Rai Effect On Cancer Cells
Some thyroid cancer cells also share the same ability as normal thyroid cells to take up iodine from the bloodstream. These are referred to as “iodine-avid”. If your cancer cells are able to do this, then I-131 may also destroy microscopic residual thyroid cancer cells or be used as a treatment for thyroid cancer that has spread to lymph nodes or other areas of the body. Doctors cannot tell by simply looking at the thyroid cells under the microscope if they can take up iodine. Determination of whether a patient’s thyroid cancer is iodine-avid depends on many factors such as the type of cancer and results of imaging studies, including whole body scans .
Prepared Foods And Eating Out
Even if you pick up a prepared dish or order something off a menu that seems to be made from foods that are fine for a low-iodine diet, you need to exercise some caution.
While some ingredients in a dish may be quite obvious, otherslike those in a “special sauce”may not be. Ask questions of your server. You may also be able to request some restaurant or catered foods without salt or with non-iodized salt.
Baked goods are often made with iodized salt, salted butter, egg yolks, and/or dairy products. Seek out specialty grocery stores and bakeries that sell items prepared with low iodine. Preparing these items yourself, however, may be easier.
Radiation Therapy For Thyroid Cancer
Radiation therapy uses high-energy rays or particles to destroy cancer cells. Many people with thyroid cancer have radiation therapy. Your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given. You may also receive other treatments.
Radiation therapy is given for different reasons. You could have radiation therapy to:
- destroy the cancer cells in the body
- destroy cancer cells left behind after surgery or chemotherapy to reduce the risk of the cancer coming back, or recurring
- destroy any normal thyroid tissue remaining after surgery to reduce the risk of the cancer coming back, or recurring
- relieve pain or control the symptoms of advanced thyroid cancer
The following types of radiation therapy are most commonly used to treat thyroid cancer.
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What Is Radioiodine Therapy And How Is It Used
Radioactive Iodine I-131 therapy is a treatment for an overactive thyroid, a condition called hyperthyroidism. Hyperthyroidism can be caused by Graves’ disease, in which the entire thyroid gland is overactive, or by nodules within the gland which are locally overactive in producing too much thyroid hormone.
Nuclear medicine uses small amounts of radioactive material called radiotracers. Doctors use nuclear medicine to diagnose, evaluate, and treat various diseases. These include cancer, heart disease, gastrointestinal, endocrine, or neurological disorders, and other conditions. Nuclear medicine exams pinpoint molecular activity. This gives them the potential to find disease in its earliest stages. They can also show whether you are responding to treatment.
The thyroid is a gland in the neck that produces two hormones that regulate all aspects of the body’s metabolism, the chemical process of converting food into energy. When a thyroid gland is overactive, it produces too much of these hormones, accelerating the metabolism.
Radioactive iodine , an isotope of iodine that emits radiation, is used for medical purposes. When a small dose of I-131 is swallowed, it is absorbed into the bloodstream in the gastrointestinal tract and concentrated from the blood by the thyroid gland, where it begins destroying the gland’s cells.
Radioactive iodine I-131 may also be used to treat thyroid cancer.
Is There Any Special Preparation Needed For The Procedure
You should not eat or drink after midnight on the day of the procedure. If you have been taking anti-thyroid medications, you must stop at least three days before the therapy is given. Frequently, the anti-thyroid medication is stopped for five to seven days before therapy.
You will be able to return home following radioactive iodine treatment, but you should avoid prolonged, close contact with other people for several days, particularly pregnant women and small children. The majority of the radioactive iodine that has not been absorbed leaves the body during the first two days following the treatment, primarily through the urine. Small amounts will also be excreted in saliva, sweat, tears, vaginal secretions, and feces.
If your work or daily activities involve prolonged contact with small children or pregnant women, you will want to wait several days after your treatment to resume these activities. Patients with infants at home should arrange for care to be provided by another person for the first several days after treatment. Your radiologist can be more specific for your given situation, but usually this time period is only two to five days.
Your treatment team will give you a list of other precautions to take following your treatment with I-131. The following guidelines comply with the Nuclear Regulatory Commission:
Women who have not yet reached menopause should fully discuss the use of I-131 with their physician.
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Signs Of Thyroid Cancer Include A Swelling Or Lump In The Neck
Thyroid cancer may not cause early signs or symptoms. It is sometimes found during a routine physical exam. Signs or symptoms may occur as the tumor gets bigger. Other conditions may cause the same signs or symptoms. Check with your doctor if you have any of the following:
- A lump in the neck.
- Trouble breathing.
Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
If the cancer returns after the original treatment, it is called recurrent cancer. It may come back in the same place , nearby , or in another place .
When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence. After this testing is done, you and your doctor will talk about the treatment options.
Often the treatment plan will include the treatments described above, such as surgery, radioactive iodine therapy, targeted therapy, external-beam radiation therapy, hormone therapy, and chemotherapy. However, they may be used in a different combination or given at a different pace. Your doctor may suggest clinical trials that are studying new ways to treat this type of recurrent cancer. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.
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Acid Body Conditions And Iodine Utilization
Iodine, which is high up on the atomic scale, requires near perfect pH for its assimilation into the body. Iodine is crucial for proper functioning of the thyroid but the thyroid does not get access to iodine unless the body pH is near perfect, as it usually is in the blood. Body mineral content and balances control the quantity of electricity in our bodies. The speed at which the electricity flows is controlled by the bodys pH balance and in fact, pH and voltage are measurements of each other.
There are complex biochemical processes taking place in the body constantly in an attempt to keep blood pH as near perfect as possible. These are known as the pH buffering systems. These buffering systems need a good balance of minerals to work effectively. If we are getting inadequate mineral intake from the food we eat, we are going to start having problems with our pH balancing systems.
Slightly alkaline intercellular fluids hold 10 to 20 times more oxygen than slightly acidic inter-cellular fluids. A pH 6.0 is ten times more acid than 7.0. pH 5.0 is 100 times more acid 4.0 is 1,000 times as acid and so on. The body pH value tells you how acidic or alkaline your body is relative to a neutral 7.0, and balanced body pH is essential for a healthy body and a major line of defense against sickness and disease.
Discuss Your Treatment Plan
Your doctor will discuss your treatment plan with you.
Your treatment plan will follow these steps that will take place over a few days:
1. On the first day, youll have blood tests. After those tests, youll see your doctor and get a thyrotropin alfa injection to help you get ready for your treatment. This injection will help any leftover thyroid tissue absorb the radioactive iodine.
2. On the second day, youll get another thyrotropin alfa injection. Then youll get a small diagnostic dose of radioactive iodine in a pill. You wont have to follow any precautions after getting this small diagnostic dose of radioactive iodine. After you take this pill, youll have a whole-body scan. This scan will show your doctor how the radioactive iodine is being taken up in your body.
3. On the third day, youll have your full dose of radioactive iodine treatment. This is an outpatient procedure, so you wont be admitted to the hospital.
4. Youll have another whole-body scan several days after your treatment. This helps your doctor see where the dose of radioactive iodine was taken up in your body.
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Side Effects And Risks
RAI treatment may cause a dry mouth, so suck on sour hard candies or chew gum to stimulate your salivary glands. It may also dry up tears, so your doctor may suggest not wearing contact lenses for a while. Drink lots of water to flush out the radioactivity.
Other side effects may include:
- Changes in taste or loss of taste
- Sore neck and swelling
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:
- Neck tenderness and swelling
- Taste changes
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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What Happens During Radioactive Iodine Treatment
You have iodine treatment as a drink or capsule which you swallow. The capsule is about the size of a paracetamol capsule. You wont be able to eat or drink for a couple of hours afterwards so that your body can absorb the iodine. After that, you should drink plenty of fluids to flush the radioactive iodine out of your system. You can eat as normal.
The treatment makes you radioactive. So your sweat, urine and saliva will be radioactive for a few days. There are certain precautions that you and the staff need to follow. Try not to be alarmed by these. Your treatment contains a low dose of radiation that is necessary to treat your cancer.
A radiation monitor may be used to check your levels of radioactivity or test anything that is taken out of your room.
Your meals may be served on disposable plates with disposable cutlery. You put these in a special bin when you have finished with them.
The hospital staff ask you to flush the toilet more than once after you have used it and to shower each day.
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.
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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.
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.
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How Does Radioactive Iodine Treat Hyperthyroidism
Your thyroid, a butterfly-shaped gland located in the lower front of your neck, produces hormones that regulate your bodys metabolism and other functions. Hyperthyroidism speeds up the bodys processes causing nervousness and anxiety, rapid heartbeat, missed or light menstrual periods, sleep problems, hand tremors and other problems.
The thyroid gland needs iodine to make these hormones. The thyroid is the most efficient organ at concentrating iodine. RAI treats hyperthyroidism by damaging or destroying thyroid cells through radiation.
RAI is taken in an oral capsule form. You dont need to be hospitalized unless the dose is very high, which is rarely needed. You will be prompted to drink lots of water after taking the pill to flush the remaining radioactive iodine out of your system.
Most patients need only one dose before their hyperthyroidism is resolved, which may take a few weeks to several months. If your symptoms are still there after six months, you may have to receive a second dose.
Radioactive Iodine Therapy For Thyroid Nodules
The thyroid, a butterfly-shaped gland that is located in the front of the neck, produces hormones that are crucial in the regulation of the bodys functions. However, to make them, the gland requires iodine. Fortunately, the thyroid is the only organ that concentrates iodine and holds on to it. This is the basis for radioactive iodine therapy.
RAI therapy uses a radioactive form of iodine because it can be taken up and processed by the thyroid, the same way as natural iodine. However, once it reaches its destination, it causes permanent destruction to the thyroid tissue by emitting radiation, while sparing other tissues in the body.
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How Is The Procedure Performed
Treatment for hyperthyroidism is almost always done on an outpatient basis because the dose required is relatively small.
The radioiodine I-131 is swallowed in a single dose, in capsule or liquid form, and is quickly absorbed into the bloodstream in the gastrointestinal tract and concentrated from the blood by the thyroid gland, where it begins destroying the gland’s cells. Although the radioactivity from this treatment remains in the thyroid for some time, it is greatly diminished within a few days. The effect of this treatment on the thyroid gland usually takes between one and three months to develop, with maximum benefit occurring three to six months after treatment. Usually, a single dose is successful in treating hyperthyroidism. However, rarely, a second treatment is needed, and very rarely a third treatment may be needed.
Cancer May Spread From Where It Began To Other Parts Of The Body
- Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor in another part of the body.
- Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if thyroid cancer spreads to the lung, the cancer cells in the lung are actually thyroid cancer cells. The disease is metastatic thyroid cancer, not lung cancer.
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