Cancer treatments have changed dramatically, thanks to new drugs, new technology, and new understandings of how those cancers work.
That's especially true of thyroid cancer, where doctors say less can be more.
It's an everyday occurrence - a scan for one medical condition turns up small lumps, or nodules, elsewhere.
One frequent spot is the thyroid, that butterfly-shaped gland in the neck that produces hormones affecting everything from breathing and heart rate, to your weight and moods.
Dr. Pankaj Sharda, director of the thyroid program at Fox Chase Cancer Center, says up to one in every two women, and one in every six men over the age of 50 will have them.
"A majority of these thyroid nodules are benign, about 70 to 80% of these nodules," says Dr. Sharda.
But they should always be evaluated.
"We not only look at the size of the nodule, but also the features, or characteristics of the nodule," he says.
Sometimes those characteristics call for a biopsy.
"Using needles finer than the needles used for a blood draw, we go into the nodule a few times to make sure we are getting good samples," he notes.
"It's a very low-risk procedure," and is generally done in the office, under local anesthesia.
Not long ago, a cancer diagnosis routinely meant removing the whole thyroid.
"Not everybody needs the whole thyroid to be taken out," says Dr. Sharda.
Patients with low-risk tumors up to four centimeters may only need half of the gland removed.
That reduces the risk of complications like serious bleeding or vocal cord damage.
And it can mean a lower dose or no thyroid medication, eliminating another concern.
"No matter how much thyroid medicine a physician gives them, they still continue to have symptoms of post-surgery fatigue, memory gaps, brain fog, etc.," he says.
Dr. Sharda says today's individualized approach also takes a team.
"We work in a very multidisciplinary fashion, with our head and neck surgery team, medical oncologist, nuclear medicine specialists, radiation oncologist and endocrinologist together," he explains.
Dr. Sharda says whether there's surgery for part or all of the thyroid, or no surgery at all, patients need life-long monitoring to make sure no other treatment is needed.