Living with a thyroid condition like thyroid nodules can cause you to experience many adverse symptoms such as pain or difficulty swallowing and breathing. It is important to visit an endocrinologist who can determine if your thyroid nodules are benign or malignant and recommend the best course of treatment.
Benign thyroid nodules may be treated with a non-invasive procedure such as radiofrequency ablation, while cancerous thyroid tissue may require surgical removal. Learn more about treatment options for thyroid nodules and why some thyroid nodules require surgical removal.
What are Thyroid Nodules?
According to the American Thyroid Association (ATA), a thyroid nodule is a lump of thyroid cells formed by abnormal thyroid tissue growth in the thyroid gland. Thyroid nodules are quite common and are found in approximately 5% to 7% of adults during routine physical examinations.
Many thyroid nodules are asymptomatic; however, if your thyroid nodules grow too large or contain cancerous cells, you may experience adverse symptoms. The ATA reports the following potential adverse symptoms for thyroid nodules:
- Visible lumps on your neck near your thyroid
- Thyroid diseases such as hyperthyroidism or hypothyroidism
- Pain in the jaw, neck, or ear
- Difficulty breathing or swallowing
- Constant tickling in your throat
- Hoarseness or damage to vocal cords, typically due to thyroid cancer
Treatment Options for Thyroid Nodules
Treatment options for thyroid nodules range from non-invasive procedures like radiofrequency ablation to a total thyroidectomy, which is the complete removal of the thyroid gland. Each treatment option is suited to different types of thyroid nodules.
At Associated Endocrinologists, we offer radiofrequency ablation and radioactive iodine therapy for patients with thyroid nodules.
Thyroid radiofrequency ablation (RFA) is a non-invasive technique that uses radiofrequency waves to kill abnormal thyroid tissue and reduce the size of your thyroid nodule. During the procedure, a small electrode is inserted into your thyroid. The tip is heated up and moved around using ultrasound guidance to destroy abnormal thyroid cells.
This treatment is safe and effective for treating benign, solid thyroid nodules. It has been shown to reduce the size of thyroid nodules by up to 80% following the procedure. RFA does not adversely affect your thyroid function, making it the preferred treatment choice when possible.
Radioactive iodine therapy
Radioactive iodine therapy (RAI) is typically used to treat hyperthyroidism and cancerous thyroid nodules. You drink a small amount of radioactive iodine mixed with water during the treatment. The radioactive iodine kills your cancerous thyroid cells as it’s absorbed into your body. One meta-analysis reported that RAI carried an overall efficacy rate of 58% for treating patients with certain types of thyroid cancers.
Thyroid surgery may be necessary for those with malignant or fluid-filled thyroid nodules. If you require thyroid surgery, your doctor at Associated Endocrinologists will refer you to a surgeon who can perform this procedure.
Thyroid surgery can indicate a thyroid lobectomy, which is a partial removal of the thyroid gland, or a total thyroidectomy or removal of the thyroid.
The surgical team puts you under general anesthesia during thyroid surgery and begins operating. They take out as much of your thyroid as is necessary to remove your nodules or cancerous tissue. Depending on your thyroid function after the procedure, you may need thyroid medications for the rest of your life.
Your Associated Endocrinologists doctor may recommend thyroid surgery if your tests show signs of thyroid cancer or if your thyroid nodule is not ideal for RFA or RAI. If other health conditions disqualify you from less invasive treatments, you may also require thyroid surgery.
When is Surgery Required for Thyroid Nodules?
Thyroid surgery is necessary for patients with thyroid nodules that don’t respond to or do not qualify for other types of treatments. Before recommending surgical interventions, your doctor performs blood tests and at least one fine needle aspiration biopsy (FNA).
Cancerous thyroid nodules only occur in about 7% to 15% of the thyroid nodules. Although malignant nodules are rare, they are found at a higher rate in those diagnosed with thyroid diseases. If you are in this high-risk group, it is vital to continually monitor your thyroid health so that if a cancerous nodule is found, it can be removed as early as possible.
Thyroid surgery may also be required for thyroid nodules that are filled with fluid. Non-invasive treatments like RFA don’t work for fluid-filled thyroid cysts because the liquid inside the nodule prevents the electrical radio frequencies from destroying the abnormal tissue.
Your doctor may prefer that you undergo thyroid surgery if your thyroid nodule is inaccessible through RFA due to its location in your body or you have a substernal goiter. They may also prefer surgery to RFA if several calcifications in your nodule make it challenging to insert the RFA electrode.
You may need to undergo thyroid surgery if you do not qualify for another type of treatment. Pregnant women and those with severe heart disease are not ideal candidates for RFA. If you wear an implantable defibrillator or pacemaker, you will not be able to undergo RFA. Additionally, if you take anticoagulant medications that you cannot stop for RFA treatment, you will likely be required to undergo surgery to treat your thyroid nodules.
Is Surgery Preferred Over Other Treatments?
While surgical intervention for cancerous thyroid nodules is preferred to no treatment, it is not preferred over less invasive therapies like RFA when the nodule is benign. When possible, RFA provides a less expensive, less risky, and less invasive treatment option for those with benign thyroid nodules.
Unlike surgery, RFA does not require a stay in the hospital or general anesthesia. It boasts a high efficacy rate upward of 80% and rarely results in long-lasting complications or necessity for thyroid medication.
Start With an Initial Evaluation
When treating thyroid nodules, your first step is to schedule an initial consultation with an endocrine specialist. The medical team at Associated Endocrinologists are Board Certified in Endocrinology. We can help you identify and treat your thyroid issues and refer you to the appropriate surgical procedure if necessary.
Schedule an initial thyroid consultation through our telehealth option or in-person at our Clarkston or Farmington Hills locations.