Nuclear power plant worker

[tayerik]

i have a thyroid nodule that has been stable since 2009. last year I took on a new role at my work which has me going into the face of the nuclear reactor to measure feeder pipes. Radiation levels are high but I wear all protective gear. Since I have started this new job, my thyroid has grown. Should I be alarmed by this? I go for a fna in April but I am wondering if my job would have an affect on my nodule.

[tayerik]

Thanks for your comments. I do wear a badge along with other devices measuring the amount I am receiving when doing these jobs. I measure the fuel channel feeder pipes. I have received over 628 mrem during 3 times for my extremities and whole body is over 1000 since being at the reactor face. We do have limits that we abide by but I just found it strange how this nodule stayed stable for years, even shrinking, then once I started this job it has grown. there's also family history involving thyroid cancer. My biopsy isn't until may now.

[898_1]

Nuclear power plant technologies are associated with external exposure to alpha (plutonium, americium) and gamma radiation (during normal operation and fuel rod change) and internal exposure to alpha, beta (I-131) and gamma emitting chemical elements released during emergency events such as pipe leak, reactor relief valve operations and partial core meltdowns with breach of containment vessels. The internal exposure is far more dangerous than external.
Here is what specifically can damage thyroid:
Injection or inhalation of I-131 isotope
High dose: damage of the tissue similar to thermal or chemical burn
Medium dose: inflammatory reaction, possible autoimmune thyroiditis, nodules and/or cancer with short latent periods
Small dose accumulated during long time (years) from drinking milk or water: mutations, formation of the nodules and/or cancer with long latent periods.
Adult liquidators working in Chernobyl did not have thyroid cancer but many developed hypothyroidism, due to the overall high EXTERNAL doses of radiation (their internal exposure was of much lesser concern than external exposure)
High level external beam radiation to the neck causes hypothyroidism    

[Mark Lupo, M.D.]

Adult exposure is less connected with nodules/cancer than childhood exposure (however still a plausible source for concern), but can be associated with hypothyroidism which may promote nodule/goiter growth.  Do you wear a radiation badge under the protective gear to measure exposure?

[Gibbon1]

Only thing I can say is, having taken a one semester class on nuclear engineering and being somewhat well read.  All one can say is it unlikely your new work has anything to do with what's going on in your thyroid.

From what I read, standard care would be an ultra sound exam to see what is happening, how much the nodule has grown, or if there are new ones.  Sometime nodule grow because the solid part grows. Sometimes you can have a hemorrhage into a nodule (sometimes painful) causing it get largers.

If the nodule gets bigger than a repeat FNA would be usual. If that shows something that looks 'cancery' or if the nodule is big enough to cause compression or just growing fast, then surgery. A lobectomy, if benign, thyroidectomy if cancer.

Note: Thyroid cancer usually fully cured via surgery and very low mortality rates.