If you or someone you love is battling thyroid cancer, you likely have many questions about treatment options.
Some thyroid cancers can be cured, especially if they have not spread to distant parts of the body, but sometimes thyroid cancer can’t be cured, especially advanced-stage thyroid cancer.
As part of a thyroid cancer treatment plan, surgery to remove or destroy as much cancer as possible and keep it from growing, spreading, or returning for as long as possible has historically been the gold standard.
But suppose you don’t want to have thyroid surgery or aren’t a candidate for one reason or another? In this case, or if you have a benign thyroid tumor or thyroid nodules, there is a non-surgical treatment you might want to consider called Thyroid Radiofrequency Ablation (RFA).
While RFA is most typically used to treat benign thyroid nodules, it is also used for some patients with thyroid cancer.
In this article, we will tell you everything you need to know about Thyroid Radiofrequency Ablation (RFA) and answer some important questions to help you determine if this surgery-free thyroid treatment is an option you should discuss with your doctor.
WHAT IS THYROID RADIOFREQUENCY ABLATION?
In medical terms, ablation is the removal or destruction of a body part or tissue or its function.
In the case of thyroid ablation, radiofrequency ablation (RFA) is one of the most widely used thermal ablative techniques for treating symptomatic thyroid nodules.
RFA is a minimally invasive procedure that avoids the removal of the thyroid gland. Instead, it targets symptomatic nodules directly using ultrasound imaging. The goal of RFA is to reduce the size of thyroid nodules and hopefully restore thyroid function and improve quality of life.
During the procedure, a qualified surgeon with special training in RFA delivers targeted radio waves that disrupt the nodule’s cells, causing them to shrink as the body absorbs the ablated tissue. This is done via a needle-like probe inserted into the thyroid nodule. The tip of the needle heats up, destroying the nodule from the inside, causing it to shrink.
RFA is a non-surgical thyroid treatment approach that eliminates the need for general anesthesia, incision, or removal of the thyroid gland, making it an appealing nonsurgical option.
IS THYROID RADIOFREQUENCY ABLATION AN OPTION IF MY TUMOR IS MALIGNANT?
Malignant tumors are typically treated with thyroid surgery called a thyroidectomy. While a thyroidectomy is considered a safe surgery that has been practiced for many years, some people don’t want to go under the knife or aren’t the best candidate for surgery.
For this reason, in the past decade, there has been a shift from treating all thyroid cancer surgically to favoring less aggressive approaches like RFA, especially for low-risk thyroid cancer.
Before diving into why you might consider RFA and its benefits, let’s go over the different types of thyroid tumors and overgrowths and stages and grades of thyroid cancer. This is important because it plays a role in determining if you might be a candidate for RFA.
If you already have all the information you need regarding the type of tumor you have and its stage, feel free to skip ahead to the next section.
TYPES OF TUMORS OR OVERGROWTHS
There are two types of tumors or overgrowths; benign and malignant. Benign nodules are non-cancerous, whereas malignant nodules are cancerous and can spread to other body parts. In contrast, malignant nodules are cancerous and can spread to other body parts.
You might not need any treatment if you have a benign thyroid nodule. However, it is often advised to explore RFA to preserve your normal thyroid tissue.
But what about life-threatening malignant tumors? Many people wonder if they are a candidate for RFA if they have thyroid cancer.
First, it’s important to understand there are three main types of thyroid cancer and various stages of thyroid cancer.
TYPES OF THYROID CANCER
If a tumor or overgrowth is malignant (you have been diagnosed with thyroid cancer), your doctor will inform you of the type of thyroid cancer you have and its stage.
The three main types of thyroid cancer are:
- Differentiated (papillary, follicular and Hürthle cell)
- Medullary
- Anaplastic (an aggressive cancer)
STAGES OF THYROID CANCER
Thyroid cancer stages are determined by three categories: tumor, node and metastasis. This is called the TNM staging system. The results are combined to determine the stage of cancer.
- Tumor: Describes the primary tumor size.
- Node: Indicates whether the thyroid cancer cells have spread to lymph nodes.
- Metastasis: Whether or not cancer has spread to distant areas of the body other than lymph nodes.
There are 5 primary stages of thyroid cancer. The stage of thyroid cancer describes how large a tumor is and the degree to which it has spread.
If you are under 55, pending the type of thyroid cancer you have, it might only be categorized into either stage one or stage two and also has slightly different guidelines than those listed below.
STAGES OF PAPILLARY OR FOLLICULAR THYROID CANCER (55+)
Stage 1: Any small tumor (typically 2 cm or less) that has not spread to the lymph nodes or distant sites.
Stage 2: A larger (typically 2-4 cm) noninvasive tumor with no spread to lymph nodes and no metastasis to other distant sites.
Stage 3: A tumor larger than 4 cm but has not spread to the lymph nodes or other distant sites. It can also describe any localized tumor with spread to the central compartment of lymph nodes but no distant spread.
Stage 4: This stage is broken up into three categories.
- (A) – Describes a tumor that has spread to nearby sites regardless of whether it has spread to the lymph nodes, but has not spread to distant places. Or a localized tumor with lymph node spread but no distant spread.
- (B) – This stage describes a tumor that has spread beyond nearby structures, regardless of spread to lymph nodes, but no distant spread.
- (C) – This stage describes all tumors when there is evidence of metastasis (spreading to distant sites.)
STAGES OF MEDULLARY THYROID CANCER
Stage 1: Any small tumor (typically 2 cm or less) that has not spread to the lymph nodes or distant sites.
Stage 2: A larger (typically 2-4 cm) tumor with no spread to lymph nodes and no metastasis to other distant sites.
Stage 3: Any localized tumor that has spread to the central compartment of lymph nodes but has not metastasized.
Stage 4: This stage is broken up into three categories.
- (A) – A tumor that has spread to nearby structures, regardless of whether it has spread to the lymph nodes but has not spread to distant sites. Or a localized tumor with lymph node spread beyond the central compartment but no distant spread.
- (B) – A tumor that has spread beyond nearby sites, regardless of spread to lymph nodes, but no distant spread.
- (C) – This stage is used when there is evidence of any metastasis.
ANAPLASTIC THYROID CANCER STAGES
This is aggressive thyroid cancer, where all tumors are classified as stage 4 regardless of tumor size, location, or spread. It also describes recurrent cancer that has come back after treatment.
- (A) – An aggressive tumor that has spread to nearby structures, regardless of whether it has spread to the lymph nodes but has not spread to distant sites.
- (B) – An aggressive tumor that has spread beyond nearby structures, regardless of spread to lymph nodes, but with no distant spread.
- (C) – This stage is used when there is evidence of any metastasis.
EFFECTIVENESS OF RFA BASED ON THYROID CANCER TYPE AND PROGRESSION
Which type of thyroid cancer you have been diagnosed with and its stage will be a factor if radiofrequency ablation is a viable treatment option.
Low-Risk Papillary Thyroid Microcarcinoma (PTMC) – According to several recent studies, thermal ablation has been deemed safe and effective for some patients with this type of thyroid cancer.
Medullary Thyroid Cancer (MTC) – Thyroid surgery remains the treatment of choice. Still, there are cases in which RFA might be a safe and effective option for early MTC in patients ineligible for surgery or with a regional recurrence after surgical resection of their MTC.
Recurrent Thyroid Cancer – Some studies show treatments such as RFA can be beneficial for patients with recurrent thyroid cancer where the risks of surgery outweigh the benefits or in patients who refuse repeat surgery.
Aggressive Forms Of Cancer – More studies need to be done to determine if RFA is an effective treatment for aggressive tumors such as anaplastic carcinoma.
WHY CHOOSE THYROID RADIOFREQUENCY ABLATION OVER SURGERY?
Surgery has always been the treatment of choice for most thyroid cancer. Most commonly, malignant tumors are treated with a thyroid surgery called a thyroidectomy. Active surveillance (AS) is also a popular alternative for low-risk thyroid cancer in select patients.
However, not all patients want to undergo lifelong monitoring, and some may wish to treat their cancer minimally invasively. For this reason, thermal ablation has become a popular minimally invasive alternative to surgery and active surveillance for some patients with thyroid cancer.
There could be several reasons someone would choose to have RFA over a more invasive thyroid surgery. While a thyroidectomy is considered a safe surgery that has been practiced for many years, some people don’t want to have surgery or, for one reason, aren’t the best candidate for surgery.
Minimally invasive techniques such as radiofrequency ablation are a popular alternative option for patients deemed high risk for surgery or those who wish to receive a more active treatment approach than active surveillance.
RFA is one of the most minimally invasive procedures. Still, it might only be suitable for some thyroid conditions, as outlined above. If your doctor is educated on and skilled in performing RFA, they can help you decide if it is an option for your unique case.
If your doctor is not well-informed regarding RFA, we would love to help you. Here at The Surgical Clinic, we are lucky to have Dr. Joshua Taylor, who is skilled and educated to perform thyroid radiofrequency ablation.
BENEFITS OF THYROID RADIOFREQUENCY ABLATION
Clinical trials involving RFA have shown great promise if your tumor is benign, with a reduction in tumor size by up to 85% within the first six months.
Most patients involved in these clinical trials also noted that nodule-related symptoms were significantly improved or completely disappeared. Studied patients also saw improvement in thyroid function.
If your tumor is cancerous, RFA might be an option for you to discuss with your doctor. If you are a candidate for RFA, the minimally invasive thyroid treatment option has many benefits:
- Out-patient (no hospitalization)
- Performed under local anesthesia
- Low complication rate
- No downtime
- Shorter recovery time
- No visible scarring
- Preserves your healthy thyroid tissue
- Allows your thyroid to function normally without the need for medication
- Improves quality of life
DOES THYROID RADIOFREQUENCY ABLATION HAVE ANY RISKS?
All medical treatments and procedures have risks, but because RFA is a non-invasive procedure, serious complications are extremely rare. At most, you should only have some localized swelling and redness.
A few more other reported symptoms following RFA might include:
- Localized swelling and redness
- Bleeding
- Nerve bruising (leading to a hoarse voice)
- Skin burns
- Infection
WHAT TYPE OF SURGEON PERFORMS THYROID RADIOFREQUENCY ABLATION?
Assuming they have received proper training, three kinds of physicians are qualified to perform the RFA procedure: endocrinologists, endocrine surgeons, and interventional radiologists.
To find out if you are a candidate for thyroid RFA, you should consult with a qualified physician that has undergone rigorous training to perform thyroid RFA.
Here at The Surgical Clinic, we have a laundry list of doctors and surgeons that are educated and experienced in performing numerous thyroid procedures.
Regarding RFA, we are lucky to have Dr. Joshua Taylor on our team. Dr. Taylor is a skilled and educated board-certified general and robotic surgeon specifically trained to perform thyroid radiofrequency ablation.
You can read about all of our doctors and the procedures they perform by clicking here.
FINAL THOUGHTS ON THYROID RADIOFREQUENCY ABLATION
Radiofrequency ablation (RFA) is the best-studied thermal ablative technique worldwide. It is shown to be safe and effective for long-term local tumor control for those that do not wish to undergo active surveillance and patients with some types of thyroid cancer that do not want to or are ineligible for surgery.
Most thyroid cancers can be cured, especially if they have not spread to distant parts of
the body. If cancer can’t be cured, treatment goals vary from patient to patient. Many are now choosing not to have surgery and try other less invasive thyroid treatments such as RFA.
Our friendly and board-certified staff at The Surgical Clinics (TSC) would love to help you decide if RFA is a fit and help you make the best treatment decisions possible during your thyroid cancer journey.
TSC is one of Middle Tennessee’s most respected surgical practices specializing in several types of surgery. Dr. Taylor is the only doctor at our practice trained and skilled to perform the RFA procedure, but we have a vast team of doctors and surgeons who specialize in over 12 divisions.
With 24 clinics in Nashville and surrounding areas, no matter where you live in Middle Tennessee, we have a clinic nearby! Call us today for more information!