My thyroid nodule has gone from the size of a lemon to the size of a grape.

When Gill’s thyroid nodule started to affect her breathing, she was offered thyroid surgery. Due to previous experiences, she was not keen to have surgery. She got in touch with us and we were able to tell her more about some of the less invasive procedures starting to become available in the UK. Gill then contacted some of the centres we signposted to and was eventually able to have a new, less invasive procedure called radiofrequency ablation (RFA) to shrink her thyroid nodule. This is Gill's story:

Picture shows left to right Gill’s thyroid nodule before and after undergoing radiofrequency ablation (RFA)

What type of thyroid nodule did you have?

I had a benign thyroid nodule which did not change my thyroid function. This is referred to as a ‘non-toxic’ or ‘cold’ nodule. It measured 5 cm X 2 cm and the radiologist described it as the size of a lemon. As far as I know, the thyroid nodule was 'cystic.’ I was told it was not suitable for ethanol ablation but would be suitable for radiofrequency ablation (RFA).

How was it diagnosed?

I had an MRI for a back problem and it showed up on the image. I had already become aware of it and had an ultrasound scan about ten years ago and was told not to worry about it. However, as it was growing and becoming symptomatic I decided to try and do something about it.

What symptoms did it cause?

Symptoms included pressure on the left side of my neck, particularly if I slept on my right-hand side. It would cause me to wake as I think it was pressing on my windpipe and affecting my breathing. I would often have a coughing fit when eating so I was always very mindful that I ate small bites. Just a month or so before treatment I began experiencing a pain which radiated from my neck along my collarbone. Then, of course, aesthetically there was a neck swelling which I thought was quite obvious.

What treatment were you offered?

The Ear, Nose and Throat (ENT) consultant offered me surgery. I asked for a referral for other options i.e. non-invasive interventions but this was declined. That’s when my research began!

Why did you decide against surgery and how did you find out about RFA?

I had just previously undergone surgery for a different condition and did not want to undergo any further open surgeries.

I decided to look for other non-invasive options and found that either ethanol ablation or RFA might be options for me. I found an interventional radiologist based at Birmingham. I arranged a private consultation with him. He performed an ultrasound and informed me that the nodule was not suitable for ethanol ablation. He advised that RFA is carried out by the interventional radiology department at the Freeman Hospital in Newcastle. 

How did you get a referral to Newcastle?

As the interventional radiologist in Newcastle does not perform RFA privately I went back to my NHS ENT consultant. I insisted on a referral and was told that an Individual Patient Funding Request (IPFR)* would take months and months and probably would not have been agreed! I contacted the IPFR department directly and spoke to them about the process, they were very helpful and encouraged me to continue with my IPFR application. They even sent the form to my consultant for him to fill in. It took eight months for the funding to be approved. Then the ENT consultant at Newcastle telephoned me for a 'verbal' consultation and then offered me a date about six weeks after that.

What was the procedure like?

I felt a little nervous but the consultant and his team kept me well informed throughout which really helped. Once the local anaesthetic was in I felt very little. The procedure itself is strangely quite noisy and sounded like popcorn popping! I felt some pain radiating down my collarbone and the consultant stopped each time this occurred to give me a moment. It was a little longer than I expected, about 45 minutes in total. I was then monitored by staff for a little while. I felt a bit tired and went back to the hotel where I was staying and rested.

How quick was the recovery?

The following day we drove back home. My neck was quite red and felt sore, like a bruise, to touch. This improved every day and was back to normal after about three days. I took paracetamol for 24 hours.

How are you feeling now?

I’m feeling great! I no longer have pain radiating down my collarbone, coughing fits or disturbed sleep and there’s quite a difference aesthetically. I had my six-month check-up recently and was told the 'lemon' is now the size of a grape; it’s reduced from 28ml down to 8ml – result!  There has been a 67% reduction and still counting. 

What would you say to anyone considering RFA, or other non-invasive techniques, to treat their benign, non-toxic thyroid nodules?

I would encourage anyone who is suitable to consider these options rather than have surgery. I know only too well how difficult, and long, it can be to recover from surgery. This was similar to having a tooth extraction; a bit of discomfort for a few days then back to full functioning. There was a lower risk of infection, no risks associated with general anaesthetic, and I was up and about immediately following procedure!

*While some hospitals offering RFA can take referrals from across the UK, not all can. In some cases, the doctor in charge of a patient’s care may consider the patient’s case to be different from other patients with the same condition. Due to that difference, the patient may qualify for a condition that is not normally funded by the Integrated Care Board (ICB). Where patients are deemed to have clinically exceptional circumstances, doctors can make an Individual Patient Funding Request (IPFR) on behalf of the patients. Patients cannot submit their own IPFR. This request will be considered by the ICB’s individual funding request team based on its clinical effectiveness, cost effectiveness, affordability and exceptionality of the patient’s case.  Find more information about individual funding requests

You can watch Gill speaking about her experience of RFA and listen to experts talking about non-surgical treatments for benign thyroid nodules in our webinar.

Further information

Thyroid nodules and swellings

Less invasive treatments for thyroid nodules