Radio Freqency Ablation (RFA): a cutting edge non-surgical treatment of thyrod nodules

We are proud to be the first center in San Diego to offer ultrasound-guided Radiofrequency Ablation (RFA) of thyroid nodules as an alternative to surgery for symptomatic benign thyroid nodules!

 

Our brains, our hearts, our digestive and metabolic systems function normally with the help of one small gland: the thyroid gland. 

Nodules on the thyroid gland, however common, can interfere with the proper functioning of the thyroid gland; Benign nodules can cause swallowing difficulty, excessive hormone production, and pressure symptoms within the neck. 

 

What are thyroid nodules and who is at risk?
A thyroid nodule is a growth of thyroid tissue or a fluid-filled cyst that forms a lump in the thyroid gland. Thyroid nodules are fairly common.  In fact, about 75% of all individuals will have a nodule on their thyroid gland during their lifetime and may not even know it.

The problems occur when thyroid nodules grow to a size that interferes with breathing and swallowing or affects the physical aspects of a patient’s appearance that they find unappealing.  

Traditionally, thyroid surgery or radioactive iodine would have been the only treatment options for problematic thyroid nodules, depending on what the problem is: until now.

Thyroid radiofrequency ablation (RFA) is a novel treatment that is highly successful in reducing the size of thyroid nodules.

Thyroid Radiofrequency Ablation: An Advanced, Non-Surgical Treatment of Thyroid Nodules

A common practice in other countries, radiofrequency ablation (RFA) is now available at Diabetes and Endocrine Specialists in La Jolla. This non-surgical alternative shrinks the nodules without compromising thyroid function and helps avoid surgery.

 

What is Radiofrequency Ablation?
Radiofrequency ablation is a medical procedure where dysfunctional tissue is being ablated using heat generated from alternating current, passed from the generator to the tissue via an electrode. Performed under local anesthesia, radiofrequency ablation is relatively painless and does not require general anesthesia.

 

Dr. Schneider will use guided ultrasound to insert the probe into the thyroid nodule. Through selective heating of the probe tip, the nodule is cauterized. The cauterized tissue is then broken down by the body over the course of months.

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How dose Radiofrequency Ablation work?
Radiofrequency ablation (RFA) uses a small needle (left) that creates very precise radio waves that heat up and destroy a small area of tissue (right). RFA is frequently used to destroy cancer cells in the liver, lung, kidney, breast, and bone, as well as to kill nerve cells that cause chronic pain. Radiofrequency ablation of thyroid tissue has been performed worldwide since 2002 and is best used in cases of symptomatic benign thyroid nodules.

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How effective is Thyroid RFA for large benign solid thyroid nodules?

Thyroid RFA is considered successful when the nodule shrinks by >50%. On average, thyroid RFA shrinks solid thyroid nodules by 80%, with a range of 65-94%, so the results are usually really good (see photo below: left before RFA, right 6 months after RFA).

Sometimes, the nodules disappear completely. Almost all patients have great symptomatic improvement, with complete or almost complete resolution of their compressive symptoms and/or cosmetic concerns. Significantly more than half the patients (around 80-90%) will do well with a single RFA session. A minority of patients with very large nodules may require more than one RFA session, to achieve the best outcomes and prevent future re-growth.

For hyperfunctioning thyroid nodules, the volume reduction is similar, and hyperthyroidism eventually resolves in 50-80% of the patients.

It is important to note that thyroid RFA does not lead to these results immediately. There is significant tumor reduction within a month after the treatment, but the nodules continue to gradually shrink for up to a year after the RFA procedure.

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How is RFA performed?
The procedure is performed in our La Jolla office. Patients are awake during the entire time and are able to breath and speak. After the neck region is numbed with a local anesthesia injection, Dr. Schneider will insert, under continuous ultrasound guidance, a small needle into the thyroid nodule and move the needle within the nodule (moving shot technique) until the entire nodule is “ablated”. The duration of the RFA procedure is about 15 to 30 minutes, depending on the size of the nodule. After a brief observation time, patients can resume their normal activities the same day of their procedure. No hospitalization and no general anesthesia are needed.
 

What are advantages and risks of the RFA procedure?
RFA is a very gentle, minimally invasive procedure and does not require general anesthesia or a hospital stay. There is no neck scar and recovery time is very short. RFA spares the healthy thyroid tissue: lifelong thyroid hormone dependency, as oftentimes seen after neck surgery, is usually not necessary.

RFA has a very low complication rate similar to a fine needle aspiration biopsy. Relevant surgical risks, such as damage to the voice box nerve or parathyroid glands, are virtually nonexistent.

What is the cost for Thyroid RFA?

Our focus is making thyroid RFA safe, effective, accessible, and affordable. We do this by eliminating or minimizing the costs associated with a hospital, surgical center, and anesthesia.

At Diabetes and Endocrine Specialists, the RFA procedure is performed in the office with local anesthesia only. The cost of thyroid RFA at DES without insurance coverage is between $3,500 and $4,500. However, we will work with your insurance company to determine coverage, benefits, and out-of-pocket cost. Make sure to ask us for a 2nd opinion before committing to surgery or RFA with another physician.

For all other questions, please schedule a consultation with Dr. Schneider. We are happy to assist with nearby (walking distance) accomodations if you are travelling from outside of San Diego.

"Diabetes  and  Endocrine  Specialists"  is  the  first  center  in  San  Diego  to  offer  this   amazing treatment to its patients.
 

Attached, please find our patient RFA brochure: