Thyroid Tumors in Males
Thyroid tumors in Males
Specializing in Thyroid Cancer & Thyroid Surgery
My best guesstimate is that at least 90% of our surgical patients are females, that is to say, I operate on about 10 times as many women as men. We perform thyroid surgery for three basic and common reasons. The first is the presence of thyroid nodules or tumors for which we have some concern that cancer may be present. The second common reason for thyroidectomy is the diagnosis of Graves’ Disease, the most common form of hyperthyroidism. And third, we remove thyroid glands, that because of their size, are putting pressure on the windpipe or the throat, thus causing distressful symptoms of compression on those structures. This is often simply a benign tumor that because of neglect on the patient’s part, has been allowed to grow to an unacceptable large size. Sometimes these tumors are malignant, but most often they are not. Very frequently thyroid glands that are putting pressure on the throat or windpipe are the result of years of uncontrolled Hashimoto’s Thyroiditis, and the development of scar tissue that, as time goes by, continues to shrink down around the vital structures of the neck. But what all these surgical indications for thyroidectomy have in common is that they are far more common in females than in males. And this brings us to a discussion about thyroid tumors in males.
Far and away, a newly diagnosed thyroid tumor in a man has a much higher statistical possibility of being cancerous than the same tumor in a female. Please don’t mistake this statement to imply that if you are male with a thyroid tumor, then it is a cancer. That is not what I am saying. The point I’m trying to get across is that I am always suspicious when a man comes to my office with a thyroid nodule or tumor, that there is a significant possibility that his tumor is cancerous. No, they all are not cancer, perhaps even the majority are not malignant, but the risk of cancer is much higher in males, and I evaluate and treat them accordingly.
I am frequently sent medical histories from patients living all over the country and elsewhere on the planet and I’m always fascinated to read about men who presented with a thyroid tumor and their doctor told them ‘not to worry about it’. I worry about all thyroid tumors but especially those found in males. Recently, a gentleman in Mexico sent us his medical records (we are fluent in Spanish) and he was “observed” for almost a year before his cancerous thyroid tumor was removed. After “watching it” for months, they did a needle biopsy that came back benign and then they operated on him anyway. (This underscores another controversial topic in the management of thyroid tumors. If you’re going to operate on a patient whose needle biopsy is benign, and you obviously will operate on a patient whose needle biopsy is malignant, then what is the purpose of doing a needle biopsy in the first place?) But I am digressing from the point of this essay, and that is that we must be especially concerned and vigilant when we evaluate male patients with thyroid tumors. That doesn’t mean they are all cancerous, but you should be pretty darn suspicious until the facts prove otherwise.