How does radioactive iodine treat thyroid cancer?
Treatment with radioactive iodine helps reduce the risk that thyroid cancer will come back. It is also used to treat thyroid cancer that has spread. Radioactive iodine enters your bloodstream and is taken up by your thyroid cells. The radioactivity destroys the cancer cells.
Is radioactive iodine treatment an inpatient or outpatient procedure?
Ana Maria Kausel, MD, is a double board-certified endocrinologist affiliated with Mount Sinai St. Luke's/Mount Sinai West in New York City. If radioactive iodine treatment (RAI) is recommended as part of your treatment for Graves’ disease, hyperthyroidism, or thyroid cancer, you will most likely be given it as an outpatient.
What are the risks of radioactive iodine treatment?
Because the radioactive iodine used (known as iodine 131) may expose those around you to the effects of radiation (and theoretically negatively affect their thyroid glands), you will be given guidelines on how to prevent such exposure.
How to clear the radioactive iodine from your body?
Clearing the radioactive iodine from your body 1 Drink lots of liquids. Starting right after your treatment, try to drink at least 1 cup... 2 Your urine will be radioactive so urinate as much as you can to empty your bladder. 3 Your bowel movements (poop) will also be radioactive. 4 Some people have a dry mouth after treatment.
Do I need radioactive iodine treatment?
Radioactive iodine therapy helps people live longer if they have papillary or follicular thyroid cancer (differentiated thyroid cancer) that has spread to the neck or other body parts, and it is now standard practice in such cases.
Who needs radioactive iodine?
Radioiodine therapy is a nuclear medicine treatment. Doctors use it to treat an overactive thyroid, a condition called hyperthyroidism. They also may use it to treat thyroid cancer.
Does radioactive iodine treatment cause cancer?
Findings from a study of patients who received radioactive iodine (RAI) treatment for hyperthyroidism show an association between the dose of treatment and long-term risk of death from solid cancers, including breast cancer.
What happens to your body after radioactive iodine treatment?
A swollen or tender neck and feeling flushed Some people may have a feeling of tightness or swelling in their neck for a few days after treatment. This is more common if you still had a large part of your thyroid gland when you have radioactive iodine treatment. Some people also feel flushed.
Does radioactive iodine treatment shorten your life?
Quality of life is worse at 6-10 years after radioactive iodine therapy of Graves' disease compared with treatment with antithyroid drugs or surgery. Quality of life is worse at 6-10 years after radioactive iodine therapy of Graves' disease compared with treatment with antithyroid drugs or surgery.
Does radioactive iodine affect your immune system?
Treatment of Graves' disease patients with radioactive iodide (RAI) can induce two therapeutically important alterations in immune response to thyroid antigens. These may be characterized as a first response and a second phase response.
What are the chances of getting cancer from radioactive iodine?
Young adults who received radioactive iodine therapy for differentiated thyroid cancer were at 92% increased risk for leukemia and 23% increased risk for any solid malignancies vs. those who did not receive radioactive iodine therapy.
Does radioactive iodine have long-term effects?
Long-term side effects from radioactive iodine treatment can impact patients' quality of life, Haymart says. The biggest issue is damage to patients' salivary glands and tear ducts caused by the radiation.
How effective is radioactive iodine therapy?
Conclusion: Radioactive iodine treatment is an effective modality for definitive treatment of hyperthyroidism with long-term cure approaching 80%.
Which is better radioactive iodine or surgery?
Surgery for hyperthyroidism was associated with a lower risk of all-cause and cardiovascular death as compared to radioactive iodine therapy during long-term follow-up, particularly in men.
What is the most common complication of radioiodine therapy?
The most common adverse reaction to medical therapy was a rash in 8 patients, followed by neutropaenia (neutrophils < 1.0 × 109/L) in 6 patients. LFT derangement was reported in 3 patients taking PTU and 1 patient taking carbimazole.
Can the thyroid gland grow back after radioactive iodine?
Once hypothyroidism has been achieved, it is usually irreversible with the patient requiring lifelong thyroid replacement. Recurrence of hyperthyroidism after RAI therapy may be due to inadequate dosing or early Marine Lenhart syndrome.
What is the radiation used for thyroid cancer?
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 (destroy) 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.
How long after radiation therapy can you go home?
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.
How long should I take thyrotropin before RAI?
Another way is to get an injection (shot) of thyrotropin (Thyrogen), which can make withholding thyroid hormone for a long period of time unnecessary. This drug is given daily for 2 days, followed by RAI on the 3 rd day. Most doctors also recommend that you follow a low iodine diet for 1 or 2 weeks before treatment.
How to treat RAI?
For RAI therapy to be most effective, you must have a high level of thyroid-stimulating hormone (TSH or thyrotropin) in the blood. This hormone is what makes thyroid tissue (and cancer cells) take up radioactive iodine. If your thyroid has been removed, there are a couple of ways to raise TSH levels before being treated with RAI: 1 One way is to stop taking thyroid hormone pills for several weeks. This causes very low thyroid hormone levels (hypothyroidism), which makes the pituitary gland to release more TSH. This intentional hypothyroidism is temporary, but it often causes symptoms like tiredness, depression, weight gain, constipation, muscle aches, and reduced concentration. 2 Another way is to get an injection (shot) of thyrotropin (Thyrogen), which can make withholding thyroid hormone for a long period of time unnecessary. This drug is given daily for 2 days, followed by RAI on the 3 rd day.
Can you use rai for thyroid cancer?
Discuss your risks and benefits of RAI therapy with your doctor. Radioactive iodine therapy cannot be used to treat anaplastic (undifferentiated) and medullary thyroid carcinomas because these types of cancer do not take up iodine.
Can radiation cause irregular periods?
Radioactive iodine may also affect a woman’ s ovaries, and some women may have irregular periods for up to a year after treatment.
Does radioactive iodine help with thyroid cancer?
Radioactive iodine therapy helps people live longer if they have papillary or follicular thyroid cancer (differentiated 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 ...
How long does radioactive iodine treatment last?
Having radioactive iodine treatment for thyroid cancer. Radioactive iodine treatment takes place in the hospital. You usually stay there for a few days until your radiation levels have fallen to a safe level. You will be looked after in a single room, where you stay alone.
How long after iodine treatment can you drink?
The capsule is about the size of a paracetamol capsule. You won’t 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.
How long does thyroid cancer last?
Papillary thyroid cancer patients must be taken off of levothyroxine thyroid hormone (T4 hormone) for a minimum of four weeks, taken off of liothyrionine thyroid hormone (T3 hormone) for a minimum of two weeks, or receive a medication which is TSH (which is a pharmaceutical production of the Thyroid Stimulating Hormone [TSH] produced as a recombinant protein which is identical to the TSH normally produced by the pituitary gland). 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 (usually at least two months). 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.
What is the uptake study for thyroid cancer?
The thyroid cancer uptake study can be utilized to determine the optimal dose of the radioactive iodine treatment the following day. In a papillary thyroid cancer uptake scan, the image will determine if there is any evidence of iodine uptake in the body. Approximately 90% of patients will have some uptake of iodine following a total thyroidectomy.
How long does it take to get a thyroid scan?
Following either of the above approaches to treat a papillary thyroid cancer with RAI, a scan is obtained following the therapeutic dose in 48 to 72 hours to determine the location and percent uptake of the radioactive iodine. The strength of radioactive iodine is described in millicuries. The papillary thyroid cancer treatment dose ...
How soon after thyroidectomy can you give RAI?
RAI can be given as early as 4-5 weeks following total thyroidectomy but can be delayed for months or even years following surgery. The papillary thyroid cancer must have the symporter for iodine and take up iodine to be effective. Papillary thyroid cancers that take up iodine are called iodine avid. Importantly, the ability of a papillary thyroid ...
What is the name of the cancer that has spread to the neck?
Papillary thyroid cancer that has spread to at least two lymph nodes in the neck (in any area of the neck) The papillary thyroid cancer team desire to destroy any additional thyroid tissue (which is producing thyroglobulin) Papillary thyroid cancer that has spread to distant sites (lungs, bones, and liver) The papillary thyroid cancer takes up the ...
Is papillary thyroid cancer a RAI?
The papillary thyroid cancer diagnosis, itself, is not an indication for RAI treatment. If you had a papillary thyroid cancer, 25 years ago, you would have almost certainly been treated with surgery and RAI. Today, only approximately 20% of all papillary thyroid cancer patients undergo post-0perative RAI treatment.
Does papillary thyroid cancer produce thyroid hormone?
Although papillary thyroid cancer rarely produces thyroid hormone itself, it frequently maintains this iodine symporter and ability to take up iodine. In the treatment of papillary thyroid cancer, this can be taken advantage of by having the patient swallow an iodine pill that has been radioactively charged.
What happens if you take radioactive iodine?
When you are given radioactive iodine, it is taken up by cancer cells and destroys them —including those that have spread to the lymph nodes or other parts of the body. If you’ve had surgery for papillary or follicular thyroid cancer, your doctor may prescribe radioactive iodine afterward.
What is radioactive iodine?
Iodine is a mineral found in table salt, seafood, and dairy products that the thyroid absorbs from the bloodstream and converts into thyroid hormone.
What hormones are needed for radioactive iodine therapy?
During that time, you experience what’s known as thyroid hormone withdrawal, which makes the pituitary excrete more TSH. Excess thyroid-stimulating hormone is necessary for the success of radioactive iodine therapy.
How long before radioactive iodine injection?
This injection is given for two days before radioactive iodine therapy begins.
Why do you need levothyroxine?
Whether you’ve been treated for a toxic nodule or thyroid cancer, you may need to take the synthetic thyroid hormone levothyroxine daily as part of your long-term care because radioactive iodine therapy destroys healthy thyroid tissue.
Where does radioactive iodine travel?
Radioactive iodine travels to the thyroid, where it is absorbed and gradually destroys overactive thyroid tissue, along with other thyroid tissue. Radioactive iodine may also be helpful for people with certain types of thyroid cancer. Papillary and follicular thyroid cancers develop from follicular cells, which absorb iodine.
How long do you stay in a hospital after iodine?
If you are receiving a high dose, you may stay in a private hospital room for a few days so that other people are not exposed to the radioactivity.
What is the National Cancer Institute?
About the National Cancer Institute (NCI): NCI leads the National Cancer Program and NIH’s efforts to dramatically reduce the prevalence of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers.
When was the thyrotoxicosis follow up study?
The new findings are from a long-term follow-up study of a large cohort of people with hyperthyroidism (mainly Graves’ disease) who were treated with radiation between 1946 and 1964 , the Cooperative Thyrotoxicosis Therapy Follow-up Study.
What is the NIH?
NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit nih.gov .
Which organ absorbs radiation?
Most of the radiation is absorbed by the thyroid gland, but other organs like the breast and stomach are also exposed during treatment. The researchers observed positive dose–response relationships between the dose absorbed by an organ and mortality from cancer at that site.
How to minimize radiation risks?
Keep Your Distance. Here are some ways to minimize radiation risks to other people (and pets) after you have had RAI treatment: Stay at least six feet away from other people, including members of the public, family members, and co-workers, for three to 11 days. This means avoiding public transportation, hotels, carpools, and in some cases, ...
How to avoid radiation?
Here are some ways to minimize radiation risks to other people (and pets) after you have had RAI treatment: 1 Stay at least six feet away from other people, including members of the public, family members, and co-workers, for three to 11 days. This means avoiding public transportation, hotels, carpools, and in some cases, your workplace. 2 Sleep apart from adults by at least six feet (a separate bedroom is recommended) and avoid sexual activity. 3 Avoid sleeping in the same bed with a pregnant woman, infant, or child for a period of six to 23 days. According to the Nuclear Regulatory Commission, infants and children should ideally stay outside the home for the recommended period. 1 4 To protect family pets, do not sleep with them for up to 21 days.
Does iodine affect thyroid?
Because the radioactive iodine used (known as iodine 131) may expose those around you to the effects of radiation (and theoretically negatively affect their thyroid glands), you will be given guidelines on how to prevent such exposure. Laura Porter / Verywell.
How long can you live after iodine treatment?
You can expect to live a fairly normal life after radioactive iodine treatment but your life will probably not be exactly as it was before your procedure. For most people, this means that you can expect to live at 80-90% of your 'normal'.
How long does radioactive iodine affect sperm count?
Important to men is the fact that radioactive iodine can cause short-term reductions in sperm count for up to 2 years after your procedure (8). This may or may not be important to you based on your age, your gender, and whether or not fertility is something you are interested in but, again, it's worth knowing about.
What happens if you destroy your thyroid gland?
And, if you destroy your thyroid gland, it turns out that that may have consequences on your metabolism. Anectodally, you've probably already heard stories about people gaining weight after their procedure.
Can you survive after RAI?
You can obviously survive after RAI (otherwise they wouldn't do the procedure) but I want to teach you how to thrive afterward. And to key to getting there is to understand what happens to your body after this procedure and how it influences your thyroid function.
Can you take a thyroid pill every day?
There's no way for doctors to give you a pill once a day and for that pill to perform the exact same function that your thyroid gland does every minute of every day. Because of this, people may experience symptoms which may lead them to want to restore whatever thyroid function they can.
Can beta cells take up iodine?
But you probably at least know a little bit about RAI or you wouldn't be here.
Can you gain weight after radioactive iodine treatment?
You may gain weight. This is probably not what you want to hear, especially if this is a procedure that is necessary for your health, but it's still important to know about it. You may gain weight after you undergo radioactive iodine treatment.
Mechanism of action
- The mechanism of how RAI Treatment works to treat thyroid cancer was not discovered until years following its use to treat papillary thyroid cancers. We now know today that papillary thyroid cancers can possess a type of key hole on the surface of their cell called a symporter that allows iodine to be taken into the cell. Under normal circumstances, iodine is taken up by normal thyroi…
Treatment
- The papillary thyroid cancer diagnosis, itself, is not an indication for RAI treatment. If you had a papillary thyroid cancer, 25 years ago, you would have almost certainly been treated with surgery and RAI. Today, only approximately 20% of all papillary thyroid cancer patients undergo post-0perative RAI treatment. RAI treatment is primarily beneficial only when the patient has undergo…
Contraindications
- Papillary thyroid cancer patients must be taken off of levothyroxine thyroid hormone (T4 hormone) for a minimum of four weeks, taken off of liothyrionine thyroid hormone (T3 hormone) for a minimum of two weeks, or receive a medication which is TSH (which is a pharmaceutical production of the Thyroid Stimulating Hormone [TSH] produced as a recombinant protein which …
Diagnosis
- Papillary thyroid cancer guidelines for post operative treatment with radioactive iodine were last updated in the American Thyroid Association 2015 edition. Some endocrinologists and nuclear medicine specialists order a preliminary nuclear study called a thyroid cancer uptake study. After your doctor has prepared your body for RAI by either stoppin...
Results
- In a papillary thyroid cancer uptake scan, the image will determine if there is any evidence of iodine uptake in the body. Approximately 90% of patients will have some uptake of iodine following a total thyroidectomy. Papillary thyroid cancer is not the only reason that iodine can be taken up by tissue. One such issue is retained thyroid tissue. How much retained thyroid tissue i…