Thyroid nodules treated without surgery or scars — just a needle

A 46-year-old woman came to my chamber with muscle cramps, tingling in her hands, and a strange twisting of her fingers. She looked worried and said these symptoms started slowly but later affecting her daily life. On examination, I noticed a large scar on the front of her neck. When I asked, she told me that she had undergone total thyroid surgery two years ago to remove a nodule. Since then, her problems had only increased. She had to take calcium injections repeatedly and swallow 6 to 8 calcium tablets daily. Her voice had changed after surgery, and she now depended on a lifelong thyroid hormone pill to survive.

As I checked her further, simple tests showed signs of low calcium in her body. She was suffering from a condition called hypocalcemic tetany —caused when the small parathyroid glands are accidentally removed or damaged during thyroid surgery. Sadly, I see many such patients who come with scars, weak voices, repeated hospital visits, and constant medication needs. Most of them went through surgery without knowing that there was another way—a better, safer option now available in Bangladesh.

That option is called radiofrequency ablation, or RFA. This is a modern, non-surgical treatment for thyroid nodules or tumours. Instead of cutting the neck and removing the thyroid, RFA uses heat energy through a thin needle to destroy only the part of the thyroid that has the problem. It is done under ultrasound guidance to ensure accuracy. The healthy part of the thyroid is left untouched, and the whole procedure takes just 30 to 40 minutes. Patients can go home the same day without needing admission, stitches, or general anaesthesia.

Unlike surgery, RFA does not leave a visible scar, and there is little to no pain. Most patients do not need lifelong thyroid hormone pills or calcium supplements after the procedure. Recovery is quick, and the cost is also lower than traditional surgery. Over time, the size of the thyroid nodule shrinks significantly—up to 93% in some cases. For those with hormone-producing nodules, hormone levels return to normal in over 80% of patients within months. This method is especially effective in Asian populations like ours.

The mentioned patient's story is not just her story—it is a reflection of many others who suffered after thyroid surgery simply because a safer, less painful method was not known or not available at the time. But now, with RFA available in Bangladesh, patients no longer need to live with scars, voice changes, or a lifetime of pills. This technology is time-demanding and necessary for our population, especially where thyroid problems are common. Early awareness and the right decision can save people from unnecessary suffering. Now is the time to embrace modern thyroid care.

The writer is the head of the Department of Endocrinology at the Sharkari Karmachari Hospital, Fulbaria, Dhaka.