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How Many Radioactive Iodine Treatments For Thyroid Cancer

Clearing The Radioactive Iodine From Your Body

Radioactive Iodine Treatment for Thyroid Cancer

Some of the radioactive iodine will be taken up by your thyroid cells, but there will be some left over. Most of the extra radioactive iodine will leave your body through your urine , and smaller amounts will leave your body in your saliva , sweat, and bowel movements .

Follow these guidelines to help the radioactive iodine leave your body quickly.

  • Drink lots of liquids. Starting right after your treatment, try to drink at least 1 cup of low-iodine liquid every hour while youre awake. Keep doing this for 2 to 3 days after your treatment. You dont have to wake up at night to drink liquids.
  • Your urine will be radioactive so urinate as much as you can to empty your bladder. Try not to get urine outside of the toilet. If you do get urine outside of the toilet, wear gloves and clean up it up with an all-purpose cleaning disinfectant. If you normally stand while urinating, sit for 2 days after your treatment unless your healthcare provider gives you other instructions. This is so you can avoid getting urine anywhere but the toilet. Try to urinate every time you feel the urge instead of holding it in your bladder.
  • Your bowel movements will also be radioactive. Go to the bathroom as much as you can so your bowel movements dont stay in your colon.
  • If youre often constipated , ask your doctor about taking laxatives before your treatment. If you dont have a bowel movement within 24 hours after your treatment, call your doctor.

What Is Radioactive Iodine Therapy

Radioactive iodine can be used for the treatment of overactive thyroid and certain types of thyroid cancer. The term radioactive may sound frightening, but it is a safe, generally well-tolerated, and reliable treatment that targets thyroid cells so there is little exposure to the rest of your bodys cells.

How Long Does It Take For Radioactive Iodine To Work

One additional patient received radioactive iodine treatment despite of having a negative radioiodine scan. Of note, all 3 patients with RAS mutations showed uptake on the scan and received radioactive iodine treatment. The average I-131 dose was 204 mCi. The cancer drug was discontinued 2 days after the radioactive iodine treatment.

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Protecting Others From The Radiation

Being in a room on your own protects other people from radiation. Pregnant women and children are not allowed into your room. Other visitors may be able to stay for a short time when it is safe for them to do so.

The amount of time staff are allowed into your room is limited. They stay at a safe distance from you and can only stay in your room with you for as long as is necessary. This is because they will care for many people who have this treatment. So the amount of radiation they are exposed to has to be carefully controlled. It is important that you know that you are not at any risk from the radiation.

What Happens During Radiation Treatment

Small Advantage for Radioiodine in Thyroid Ca

Two types of radiation are used for thyroid cancer patients.

During I-131 treatment: You will swallow a capsule or pill that contains radioactive iodine . Both healthy and cancerous thyroid cells absorb the I-131, which destroys them. This treatment is usually given in a hospital. You may stay overnight. During the treatment and for a short period after, you will give off radiation. Your doctor will tell you how to protect your family, friends and pets at home. See the Radioactive Iodine Therapy page for more information.

External Beam Therapy : EBT begins with treatment planning using either x-rays or a computed tomography scan. These exams help plan the type and direction of radiation beams to treat the cancer. Each treatment will last a few minutes each day, although it may take longer to get you set up. Once the radiation starts, you will hear some electrical noise and see warning lights from the machine. Patients do not feel the radiation during treatment.

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Pregnancy And Radioactive Iodine Therapy

Dont get pregnant or get your partner pregnant for at least 6 months after getting radioactive iodine therapy, or as long as your doctor tells you to. Use birth control after treatment for at least 6 months after getting this treatment. If youre planning to have a child, talk with your doctor about your plans before your treatment.

If I Choose Surgery Will I Need Radiation Therapy Or Vice Versa

Surgery is the primary therapy for thyroid cancer and is often effective. If the tumor is large, has spread to lymph nodes or you are at high risk for the cancer returning after treatment, you will most likely have surgery followed by I-131 treatment. Surgery followed by EBT and chemotherapy or targeted therapy is used for medullary or anaplastic thyroid cancer. For advanced thyroid cancer patients, treatment may consist of all the therapies listed above.

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How Can I Choose From Among The Options

In addition to talking with family and friends, you will need a team of doctors to help advise you. This team may include a surgeon, a radiologist, a radiation oncologist, a medical oncologist and an endocrinologist, a doctor who specializes in diseases of the glands. A radiation oncologist treats cancer with radiation. A medical oncologist treats cancer with drugs. You and your care team will create a treatment plan that works best for your cancer.

Preparation Of A Papillary Thyroid Cancer Patient For Radioactive Iodine Treatment

Demonstration of Radioactivity from Thyroid Cancer Treatment

Papillary thyroid cancer patients must be taken off of levothyroxine thyroid hormone for a minimum of four weeks, taken off of liothyrionine thyroid hormone for a minimum of two weeks, or receive a medication which is TSH . Additionally, papillary thyroid cancer patients must be on a low iodine diet for a minimum of four weeks to starve their body of iodine. Those patients which have undergone CAT scans with intravenous contrast must wait until their blood iodine levels have been adequately decreased . Note, a desire to treat with radioactive iodine should never prevent the use of necessary CAT scans for the evaluation of a papillary thyroid cancer patient.

The potential risks of RAI treatment include:

  • Dry mouth and or eyes
  • Narrowing of the drainage duct of the eyes tears leading to excessive tearing down the cheek
  • Swelling in your cheeks from inflammation or damage to the saliva producing glands
  • Short term changes to taste and smell
  • Lowered testosterone levels in males
  • Change in periods in women
  • Second tumors

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If Treatment Does Not Work

Recovery from thyroid cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and for some people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.

People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life.

You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

After Radioactive Iodine Treatment For Thyroid Cancer

Having radioactive iodine treatment means you will be radioactive for several days afterwards. You will be able to go home from hospital when the radiation level in your body is at a safe level. As you will still have some radioactivity in your body you may still have to take some precautions when you go home. Your healthcare team will explain everything to you.

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How Does Radioactive Iodine Treat Thyroid Cancer

The most common types of thyroid cancer can usually be treated with large doses of radioactive iodine. The therapy is usually given after removal of the thyroid gland to destroy any remaining thyroid tissue.

A tracer dose of radioactive iodine can also be used to track remaining thyroid tissue and/or cancer that could have spread to other parts of the body. These tests show if iodine concentrates in areas that contain thyroid cancer, and whether large amounts of RAI are needed to destroy the tumor implants.

Diagnosis Of Thyroid Cancer

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    Usually, diagnosing thyroid cancer begins when a routine test suggests a problem with the thyroid. Your doctor will ask you about any symptoms you have and do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for cancer or other health problems.

    The process of diagnosis may seem long and frustrating. Its normal to worry, but try to remember that other health conditions can cause similar symptoms as thyroid cancer. Its important for the healthcare team to rule out other reasons for a health problem before making a diagnosis of thyroid cancer.

    The following tests are commonly used to rule out or diagnose thyroid cancer. Many of the same tests used to diagnose cancer are used to find out the stage, which is how far the cancer has progressed. Your doctor may also order other tests to check your general health and to help plan your treatment.

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    Radioiodine Should Be Used Only In Selected Cancer Patients

    In patients with distant metastases, various treatment dosages are administered depending on the center. However, no evidence exists that any protocol based on dosimetry or using high activities may be more effective than repeated treatments with a standard activity of 3.7 GBq administered following thyroid hormone withdrawal. Complete responses are obtained in 40 percent of distant metastases with radioiodine uptake, and predictive factors for cure are younger age at discovery of the metastases, small size of metastases, well differentiated cancer histotype, and low uptake of FDG on PET scan. Almost all complete responses were obtained with a cumulative activity of 22 GBq or less, and few progressions have been observed after complete remission.

    These findings led to the definition of refractory thyroid cancers, which are observed in patients with: at least one target lesion with no detectable iodine uptake, progression during the 12 months following radioactive iodine remnant ablation, or persistent disease after the administration of 22 GBq. Indeed, radioiodine should not be given to patients who meet one of these criteria. They may be candidates for other treatment modalities in case of documented progression.

    In conclusion, the use of radioiodine is easy and is usually well tolerated, but it should be used only in selected thyroid cancer patients for whom benefits have been demonstrated.

    Plan For Transportation After Treatment

    Radioactive iodine gives off radiation. This means that after your treatment, you wont be able to go home using public transportation such as buses, the subway, trains, or a plane. You can drive yourself home, have someone pick you up and take you home, or take a taxi or private car home. See our Resources section for information about car services.

    Make a plan for getting home before you come for your treatment.

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    Are There Permanent Side Effects From The Procedure

    It is highly likely that some or most of the thyroid gland will be destroyed with this procedure. Since hormones produced by the thyroid are essential for metabolism, most patients will need to take thyroid pills for the rest of their life following the procedure. Thyroid pills are inexpensive, and patients will typically be instructed to take one per day. There are essentially no other permanent side effects from the procedure.

    What Is Radioactive Iodine

    Radioactive Iodine Treatment of Thyroid Cancer and Risk of Myelodysplastic Syndromes

    Radioactive iodine is a treatment that uses radiation to treat thyroid cancer. The radiation comes from a radioactive substance called iodine-131. You usually take radioactive iodine as a capsule that you swallow. Radioactive iodine is a treatment for papillary and follicular thyroid cancers.

    RAI may be given to:

    • destroy any normal thyroid tissue still in the neck after surgery this is called radioiodine remnant ablation
    • treat any thyroid cancer that could not be surgery
    • reduce the risk of thyroid cancer coming back
    • treat thyroid cancer that has come back after treatment.

    Usually, the thyroid gland takes iodine from our diet and uses it to make thyroid hormones. When you have RAI, the thyroid cells take in the iodine and get a very high dose of radiation. This destroys the thyroid cells and any cancer cells that may be left after surgery.

    RAI does not affect other parts of the body in the same way. This is because other cells do not absorb iodine as much as thyroid cells.

    You may be offered RAI treatment again if your tests show:

    • there are still some thyroid cells after treatment
    • the cancer has come back.

    Before you have radioactive iodine treatment, you will usually be asked to start eating a low-iodine diet. You may be asked to stop taking your thyroid hormones.

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    Having Your Radioactive Iodine Treatment

    You are usually admitted to the ward on the day of your RAI treatment. You usually have radioactive iodine as a capsule. Before and after the treatment, you can eat normally. Your nurse will encourage you to drink plenty of fluids.

    Because the iodine is radioactive, you will be radioactive for a while after the treatment. The radioactivity will slowly leave your body in your:

    • urine

    When Do You Have Radioactive Iodine

    You might have radioactive iodine treatment:

    • after surgery, to kill any cancer cells that may have been left behind
    • to treat thyroid cancer that has spread
    • to treat thyroid cancer that has come back after it was first treated

    You may only need to have this treatment once. But it can be repeated every 3 months if needed, until there is no sign of any thyroid cancer on your scans.

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    When To Have Rai Treatment

    RAI is generally not given until some weeks after surgery, once any swelling has gone down. This is because swelling can affect the blood flow and stop the RAI circulating well.

    It is not safe to have RAI treatment if you are pregnant or breastfeeding, so treatment may be delayed. RAI may be given up to six months after surgery. Ask your doctor for more information.

    Radioactive Iodine Therapy For Thyroid Cancer

    Thyroid Cancer

    Your thyroid gland absorbs nearly all of the iodine in your body. Because of this, radioactive iodine can be used to treat thyroid cancer. The RAI collects mainly in thyroid cells, where the radiation can destroy the thyroid gland and any other thyroid cells that take up iodine, with little effect on the rest of your body. The radiation dose used here is much stronger than the one used in radioiodine scans, which are described in Tests for Thyroid Cancer.

    This treatment can be used to ablate any thyroid tissue not removed by surgery or to treat some types of thyroid cancer that have spread to lymph nodes and other parts of the body.

    Radioactive iodine therapy helps people live longer if they have papillary or follicular thyroid cancer that has spread to the neck or other body parts, and it is now standard practice in such cases. But the benefits of RAI therapy are less clear for people with small cancers of the thyroid gland that do not seem to have spread, which can often be removed completely with surgery. Discuss your risks and benefits of RAI therapy with your doctor. Radioactive iodine therapy cannot be used to treat anaplastic and medullary thyroid carcinomas because these types of cancer do not take up iodine.

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    Risks And Side Effects

    Your body will give off radiation for some time after you get RAI therapy. Depending on the dose of radioiodine used and where you are being treated, you might need to be in the hospital for a few days after treatment, staying in a special isolation room to prevent others from being exposed to radiation. Some people may not need to be hospitalized. Once you are allowed to go home after treatment, you will be given instructions on how to protect others from radiation exposure and how long you need to take these precautions. These instructions may vary slightly by treatment center. Be sure you understand the instructions before you leave the hospital.

    Short-term side effects of RAI treatment may include:

    Chewing gum or sucking on hard candy may help with salivary gland problems.

    Radioiodine treatment also reduces tear formation in some people, leading to dry eyes. If you wear contact lenses, ask your doctor how long you should keep them out.

    Men who receive large total doses of radiation because of many treatments with RAI may have lower sperm counts or, rarely, become infertile. Radioactive iodine may also affect a womans ovaries, and some women may have irregular periods for up to a year after treatment. Many doctors recommend that women avoid becoming pregnant for 6 months to a year after treatment. No ill effects have been noted in the children born to parents who received radioactive iodine in the past.

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