Don't Worry About Cysts, Polyps, and Small Nodules on Your Physical Exam Report
Friends often come to me who, upon finding cysts, polyps, or nodules as small as a few millimeters on a physical exam, become deeply worried as if disaster had struck. This is quite unnecessary; most cysts, polyps, and nodules are benign and have no potential for malignant transformation. If the possibility of malignancy is significant, the doctor will point it out.
The human body is not perfect, so it is normal to develop some small cysts, polyps, or nodules. I have had cysts and polyps in my own body for years — ganglion cysts, renal cysts, and multiple gallbladder polyps. As far as I know, the possibility of malignant transformation for all three is negligible. So besides regular physical exams to observe changes, I have done nothing about them.
But some friends, after finding a few-millimeter cyst in the kidney or liver, cannot eat or sleep in peace and want to treat the cyst by all means. In fact, besides surgery, there is no good way to treat these small internal cysts, and surgery is too costly; no doctor will casually recommend that patients surgically remove cysts that do not affect quality of life. The cause of most cysts is unclear, and taking medicine indiscriminately can easily damage the liver and kidneys. As long as they are not causing serious discomfort, such cysts can be left alone; regular physical exams to observe changes are sufficient.
As for ganglion cysts, they are mostly caused by strain. Women who hold babies for long periods and people who use computer keyboards for long hours are prone to ganglion cysts. When symptoms from a ganglion cyst are severe, it can be surgically removed or treated with an acupotomy. Some experienced TCM doctors can use a slightly thick silver needle to puncture the cyst wall, then squeeze out the cyst fluid. Mild cases can often be cured without recurrence. After a ganglion cyst heals, the patient needs a period of rest to avoid overusing the hands.
When I was very young, I developed ganglion cysts from overusing both wrists. At first, a local elderly doctor directly ruptured it by pressing, but it recurred soon after. The main reason was that I could not reduce my hand use, so the ganglion cysts kept recurring. Later I just stopped bothering about it; for someone like me who needs to type large amounts of text on a keyboard every day, this is essentially an occupational disease. Unless I stop working, it is hard to avoid ganglion cysts as long as I work, so I have grown accustomed to their presence. Some women, during the period of caring for children, develop tenosynovitis or ganglion cysts from frequently holding babies, causing wrist pain. Generally, soaking in hot water or using a hairdryer, trying to hold the baby less, and self-recovery suffice; no need to worry about it.
Only a very small number of cysts require prevention of malignant transformation — for example, patients with ovarian cysts and a family history of ovarian or breast cancer need regular follow-up or prophylactic removal.
Nodules appearing on physical exam reports are also very common; among my friends and relatives over forty, many have nodules on their exam reports. But most nodules are nothing to worry about; they can be followed regularly to observe changes. If a nodule keeps growing, surgical removal should be considered. Most surgeries to remove small nodules are minimally invasive, with very little trauma; no hospitalization or only a few days of hospitalization is needed, so there is no need to fear. If a nodule has not changed for years, there is no need to pay too much attention to it. There are many reasons for nodules in the body, and the cause is difficult to determine; so if these nodules cause no obvious discomfort and do not change over the long term, learn to coexist with them. Excessive anxiety will instead affect your life.