Brief Answer:
Cancer is less likely

Detailed Answer:
Hi XXXXXXX
Thanks for writing in to us.

Glad to hear from you, I am doing well and hope you are good.

I read through your report concerning ultrasound scan of thyroid gland.

My opinion is that the chances that there is a cancer are small if the swelling is growing over years.

A cancer is suspected usually when there is a family history of thyroid or other endocrine cancers, age of the patient is younger than 30 or older than 60, or have a history of radiation exposure to the head and neck area.

Also a nodule that is large and hard or causes pain or discomfort is more worrisome in terms of cancer.

You do not have any neck lymph nodes or calcification in thyroid nodules and the largest nodule in the left lobe is showing small areas of cystic degeneration.

I recommend that you get a FNAC (needle test) and if that is not confirmatory then a biopsy might help to confirm.

It is assured that the chances of cancer are very less but you must get more tests done.

Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Cancer chances are less than 5 percent

Detailed Answer:
Hi XXXXXXX
Thanks for writing back with an update.

Telling a patient that a thyroid nodule is cancer is a delicate situation.
I have experience in working with cancer patients for more than 5 years and have seen many with problems similar to you. In thyroid nodules about 85 percent are non malignant. I will be happiest if your nodule is confirmed to be benign.

There are certain criteria which make a nodule more likely to be cancer, such as
young
male
solitary
cold on thyroid scan
past history of radiotherapy

Of the above the only condition that fits you is that you are a male. At your age, you cannot be called young, there are more than one nodules so not solitary. The thyroid scan is not done and I think you never received any radiation treatment before.

There is further criteria on imaging which points to malignancy, such as
hypoechoic solid (your largest nodule is heterogeneous with cystic change)
intranodular blood flow (the blood flow in the larger nodule is described as mildly increased vascularity in your case)
large size: the cut off is often taken as 10mm (this is a concern because size is 23 mm)
presence of microcalcifications (you do not have this)

From the above features we see that you satisfy 1 out of 4 (size) and research shows that size is not the main predictor for malignancy. You also do not have any lymph node which is a feature seen in mostly in a malignancy

Another point to be discussed after reviewing literature is as below.

....It is generally believed that thyroid nodules with large cystic components are usually benign nodules that have undergone cystic degeneration or haemorrhage. However, papillary carcinoma occasionally demonstrates a cystic component and may mimic a benign nodule, though the presence of punctate calcification within the solid component helps in its identification....

The fact that you do not have calcification makes me think that a papillary cancer is less likely even if you have a cystic nodule.

In conclusion, getting checked at a cancer hospital is most important for you. They will do a small needle test called FNAC. The chance of a cancer is less than 5 percent. Even if it is a cancer, it is completely treatable and I have seen many thyroid cancer patients who have survived for more than 20 years after cancer was diagnosed.

It will also help if you get a chest X ray and ultrasound scan of abdomen done as a routine check

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Welcome and happy to help you always

Detailed Answer:
Hi Mr XXXXXXX
Thanks for the good news.

I am happy to know that if is confirmed benign by lab reports.

You are most welcome. If Almighty wishes we can meet someday.

Your report will help me guide other patients and thanks for sharing it.

If you have any heatlh query and want it to be answered by me then please direct it to me as you have done earlier.

My name is Dr.Vivek Chail and I am a doctor - Radiologist.
Will be glad to help you in future as required by you.

Wish you and your family good health.

Regards,
Dr.Vivek

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