Overview
The thyroid gland is an endocrine gland located in your neck. The word endocrine means it controls the hormones of your body. This vital gland; through hormonal control, indirectly controls all the organs of your body. It plays a pivotal status in controlling your basal metabolism, sleep, heart rate, growth, bodily functions and overall development. Any lump or lesion developing within the thyroid gland is called a thyroid nodule. Thyroid nodules may be solid or fluid-filled i.e cystic. These nodules are very common in the general population and as per data can be present in roughly 1 of 3 individuals.
As stated above, thyroid nodules are very common and most are asymptomatic. However, every nodule needs to be evaluated. Your doctor would first examine you and ask for investigations. Most importantly, it is important to know whether the nodule is arising from thyroid or from a surrounding structure (i.e. extra-thyroid). An ultrasound (USG) is the best investigation to evaluate the thyroid nodule. This is required to know the size, location and nature of the lump or mass/nodule. Most thyroid nodules are benign i.e non-cancerous. You need not worry. Almost 95% are benign. Only a small percentage (around 5%) of thyroid nodules may be worrisome i.e are cancerous.
Symptoms & Diagnosis of Thyroid Nodule
Most often, you won’t even know you have a thyroid nodule as they have no symptoms. These are most likely incidentally detected or discovered during a heath check up. Rarely, your doctor may find it during a neck examination. In other cases, it may be picked up on a CT scan or ultrasound done for other reasons.
However, that said, large thyroid nodules may have symptoms. These symptoms include:
- Feeling of a lump, difficulty in eating or swallowing.
- Difficulty in breathing or occasional pain and heaviness.
- A cancerous nodule may present with pain, nausea, weight loss and anorexia/loss of appetite.
Diagnosis of Thyroid Nodule
- Work up starts with a physical examination.
- Your doctor will most likely ask for a few blood tests including a thyroid profile (T3, T4, TSH levels).
- An ultrasound of the neck Is the first imaging advised. USG is cheap, easy and poses no hazards.
- This would most likely be followed by a biopsy or an FNAC. A biopsy/FNAC is a needle test performed under local anaesthesia, wherein a sample from the nodule is removed.
- The FNAC usually differentiates benign from malignant nodules.
Benign Thyroid Nodule & Treatment
If the nodule turns out to be cancerous or malignant
In this case, the most likely option is surgery or chemotherapy. This may be combined with radioactive Iodine therapy. You would require a mullti-disciplinary team of doctors for taking the right decision for you, this would include a medical oncologist, a surgical oncologist, an endocrinologist, an interventional radiologist and a pathologist. They would advise the next steps of investigations and treatment plan.
If the nodule turns out to be benign
Treatment options for a benign symptomatic thyroid nodule
Percutaneous Thermal Ablation of the Thyroid Nodule
Overview
“Percutaneous” means through the skin. The word ablation means destruction of tissue. “Thermal” means heat.
Therefore this procedure involved destroying the nodule using a special device through your skin with the help of heat.
Heat is given either in the form of radiofrequency energy (RFA) or microwaves (MWA). We have used RFA and MWA safely in other organs like the liver and lung for almost 20 years for destroying liver and lung tumours.
Thyroid RFA has been performed at specialist centres abroad for many year.
Benefits of percutaneous radiofrequency thyroid nodule ablation compared to open surgery
- It is minimally invasive compared to surgery, called minimally invasive treatment (MIT)
- No need for general anesthesia
- Shorter hospital stay
- Faster recovery
- No scar on incision. No cut
- Most importantly, the thermal ablation does not involve removal of part of thyroid gland or parathyroid gland. Therefore, post procedure hormonal changes do not happen
Why Choose Dr Aser for Percutaneous Thyroid ablation Procedures?
- Subspecialty training in Musculoskeletal Radiology and Interventional Radiology in the UK and Canada
- Access to advanced imaging and Angio Suite facilities in a tertiary centre
- Collaboration with orthopaedics, sports medicine, rheumatology, physiotherapy and pain specialists
- Focus on clear explanation, realistic expectations and only recommending procedures where there is a reasonable chance of benefit
FAQ
1. What are the risks?
No procedure can be risk free. But since thermal ablation is a minimally invasive treatment option (MIT), risks are much lesser than open surgery. Serious complications are extremely rare. The main risk is hoarseness of voice on the post procedure follow up. This happens due to nerve injury. Even if this ensues, it is self limiting and generally recovers on its own over 1-3 months.