We know you have many important question for your RFA Procedure. our care to you is of utmost importance
Q. WHY SHOULD ONE CONSIDER NON-SURGICAL ALTERNATIVES?
A. Thyroid surgery is often recommended to patients because of the presence of a large thyroid mann/Goiter, or "cold nodule", because of bothersome symptoms (difficulty swallowing, strange feeling in the neck) caused by large, frequently readily visible nodules.
Q. WHAT ARE THE POSSIBLE DISADVANTAGES OF THYROID SURGERY?
A. Thyroid surgery is frequently associated with transient or even enduring complications (7 to 11% when one thyroid lobe is removed, and 14 to 24% when the thyroid gland is completly removed).
If surgery is chosen: the following are unavoidable:
Hospital admission, a convalescence peroid (typically 2 weeks), permanent scar in the neck region, as well as in life-long thyroid medication / regular check-ups and an associated risk.
Q. AM I A SUITABLE CANDIDATE FOR RADIOFREQUENCY ABLATION?
A. There are specific set of criteria e follow to select the right candidates who would receive the most benefit from this procedure. This includes blood tests, ultrasounds, and possibly needle thyroid biopsies.
Q. THYROID RADIOFREQUENCY ABLATION (RFA)
A. is a treatment for reducing the size of benign thyroid nodules if they are symptomatic (pressure feeling in the neck) or causing a visible neck swelling.
Q.IS THE PROCEDURE AVAILABLE IN THE USA?
A. Yes.
Q. MY SURGEON SAYS THIS IS AN EXPERIMENTAL TREATMENT. IS THAT TRUE?
A. Surgeons have an obvious vested interest in performing surgery! This is not an experimental treatment. It has been validated and tested over many years in large series of patients and is now an established treatment performed in many countries around the world and also in a small trial at the Mayo Clinic, we also have successfully treated over 15 patients.
Q. HOW DOES IT WORK?
A. Thyroid radiofrequency ablation is performed under local anaesthetic using a special needle which is passed into the thyroid nodule under ultrasound guidance. The tip of the needle heats up and this heating of the needle heats the adjacent thyroid tissue. This causes the nodule to subsequently shrink down over time. The ablation changes during the treatment can be seen in real time by the doctor delivering the treatment using the ultrasound machine.
Q. IS IT EFFECTIVE?
A. The evidence for the effectiveness of RFA is well established.The maximum benefit of the treatment is achieved 6-12 months following treatment . In general, RFA can reduced the volume of a nodule by 35-60 % at 1 month following treatment and 60-90% at 6-12 months.
Q. HOW LONG DOES IT TAKE?
A. The treatment itself takes betwee 20-40 minutes depending on the size and location of the thyroid nodule.
Q. IS IT PAINFUL?
A. Minimal to no pain is the typical experience of our patients. We do use Local anesthetic and we also give other medications as needed to make it a easily tolerated procedure.
Q. HOW LONG AFTER THE PROCEDURE CAN I GO HOME?
A. Patients are able to go home 20-30 minutes after the treatment 0we typically give you a ice pack and some Motrin.
Q. WILL I HAVE A SCAR ON MY NECK?
A. No. The treatment is delivered using a thin needle. You may have a small needle site on your neck for a couple of days after the treatment but this very soon heals and it will not leave any visible scarring.
Q. MY NODULE IS BENIGN. CAN I HAVE THIS TREATMENT?
A. If you have a visible swelling in you neck and or have symptoms which are attributable to your nodule then you may be suitable for this treatment. Please contact us to arrange a consultation.
Q. WILL THE TREATMENT AFFECT MY THYROID FUNCTION?
A. With RFA the rate of hypothyroidism following treatment is very low (<1%).
Q. WILL THE NODULE DISSAPPEAR COMPLETELY?
A. Unless the nodule is almost entirely made of fluid it will not dissapear completely. There will always be some residual nodule although the tissue within it may not be alive and the aim of the treatment is for the nodule to not be visible as a swelling in your neck or giving you symptoms.
Q. I HAVE MULTIPLE NODULES. CAN YOU TREAT MORE THAN ONE AT THE SAME TIME?
A. Yes. It is possible to treat more than one nodule on the same side of the thyroid during the same treatment and we have done this for some of our patients.
Q. I HAVE NODULES ON BOTH SIDES OF MY THYROID. CAN YOU DO BOTH SIDES AT THE SAME TIME?
A. In general we do not treat nodules on different sides of the thyroid at the same treatment as there is some initial swelling associated with the procedure and it is safer to perform one side at a time.
Q. I HAVE A TOXIC NODULE. CAN RFA TREAT THIS?
A. Yes. Thyroid radiofrequency ablation (RFA) is an exciting treatment for toxic nodules and can result in a a normalisation of thyroid function with one treatment, avoiding the need for surgery, radioiodine and long term thyroxine medication.
Q. WHAT ARE THE MAIN POTENTIAL SERIOUS COMPLICATIONS?
A. The published rates of major complications (mainly in research from Korea) are low and are summarised here. The rate of major complaications in these series was 1.4% including 1% voice change (all resolving after 3 months), nodule rupture (0.14%), abscess (infection in the neck) (0.07%), hypothyroidism (0.07%) and injury to the brachialplexus (0.07%). Minor complications include brusing around the thyroid (haematoma)(1%), vomiting, (0.62%) and skin burn (0.27%).
So far we have not experienced any complications with our patients.
Q. MY NODULE HAS REDUCED IN SIZE WITH RFA. I'M PLEASED WITH THE RESULT. CAN I REPEAT IT TO REDUCE THE SIZE SOME MORE?
A. Yes. Thyroid RFA can be repeated on the same nodule if needed or at different sites. Patients with larger nodules at baseline are more likely to need additional treatments to achieve the desired result.
Q. WHAT IS THE RISK OF THE NODULE REGROWING?
A. If the thyroid ablation is incomplete there is a small risk of nodule regrowth. The aim of the treatment is to fully ablate the thyroid nodular tissue to prevent regrowth.
Q. WHAT SKILLS DO YOU NEED TO PERFORM RFA?
A. The key skills needed are a good knowledge of the anatomy of the thyroid region on ultrasound but specifically extensive experience of visualising a needle in the thyroid. This means having perfomed thousands of ultrasound guided FNAs and biopsies.Dr Ahmad And Aljammal have performed over 10 thousand biopsies.