Are You a Candidate for Alternative Thyroid No Surgery Ablation of Your Benign Thyroid Nodule?
Here is a list of what needs to be done to recommend you for RF thyroid Mini-probe ablation of your nodule.
- At least two biopsies with benign diagnosis.
- Molecular markers and classifiers if negative can replace one biopsy.
- US features of the nodule and other neck structures ( goiter, more nodules and abnormal lymph nodes).
- Nodule is spongiform, mixed cystic, or solid.
- Nodule volume
- A list of your symptoms and cosmetic complaints.
- Thyroid lab tests. TSH T4 Thyroid antibodies. thyroglobulin, TG ab
- Thyroid scan if TSH <0.1. to evaluate autonomy or toxic nodule.
Informed consent forms should include the following content
1) Ablated thyroid nodules decrease slowly in size for several months to years
2) Number of expected treatment sessions
3) Possibility of regrowth of the treated nodule and the need for additional treatment
4) Patients may experience various degrees of pain during the ablation
5) Complications of RF ablation
6) Patients should inform the physician about their history of thyroid surgery, the side effects of any drugs they are taking, and whether they are taking drugs such as antiplatelets, anticoagulants and thyroid hormones.
7) Further observation or admission may be required after RF ablation, depending on the patients’ condition after ablation.
Patients taking drugs associated with a bleeding tendency should be told to discontinue those drugs before RF ablation: 7-10 days for aspirin or clopidogrel, 3-5 days for warfarin and 4-6 hours for heparin. Patients can take heparin 2-6 hours after RF ablation, warfarin on the night after the procedure and aspirin (or clopidogrel) the next day (51). However, physicians should compare the benefits of RF ablation with its potential complications related to the interruption of these drugs. If required, patients should consider changing warfarin to heparin, which has a shorter half-life (1-2 hours) (51). Moreover, patients should fast for at least 6 hours before each procedure. We recommend that a venous line be installed before the procedure for drug delivery.
RFA for thyroid is not available in the US until next year. A short visit to Italy or Korea now can be arranged by my center after an evaluation to see if you are a candidate. Call Matt at 310-393-8860 for details and this alternative to surgery.