Radiofrequency ablation (RFA) is a minimally invasive surgical procedure that uses radiofrequency waves to destroy abnormal cells. The doctor inserts a thin tube into the growth and releases the waves into the tissue. As the cells in the tissue die, the immune system removes them, shrinking the area.
At Associated Endocrinologists, we have over 40 years of experience providing expert endocrinological care and treatment, including using radiofrequency ablation.
What Are Some Common Uses of Radiofrequency Ablation?
RFA is commonly used to treat thyroid nodules, which are growths that can develop on the thyroid gland.
RFA is also sometimes used to treat other conditions, such as liver cancer, chronic pain in the back and neck, joint pain, and certain types of heart arrhythmia. It is often used in patients who are not candidates for surgery or have multiple thyroid nodules that cannot be removed surgically.
Who is a Candidate for RFA?
If your thyroid nodules are asymptomatic or small enough that they do not impact your appearance, you may not need RFA treatment. Generally, good candidates for RFA treatment include:
- People with benign thyroid nodules
- People with medical conditions that make surgery risky
- People who want to avoid the side effects of surgery, such as temporary hoarseness or nerve damage
Ultimately, you and your doctor will decide whether or not to undergo RFA based on your personal medical history and treatment goals.
Who is a Candidate for Thyroid Surgery?
Radiofrequency ablation (RFA) is typically reserved for patients with benign thyroid nodules (non-cancerous). However, there are some instances where surgery may be the better option.
If the thyroid nodule is large, RFA may be unable to destroy all of the tissue. If you have had previous surgery on your thyroid and have extensive scar tissue or damage to your vocal cords, you are at a higher risk of complications. The needle may not be able to penetrate thick scar tissue, leading to incomplete ablation.
Patients with cancerous thyroid nodules or thyroid cancer that has spread to other parts of the body are not candidates for RFA and will need to undergo thyroidectomy (surgical removal of the thyroid).
RFA is not an option for pregnant patients or those with certain types of heart conditions. The electric current can interfere with defibrillators and pacemakers.
Risks of Radiofrequency Ablation
RFA is considered a safe and effective treatment option, but there are potential risks and complications associated with the procedure. These include:
- Thyroid damage
- Risk of infection
- Temporary numbness, pain, and swelling in the treated area
- Risk of damage to nearby nerves, which can cause hoarseness or difficulty swallowing
RFA can cause the thyroid gland to become overactive, leading to symptoms like anxiety, weight loss, and heart palpitations. In rare cases, RFA can cause thyroiditis, a thyroid gland inflammation that floods the bloodstream with thyroid hormones.
As with any medical procedure, it is crucial to speak with your doctor about the risks and benefits of RFA before making a decision.
Benefits of Radiofrequency Ablation
Radiofrequency ablation is a minimally-invasive treatment that offers many benefits, including:
- Lower risk of thyroid cancer recurrence
- Fewer side effects from thyroid hormone therapy
- Local anesthesia
- Usually, it only takes one hour
- Improved function in the thyroid gland
- Less invasive
- Normal tissue is left intact
- Shorter recovery time
- You are treated on an outpatient basis
How Should I Prepare for RFA?
You must stop taking certain medications, such as blood thinners like Warfarin or Heparin, at least a week before having an RFA. This is to prevent excessive bleeding during and after the treatment.
You should also avoid eating for several hours before the treatment; however, you can drink clear liquids up until two hours before the procedure.
You should dress in light, comfortable clothing and avoid wearing jewelry or cosmetics around your neck.
The Radiofrequency Ablation Procedure
Pre-procedure preparation includes checking your vital signs such as heart rate and blood pressure. Your doctor will also place grounding pads on your thighs to eliminate electroshock risk.
Your doctor will apply lubricating jelly to the side of your neck to allow the ultrasound transducer to glide effortlessly over your skin. An ultrasound imaging machine enables the doctor to place the electrode precisely in the thyroid nodule without damaging the normal tissue.
The doctor applies a numbing gel to the area above your thyroid and injects a local anesthetic. Once the area is numb, they insert the electrode needle and activate the generator.
The generator creates an alternating current that heats the tip of the needle to approximately 122 to 176°F. These temperatures are hot enough to cause a heat lesion on the abnormal thyroid tissue, leading to necrosis. The dead thyroid nodule tissue is then gradually eliminated by the body.
During the procedure, your doctor will gently move the needle around. This technique is called the moving shot, allowing the doctor to ablate the nodule completely.
Once the ablation is complete, the doctor removes the needles and applies an adhesive wound dressing. The entire procedure typically only lasts about an hour and can provide lasting relief. Because it is an outpatient procedure, you can resume normal activities the same day.
What About Pain?
You should feel little or no pain or discomfort during the procedure. Many patients can immediately experience pain relief at the site of the nodules. If you have some temporary pain, such as lingering peripheral nerve or neck pain, an ice pack and over-the-counter oral pain medications will provide sufficient pain relief.
Radiofrequency Ablation Recovery
Following treatment, drink plenty of fluids and rest with your head elevated. Change your wound dressing daily and keep the site dry for at least 48 hours to allow for proper healing.
You may experience mild discomfort, tenderness, and bruising around the insertion site. You can manage discomfort with cold packs applied intermittently for 15 minutes on and off. You can also take OTC pain relief medications; however, avoid aspirin because it thins the blood and may leave you vulnerable to bleeding from the wound site.
Visit your doctor for a follow-up at six weeks, six months, and twelve months. This allows your doctor to monitor the size of the nodules as they shrink and detect potential complications early.
If you experience nausea, fever, or persistent pain, contact your doctor immediately for a consultation.
What if the Treatment Doesn’t Work?
The success rate for RFA is very high. Studies have shown that RFA can reduce nodule volume by up to 81% after 5 years. RFA usually destroys the thyroid tissue that contains abnormal cells, but some thyroid tissue may remain after the procedure.
If this happens, you may need additional treatment for this medical condition. Several options are available, depending on the location and size of the remaining thyroid tissue:
- Thyroidectomy: A thyroidectomy is a surgery to remove all or part of the thyroid gland.
- Radioactive iodine therapy involves taking a radioactive substance that selectively targets thyroid cells and destroys them.
Contact AE Associated Endocrinologists
Associated Endocrinologists is one of the first locations in Michigan to offer thyroid RFA treatments. Our experienced doctors can provide treatment for your thyroid condition with thyroid RFA, thyroid ultrasound, and fine-needle aspiration biopsies. We can also treat health issues like osteoporosis, adrenal insufficiency, and type 1 diabetes to improve your quality of life.