MD Anderson's specialists carefully select patients for whom this can be a safe and effective option.
“Some thyroid cancers start as small nodules and grow very slowly,” explains Weitzman. “For carefully selected patients, it can be safe to monitor the nodule rather than treat it right away. If the nodule shows signs of growth or change, treatment can still be effective when started later. Many small thyroid cancers never spread or affect how long a person lives.”
What makes UT MD Anderson’s Thyroid Nodule Clinic different?
UT MD Anderson’s Thyroid Nodule Clinic sees both new and current patients. Weitzman says the clinic is unique because the team takes a comprehensive approach to evaluating thyroid nodules and guides patients through their treatment and monitoring options.
“The right care is not always the most aggressive care. Sometimes, it’s best not to remove the nodule,” he says. “Our team is excellent at making this distinction.”
The multidisciplinary team of specialists works together to evaluate thyroid nodules and recommend the right treatment, if treatment is needed. Using the latest evidence and national guidelines, the goal is to identify nodules that need attention while helping patients avoid unnecessary procedures.
Request an appointment at UT MD Anderson online or by calling 1-877-632-6789.