Thyroid nodule thermal ablation

About thyroid nodule thermal ablation

Your consultant has recommended thyroid thermal ablation as a treatment for a benign (non-cancerous) thyroid nodule.

Thyroid nodules

A thyroid nodule is a lump that forms within your thyroid gland. The lump (nodule) is either solid or filled with fluid.

The thyroid gland lies in your lower neck. It produces hormones, and acts as a regulator for your body's metabolism. (Your metabolism converts food and drink into energy.)

Thermal ablation

Thermal ablation uses a heat source to shrink your thyroid nodule. We use ultrasound guidance to insert a thin needle (a kind of electrode) through your skin and into the nodule. The heat it generates causes your nodule’s cells to die. This shrinks the nodule gradually over the next weeks or months.

This treatment aims to reduce any symptoms you have because of the thyroid nodule (such as discomfort or pressure on your neck). It also improves the appearance of the area in your neck where the nodule appears.

During the procedure, you may experience pressure, mild heat, or slight discomfort, but most patients do not find it painful.

The treatment typically lasts about 30 minutes.

Alternatives to thermal ablation

We will explain alternatives to you, which may include:

• surgery
• monitoring your nodule (if symptoms are not causing you significant problems).

Why we recommend it

We recommend this treatment for patients who:

• are at higher risk from surgery, or
• prefer to avoid surgery.

We recommend this treatment after we have carried out the following:

• an ultrasound scan of your thyroid
• needle testing (biopsy) of the nodule (sometimes more than once)
• full discussion with you about your symptoms and preferences.

Benefits and risks

Benefits

The benefits are as follows:

• no need to use surgery or remove part of your thyroid gland
• no surgical scar
• day-case procedure (you can go home the same day)
• usually performed under local anaesthetic (avoids general anaesthesia in most cases)
• preserves normal thyroid function
• surrounding healthy thyroid tissue is generally preserved, often avoiding the need for lifelong thyroid medication
• short recovery time.

Risks and side effects

Possible risks and side effects are as follows:

• mild discomfort when swallowing, which usually settles down quickly
• temporary bruising or swelling in your neck
• a feeling of pressure or fullness in your neck
• mild neck pain for 1 to 2 days after treatment (you can treat this with paracetamol)
• tiredness
• small risk of bleeding (which we will attend to on the day)
• superficial skin burn
• infection (uncommon)
• temporary hoarseness or voice change (this is rare)
• nodule rupture (this is rare)
• tracheal or oesophageal injury (this is very rare)
• irritation to the nerve controlling the voice (this is very rare)
• nodules may grow back over several years, potentially requiring a second treatment (this is very rare).

Preparation and on the day

Medications (including blood thinners)

We will offer you an appointment before your procedure date, to discuss any medications that you take. At this appointment we will let you know if you will need to stop taking any of your medications (such as blood thinners) before treatment. 

On the day

We will carry out the procedure at Kingston Hospital Aspen Wing.

• We will ask you to change into a gown.
• We will fix some sticky electrode pads to your thighs.
• We will give you a local anaesthetic to numb the area where we insert the needle in your neck. Most patients do not experience pain during the procedure.
• We will apply a small dressing to the entry site. This can be removed later in the day.

Afterwards

You can expect the following after treatment.

• After treatment, we will take you back to Aspen Wing and monitor your recovery for 2 to 3 hours.
• You can eat and drink normally after treatment.
• Most patients go home the same day.
• When you get home, we advise you to take it easy for the rest of the day.
• You can shower as normal when you get home.

Pain

Most patients do not experience significant pain after treatment. If you experience any pain, you can take paracetamol.

Avoid taking anti-inflammatory painkillers (such as ibuprofen) unless advised to do so by your doctor.

Everyday activities

• You can return to everyday activities after 2 days.
• Most patients take 2 or 3 days off work.
• For 4 weeks after treatment, we advise you to avoid heavy lifting, strenuous activities and contact sports.

Follow-up

We will schedule a follow-up appointment after 3 months, to check that your nodule is shrinking. This will include an ultrasound scan in our Radiology Department.