FAQs

What nonsurgical procedures are available?

Radiofrequency Ablation (RFA)
Ethanol Ablation (PEI)
Laser Ablation (LA/PLA)
Microwave Ablation (MWA)
Cryoablation
Thyroid Arterial Emboliation (TAE)
Nanosecond Pulsed Field Ablation (nsPFA)

To read medical literature on each of these procedures, please visit the PROCEDURES page.

Who might be a candidate for nonsurgical treatment?

Patients with benign thyroid cysts or nodules which cause compression symptoms (difficulty swallowing or breathing) or are cosmetically concerning
Patients with “hot” toxic thyroid nodules causing hyperthyroidism (overactive thyroid)
Patients with a solitary papillary thyroid cancer (PTC), less than 2 cm, without thyroidal extension and not close to any critical structures in the neck, and no lymph node involvement
Patients who have already undergone thyroidectomy (full thyroid removal) who have a solitary papillary thyroid cancer (PTC) lymph node recurrence and do not wish to undergo further surgery
Patients who are not good surgical candidates
Patients with inoperable thyroid cancer (this is not curative and is only palliative until other treatment options can be pursued)

How do I find out if I’m a candidate for nonsurgical treatment?

For more information about the steps to diagnosis, click here.
This paper describes several of the procedures and gives guidance for when each may/may not be appropriate.
To truly determine if you are a candidate for any of these procedures, you must be evaluated by a physician who has been trained in nonsurgical modalities.
Click to visit the FIND A PHYSICIAN page.

What are the benefits of nonsurgical treatment of thyroid nodules compared to surgery?

Fewer complications
Shorter recovery time
Preservation of thyroid function (in most cases)
Local anesthesia (no general anesthesia)
Outpatient procedure (no hospital stay, may be performed in an office setting)
No scar

What are the disadvantages of nonsurgical treatment of thyroid nodules compared to surgery?

Gradual reduction in thyroid nodule volume (over a period of months)
May require repeat treatment or a multistage approach
Marginal regrowth can occur in undertreated nodules
May or may not be covered by health insurance

When is nonsurgical treatment appropriate treatment for cancerous nodules?

See answer to question #2 above.
Patients who are good candidates for active surveillance of papillary thyroid cancer may be candidates for nonsurgical treatment.
Review data on active surveillance here.

I have already had thyroidectomy for papillary thyroid cancer. Are any of these treatment options available for thyroid cancer recurrences after thyroid surgery?

Yes, after thyroidectomy, some thyroid cancer recurrences can be treated nonsurgically.

Will insurance cover the cost of a nonsurgical procedure?

Insurance coverage can vary and is not universal at this time for all the procedures listed above.
Many patients opt to pay out of pocket, which may be comparable to out of pocket costs associated with thyroid surgery.
CPT billing codes currently exist for PEI (60300), laser (0673T), and TAE (37243)
A CPT billing code is being developed for RFA. Currently, 60699 is used, but may be insufficient
Please call your insurance company to verify coverage.
If your procedure is denied coverage by insurance, you can submit an appeal letter. We have a template for this here.

How are these nonsurgical treatment options different from RAI ablation and/or surgical removal?

RAI ablation indiscriminately destroys the thyroid gland, preventing it from functioning. After this procedure, patients usually become hypothyroid and are dependent on lifelong thyroid medication. RAI treatment requires patients to isolate a few days and follow careful procedures to avoid contamination of their environment. RAI can have risks on fertility and future cancer development. Learn more here.
Surgical removal of the thyroid gland (thyroidectomy) results in permanent hypothyroidism. After surgery, patients are dependent on lifelong thyroid medication. Surgery also requires a hospital stay, general anesthesia, and can have risks of damage to vocal nerves and parathyroid glands. Learn more here.

Is it painful/what does recovery look like?

Each procedure is a little different, but generally, they are well tolerated by patients.
To learn more about each procedure, click here.
There is little to no downtime after nonsurgical intervention for thyroid nodules.
Read patient testimonials here.

What is the follow up like?

In the months following the procedure, patients will need routine imaging (usually ultrasound) to monitor the progress of their nodules.
After a year, patients usually need follow up imaging once per year.

Why hasn't my doctor heard of any of these treatment options?

Doctors are very busy today and sometimes don’t have time to devote to learning a new treatment technology.
Please point them to our website and let them know about our robust patient community!

Are there physicians offering these treatment options near me?

Find a physician here.

Where can I find patient testimonials?

They can be found on the RESOURCES page.

Disclaimer: None of the statements made here should be considered medical advice. We are patients, not doctors. You must seek the guidance of a physician who has been specifically trained in these procedures. Additionally, it is beneficial to get the opinions of multiple doctors when making decisions that can impact the rest of your life. Educate yourself on the risks and benefits so you can make informed decisions about your healthcare.