NCCN Guidelines for Patients
Thyroid Cancer, Version 1.2017
Once you know about thyroid cancer, it is helpful
to know about thyroid nodules. Nodules are small,
often round areas of abnormal tissue. Most nodules
are not cancer (benign) but some may be cancer
(malignant). People can have one thyroid nodule or
more than one at a time. The nodules can vary in
size. If the nodules are small, they usually can’t be
felt or seen on exam.
Most thyroid nodules do not cause any symptoms. If
the nodules are large, they may be found by a doctor
or you while examining your neck. Many nodules
are found while getting an examination for another
reason such as a CT (
or carotid ultrasound (heart ultrasound). Sometimes
an abnormal value is found while doing a routine
blood test. If any thyroid-related hormones or other
values are out of range, your doctor will order
more blood tests or imaging tests (for example, an
ultrasound) to further check your health.
Anything that increases your chances of having
cancer is called a risk factor. Certain risk factors can
be seen with this cancer type. Risk factors can be
activities that people do, things in the environment, or
traits passed from parents to children through genes.
Genes are coded instructions for your cells.
A process called mutation is when something
goes wrong in the genetic code. Mutations can be
passed on from a parent and present before you are
born (inherited), or they can be caused by genetic
damage (acquired) that occurs later in life. People
with inherited genetic mutations have a higher risk
for certain cancers, but that doesn’t mean they will
definitely develop cancer. Only a small number of
cancers are a result of inherited mutations.
About 1 in 100 people have a lifetime risk for
developing thyroid cancer in the United States.
Doctors are not completely sure what causes thyroid
cancer, but are aware of certain risk factors. Ask your
doctor or nurse to explain the possible risk factors for
See Guide 1.
Guide 1. Risk Factors
• History of contact with radiation in the head and
• History of elevated TSH
• Family history of thyroid cancer
• Personal or family history of a syndrome related to
developing thyroid cancer
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