Did you know thyroid nodules are extremely common?

Do you know what your thyroid does? The butterfly-shaped gland located at the front of the neck plays a critical role in regulating numerous processes in the body through the production of thyroid hormones, including metabolism, early growth and development, and body temperature regulation.

By age 60, approximately 50% of Americans develop thyroid nodules, according to the American Thyroid Association. Most are benign, but 5% to 10% may be cancerous.

Detecting a thyroid nodule

Large nodules may be identified during a physical examination. However, most nodules are often discovered incidentally during imaging studies, such as CT scans or MRIs of the neck conducted for unrelated reasons. Your health care provider will assess whether these nodules warrant further investigation or intervention. Ultrasound is the best way to evaluate thyroid nodules and determine whether they are suspicious. Some nodules, although benign, may need a needle biopsy to rule out cancer.

Even if benign, thyroid nodules can still cause significant symptoms, such as altering the neck’s appearance or producing compressive symptoms, including a sensation of a lump in the throat, difficulty swallowing and, in rare cases, voice changes.

Thyroid nodule treatment

Historically, patients with suspicious or cancerous nodules, benign nodules causing compressive symptoms or other thyroid-related conditions, like Graves’ disease, often required surgery to remove part or all of the thyroid gland. This approach frequently led to lifelong thyroid hormone replacement therapy.

Advancements in medical technology now offer a less invasive alternative: radiofrequency ablation (RFA). This minimally invasive procedure can effectively reduce nodule size, improve symptoms and preserve normal thyroid tissue, thereby enhancing quality of life. Additionally, RFA is often used to treat overactive nodules causing hyperthyroidism and even small thyroid cancers.

RFA is performed in an office setting under local anesthesia. With the guidance of an ultrasound, a small probe is inserted through the skin to deliver targeted heat, selectively destroying the nodule tissue. Over the subsequent weeks to months, the body absorbs the treated tissue. Unlike traditional surgery, this technique spares as much healthy thyroid tissue as possible, maintaining the gland’s overall function. The procedure typically takes 15 to 60 minutes depending on the nodule’s size.

RFA recovery

Most patients experience minimal discomfort during the procedure and can resume normal activities, including eating, almost immediately afterward. The most common risks from the procedure include bleeding, infection or changes in voice. However, a minimally invasive approach reduces these risks compared to traditional surgery.

In the days following the procedure, you may have some swelling or firmness around the treated area. The immune system gradually clears the treated nodule tissue, with reductions in size typically ranging from 30% to 50% at three months and 50% to 80% at one year. Meanwhile, the surrounding thyroid tissue remains unharmed, continuing to produce hormones as usual.

If you have concerns about your thyroid, consult with your health care provider or an endocrinologist to discuss the best diagnostic and treatment options.

Dr. Max Plitt is an otolaryngologist – head and neck surgeon at Advocate Health Care with fellowship training in thyroid and parathyroid surgery and expertise in radiofrequency ablation. 

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