A thyroid nodule is a small firm lump or growth of abnormal tissue in the thyroid gland. The condition likely affects between 50 and 65% of the population, but most are benign and go undetected because they don’t cause symptoms. For those that do, a new nonsurgical procedure – called radiofrequency ablation or RFA – is now offered through the Division of Head and Neck Surgery at Washington University in St. Louis.
RFA is a medical procedure that uses radio waves to heat and destroy abnormal cells or tissues. Delivered through a needle electrode, the procedure is currently used to treat a variety of health conditions, including pain mangement, chronic venous insufficiency, or to shrink or destroy tumors and other growths.
The procedure is offered by head and neck surgeon and Assistant Professor of Otolaryngology Alex Harbison, MD. Harbison works in tandem with endocrinologist Sina Jasim, MD, to ensure optimal levels of patient evaluation, treatment, and follow-up care.
To date, the group has conducted ablations on a handful of patients, with several more cases on the schedule. According to Harbison, they will likely perform around 60 procedures each year on patients with benign nodules large enough to cause cosmetic concerns or some discomfort – typically a sensation of pressure – when swallowing or lying down.
The procedure itself is quick, lasting from 10 to 30 minutes and can be completed under local or general anesthetic. Using ultrasound imaging as a guide, a fine needle electrode is inserted into the tumor body. Radio frequency waves agitate ions in the surrounding tissues, causing sufficient heat to destroy tissues within a few millimeters of the electrode tip. Depending on the size of the nodule, the electrode may be re-positioned a number of times to adequately address the full volume of the tumor.
Significant shrinkage (30-50%) of the nodule is evident within several weeks of the procedure, with most patients seeing continued reduction in tumor bulk for several months. Side effects of the procedure are rare, but can include pain, managed with over-the-counter analgesics, and temporary changes to the voice.
Although the group currently only treats benign nodules with RFA, they are preparing an application that would allow the procedure for treatment of indeterminate or malignant nodules smaller than 2 cm in size.
The treatment is gaining acceptance as a safe, minimally invasive procedure with good therapeutic response and without the risks and complications associated with surgery.
To learn more about RFA, please contact Alex Harbison, MD.