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At a routine checkup three years ago, Linda Mumford learned she had a lump on her thyroid. Linda's calm, easy-going personality prevailed even when she learned the nodule, or abnormal growth of cells, could be cancer. Doctors wouldn't know for certain unless a surgeon removed her thyroid, which can be a difficult surgery.
"That just wasn't acceptable," says Linda, a 39-year-old wife and mother who lives in Millcreek. "They couldn't tell me if it was cancerous, but they still wanted to remove it. I didn't want to go through a surgery if I didn't have to."
The surgery, which is standard when a tumor could be cancer, would also mean she would have to take hormone replacement therapy medication for the rest of her life.
A close friend of Linda's recommended she seek a second opinion. That's when she saw Devaprabu Abraham, M.D., an endocrinologist at Huntsman Cancer Institute, and a professor of medicine at the University of Utah (the U). Dr. Abraham presented Linda with another option after performing a DNA test on the nodule—wait and monitor it. Linda chose to wait.
While Linda took the waiting in stride, her husband, Eli, who fully supported her decision, was understandably worried. "There's always a moment of panic," Eli Mumford says. "But Dr. Abraham explained the risk, how long we would monitor it, and our options, which made me more comfortable. Waiting also gave Linda time to make the right decision for her, rather than the rash one." Linda and Eli have been married for 12 years and met at work, where she was a receptionist and he worked in IT.
After about three years of monitoring the nodule, Abraham performed a ground-breaking procedure called radiofrequency ablation (RFA). It allows a patient to keep their thyroid but get rid of the nodule by using heat to destroy tissue. Radio frequency waves are passed through a precisely placed needle to generate heat within the nodule tissue, destroying it and preserving the normal thyroid. Linda will require ongoing surveillance of the destroyed area for regrowth.
"In this technique, only the tumor is destroyed, and the functional portion of the thyroid is conserved," says Dr. Abraham. "It truly is a thyroid-sparing intervention."
The thyroid is an important gland shaped like a butterfly located in the front of the neck. It acts as a control center for the body, producing hormones that affect breathing, heart rate, digestion and body temperature. Thyroid nodules are very common, and the risk of getting them increases with age, Abraham explains. Most of these nodules are benign but some become cancerous when cells grow out of control, according to the American Cancer Society.
"This technique has been revolutionary in Asia and Europe," Abraham says. "It's being adopted in the United States now, albeit slowly despite the prevailing need."
Other advantages to RFA include fast recovery and no scarring, Abraham says. Doctors perform the procedure under local anesthesia while the patient is fully awake. RFA only takes 20-30 minutes and has very low complication rates. It's also far less expensive than thyroid surgery, costing $5,000 compared to $25,000. The procedure doesn't require hospitalization.
There are about 43,800 new cases of thyroid cancer each year in the United States, according to the American Cancer Society. Women are three times more likely to get thyroid cancer than men.
Linda is grateful she could take advantage of the far less-invasive procedure. "The procedure was really easy," she says. "They applied the anesthetic, and the needle was uncomfortable but not painful. I took ibuprofen that afternoon and evening, and the next day I got on airplane and flew to Arizona. I had just tiny bruise on my neck."
At her latest checkup, Abraham found her nodule had shrunk by 80%. "It was great news. "I was excited that it had worked. But the person who got the most out of it was my husband," Linda says. If it grows back, Linda can choose to have RFA again.
Eli says, "I was also relieved that this treatment was relatively easy on her compared to a thyroidectomy, where the outcome is a potential lifelong dependency on supplemental treatments that could bring their own hardships."
Thyroid cancer found early can be treated successfully, according to the National Cancer Institute. Doctors recommend routine screenings at regular checkups. They advise getting neck lumps checked as soon as possible.
"I was glad I waited. I got to take advantage of the advancements in science with minimal risk," Linda says.