University HealthCare Alliance

August 20, 2020

Stanford Health Care Introduces New, Less Invasive Treatment for Benign Thyroid Nodules

A recently approved technique for radio-frequency ablation treats or prevents problems caused by thyroid nodules, providing an alternative to surgical removal of the gland.

When Sarah O’Brien injured her neck in a car accident in 2012, a doctor examining her medical scans happened to notice that she had nodules on her thyroid, a gland located just below the Adam’s apple on the front of the neck. At the time, she was 24 and had no idea what that even meant.

Over the next eight years, after her neck injury was long forgotten, those nodules grew into a goiter-sized lump that protruded from her neck and caused a range of symptoms, including explosive anger, fatigue, muscle weakness and hot flashes. Medications helped some, but the best available treatment option was the surgical removal of the thyroid, an important gland that secretes hormones controlling the body’s metabolism. She kept putting off the surgery hoping that a better option would emerge. Finally, it did.

Earlier this year, O’Brien became the first patient at Stanford Health Care to undergo a nonsurgical treatment, recently approved by the Food & Drug Administration for benign thyroid nodules, called radio-frequency ablation. 

“It’s definitely helped a lot,” O’Brien said three months after the procedure. “The hot flashes are gone and the goiter on my neck is significantly smaller.”

‘A safe, less invasive way’

The procedure, which has been used for years to treat benign thyroid tumors in Korea, Italy, Brazil and a handful of other countries, involves inserting a thin, needle-like probe through the skin of the neck into the troublesome nodule, said Julia Noel, MD, assistant professor of otolaryngology at Stanford. The probe is activated via a foot pedal, triggering radio waves that send an electrical current through the probe; the heat then destroys tissue of the nodule.

“It’s based on radio-wave technology that has already been used in the U.S. to treat bone, lung, liver and kidney tumors,” Noel said. “It allows us a safe, less invasive way to intervene on a benign thyroid nodule that’s causing problems without the risks of surgery and the need for hormone therapy caused by its removal.”

Thyroid nodules are lumps in or on the thyroid gland. They are relatively common, and, in most cases, their cause is unknown, Noel said. About 50% of people in the U.S. over the age of 60 have at least one nodule. The vast majority of nodules — more than 90% — are benign.

Still, benign nodules can wreak havoc, she said. They need to be watched in case they grow and start pushing on important structures. They can also become unsightly goiters, which are groupings of several nodules that bulge from the neck. Some nodules can become toxic, like O’Brien’s, secreting unwanted hormones that can cause a variety of symptoms, including a racing heart, difficulty sleeping, anxiety and irritability. 

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