Thyroid No Surgery #4 The art of Refusing a Surgery for a Large Symptomatic Solid Thyroid Nodule.
You have a thyroid problem you have known for years. It is an enlarging thyroid nodule or multiple nodular goiter. Recently it is giving you neck symptoms as it grows slowly. I also may be a cosmetic problem as your spouse or friends comment on the size. Your primary will think of only one thing.That is to refer you to his surgeon.How do you go about the initial plan to determine if you can have the nodule treated without surgical removal of a part or all of your thyroid gland?
- This alternative to surgical treatment by Radiofrequency Ablation RFA is not for thyroid cancer nodules.
- You need to determine if you are a candidate for this simple out-patient therapy.
- Collect all your records including prior recent ultrasound, 3D imaging and the actual prior needle biopsy slides.
- Make an appointment with an expert interventional thyroidologist to do the evaluation. This will require a repeat needle biopsy with molecular markers and classifiers to rule out cancer to the best of our present knowledge.
- If you have symptoms connected with the large goiter nodule and the evaluation by the second opinion agrees you are a candidate you can have alternative RFA therapy in places that are approved for this use of RFA.
- The evaluation work up will be sent to your choice of RFA centers in Europe or Korea, and you will have a short visit for 2 days for the actual ablation procedure.
- We are working on getting RFA FDA approval for thyroid nodules in the USA.
- What happens when you are post RFA?You return to the RFA center the next morning for an exit contrast ultrasound to determine if the nodule was been ablated. They usually have no post RFA symptoms or complications, and of course no scar!
- Then you fly back home and have an ultrasound and follow up examination.
- The nodules that respond well will continue to decrease in size for years.
- The patient still has the thyroid gland intact and my not need thyroid hormone therapy.
- Santo Monica Thyroid Center Richard Guttler MD,FACE,ECNU is a referral center for selecting candidates for travel to Europe or Korea for RFA treatment of their large benign solid cosmetic problem nodules.
- Matthew Foss is the contact person to get the details and obtain a consultation evaluation 310-393-8860.