Your thyroid, a butterfly-shaped gland located in the base of your neck, plays a large role in your body, releasing hormones that control metabolism and a host of other tasks. Some people, particularly women, develop abnormal overgrowths of tissue in the thyroid called nodules.

Often, nodules are benign and do not produce symptoms. However, larger nodules can cause swelling, difficulty breathing and swallowing, coughing, and neck pain. Historically, treatment for these nodules involved surgery.

A minimally invasive procedure now available at Virtua called thyroid radiofrequency ablation (RFA) shrinks nodules while preserving gland function and reducing the need for lifelong hormone therapy. Virtua is one of the few health systems in the region to offer thyroid RFA.

“Patients may not necessarily want to have surgery for a benign nodule and don’t want the possibility of having to take thyroid medication,” said Virtua endocrinologist Jean Davidson, DO. “Through this new procedure, we are able to shrink the nodule and relieve cosmetic and compressive concerns without the risks of surgery and without the need for medication.

Targeted Treatment

It’s not entirely clear why thyroid nodules develop. Nodules are three times more common in women than men. Incidences of nodules increase with age.

Most times, nodules are discovered by a health care provider during a routine exam or imaging test for another condition. An ultrasound and fine needle biopsy will determine the size and location of the nodule and whether it is cancerous, while blood tests will examine hormone production.

Candidates for thyroid RFA will have a benign nodule (confirmed twice by needle biopsy) that is at least 3 centimeters in size.

The procedure is performed under local anesthesia, with the option of receiving additional medication to help you feel comfortable. A thin needle is inserted through the skin and guided using ultrasound to the nodule. The tip of the needle heats up, destroying (ablating) it from the inside. The normal thyroid tissue around the nodule is not affected.

The ablated nodule turns into scar tissue, shrinking over time.

“You start to see a reduction in size in about a month,” said Dr. Davidson. “Larger nodules, such as those that are 7 or 8 centimeters, may require more than one treatment to reach an optimal result.”

The procedure typically takes up to 60 minutes, and patients are able to resume normal activities later in the day. A small bandage covers the incision site.

“Most of the time, people do not require any pain medication following the procedure,” said Dr. Davidson.

Thyroid Function Maintained

Traditionally, surgery was the standard treatment for thyroid nodules. During a lobectomy—performed under general anesthesia at a hospital or outpatient center—half of the thyroid gland is removed.

While the remaining portion of the thyroid takes over and is able to meet the body’s needs, 15 to 20% of people will eventually need hormone supplementation.

“With RFA, we are targeting only the nodule, so more of the healthy thyroid remains,” said Dr. Davidson. “Studies have shown only 1% of patients later need to take hormone therapy.”

Radiofrequency ablation is widely used for the treatment of chronic pain, some cancers, uterine fibroids and irregular heart rhythms. While its use for benign thyroid nodules received U.S. Food and Drug Administration approval in 2018, it may not be covered by your medical insurance. The Virtua team will discuss with you out-of-pocket costs.

Get Started

Request a consultation online, or call 856-247-7220.