Avoiding thyroid removal: the benefits of RFA for thyroid cancer patients

Five years ago, Ashley Freeman was diagnosed with Hashimoto’s disease, an autoimmune condition that can lead to hypothyroidism, a condition where the thyroid gland produces too much thyroid hormone. Though Hashimoto’s had not caused significant symptoms for Freeman, it was always in the background of her health journey. In late 2022, she switched to a new primary care physician who asked whether she had ever had an ultrasound of her thyroid – a common practice for those with Hashimoto’s, as the disease often can cause nodules on the thyroid.

In the thyroid, these nodules are typically solid or fluid-filled and can vary in size. Many thyroid nodules are benign (non-cancerous) and may not cause noticeable symptoms. However, in some cases, they can grow large enough to cause swelling, discomfort or difficulty swallowing. While most nodules are harmless, a small percentage can become cancerous, which is why doctors often biopsy nodules to ensure they don’t pose a health risk.

Freeman’s new doctor had her get an ultrasound, which revealed small nodules, but there was no immediate cause for concern. Her doctor advised Freeman to return for a follow-up in a year. “Life got busy, and it ended up being a year and a half before I came back,” Freeman explained. During that time, her nodules had grown, prompting her doctor to recommend a biopsy, although no one expected cancer.

The results were shocking: Freeman was diagnosed with papillary thyroid cancer, the most common type of thyroid cancer. Faced with a diagnosis that carried a range of treatment options, Freeman took matters into her own hands. “I started researching online and came across thyroid radiofrequency ablation (RFA),” she said. “The idea of removing my thyroid, which would require lifelong medication, was something I wanted to avoid if possible.”

Unlike thyroidectomy, which often results in the need for lifelong thyroid hormone replacement, thyroid RFA targets only the cancerous or problematic tissue while leaving the rest of the thyroid intact, allowing the gland to continue functioning normally. This option not only reduces the risk of complications but also helps maintain a higher quality of life for patients like Freeman who want to avoid the permanent effects of thyroid removal.

“RFA is a great option for patients with small, localized thyroid cancers or benign nodules,” said Dr. James W. Suliburk, chief of endocrine surgery at Baylor Medicine. It allows us to treat the cancerous tissue with precision, avoiding more invasive surgery and preserving the thyroid function.”

Freeman discussed the RFA option with her medical team and underwent additional imaging to determine if she was a candidate. Fortunately, she was an ideal candidate for the procedure.

In August, Freeman underwent thyroid RFA under the care of Suliburk. “He was very kind and helpful, answering all of my questions,” Freeman said. “The procedure went smoothly. He even explained everything to me during it.”

The outpatient procedure was minimally invasive, allowing Freeman to return home the same day. “It was a simple process. I left the hospital feeling like I could get back to my life without a major recovery,” she said. Freeman will return for a follow-up ultrasound in November to ensure the nodules have not returned.

For Freeman, the experience reinforced the importance of staying proactive about her health. “I’m so glad I asked about the RFA procedure and found a way to treat my cancer without losing my thyroid,” she said. “If you’re facing a thyroid issue, don’t hesitate to explore your options.”

“With advancements like RFA, we can offer patients more personalized treatments that suit their specific needs and avoid unnecessary surgeries,” said Suliburk.

As Freeman looks toward the future, her message is clear: “Don’t be afraid to ask questions and advocate for yourself,” she said. “You never know what options are available until you explore them.”

By Tiffany Harston, senior communications associate in the Michael E. DeBakey Department of Surgery