What happens during radioactive iodine therapy for thyroid cancer?
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. Rarely, people can feel pain in their neck.
What is radioactive iodine used for?
Radioactive iodine (RAI) is treatment for overactive thyroid (hyperthyroidism) 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 body’s cells.
What is a pretherapy scan before radioactive iodine treatment?
Jan 12, 2022 · Pediatrics 47 years experience. translation= focal is a derivative of focus meaning the uptake is most apparent at that location. Answered Jan 12, 2022. Thank. 1 thank. Ask U.S. doctors your own question and get educational, text answers — it's anonymous and free! 0/250.
How do you receive radioactive iodine treatment?
Jul 10, 2012 · Pathologic radioiodine uptake in benign fibroadenoma of the breast; A - planar scintigraphy, B - MR mammography. Post-therapy scintigraphy, performed 4 days after a second course of I-131 treatment, showed mild iodine uptake in the former thyroid bed as well as focal dystrophic radioiodine uptake in the region of the right breast (A, arrow).
What is the most common complication of radioiodine therapy?
Acute risks associated with RAI therapy include nausea and vomiting, ageusia (loss of taste), salivary gland swelling, and pain.
Can you get thyroid cancer after radioactive iodine?
The present meta-analysis similarly found an increasing cancer risk after RAI therapy for hyperthyroidism with higher administered dose. The studies that reported dose-response cancer risks by RAI doses were relatively higher quality than those of other included studies.Sep 17, 2021
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.May 24, 2021
Can thyroid still function after radioactive iodine treatment?
Some patients will still require treatment with antithyroid medication for some weeks or months until the radioactive iodine has been effective and the overactivity has settled. Over two-thirds of those who have radioactive iodine treatment will develop hypothyroidism (an underactive thyroid).Sep 11, 2019
Is thyroid cancer curable?
This gland produces hormones that regulate your metabolism (how your body uses energy). Thyroid hormones also help control your body temperature, blood pressure and heart rate. Thyroid cancer, a type of endocrine cancer, is generally highly treatable with an excellent cure rate.Aug 13, 2020
What type of cancer does radioactive iodine cause?
This new analysis concluded that radioactive iodine was associated with an increased risk for mortality from overall cancer, breast cancer, and non-breast solid cancers.Jan 18, 2022
What are the side effects of radioactive iodine?
What are the side effects of radioactive iodine?Neck tenderness and swelling.Nausea.Swollen salivary glands.Loss of taste or taste change.Dry mouth/insufficient salivary production.Dry eyes.Excessive tearing from the eyes.Sep 8, 2020
How long does radioactive iodine side effects last?
Other side effects of radioactive iodine include: Metallic taste in the mouth: This can last for a few weeks. Nausea: This usually subsides one to two days after treatment. Swollen salivary glands: This can last for a few weeks.
How long does it take to recover from radioactive iodine treatment?
In almost all cases, your thyroid hormone levels will return to normal or below normal after radioactive iodine treatment. This may take 8 to 12 weeks or longer.
Can hyperthyroidism return after radioactive iodine?
Abstract. The use of radioactive iodine (131I) in the treatment of Graves' disease results frequently in hypothyroidism requiring thyroid hormone supplementation. Relapse of Graves' disease months after inadequate treatment with 131I is well-recognized.
Can radiation treatment cause thyroid problems?
Many patients who have radiation therapy for head and neck cancer receive radiation to the area of the thyroid gland, an important organ located in the midline lower neck. Damage to the thyroid gland from radiation therapy can result in hypothyroidism.
Do you still need iodine without a thyroid?
Iodine is an element that is needed for the production of thyroid hormone. The body does not make iodine, so it is an essential part of your diet. Iodine is found in various foods (see Table 1). If you do not have enough iodine in your body, you cannot make enough thyroid hormone.
What is the treatment for thyroid cancer?
The most common types of thyroid cancer (papillary and follicular) can usually be treated with large doses of radioactive iodine. (The dosages of RAI are much higher than with hyperthyroidism treatment.) The therapy is usually given after removal of the thyroid gland to destroy any remaining thyroid tissue. A “tracer” dose of radioactive iodine can ...
What are the side effects of RAI?
Temporary side effects of RAI may include: 1 Neck tenderness and swelling. 2 Nausea. 3 Swollen salivary glands. 4 Loss of taste or taste change. 5 Dry mouth/insufficient salivary production. 6 Dry eyes. 7 Excessive tearing from the eyes.
When should breast feeding be stopped?
Breast feeding should be stopped at least six weeks before RAI and should not be resumed. In the days immediately following your RAI therapy, be aware of these general precautions to prevent radioactive exposure to others.
What is a tracer used for?
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.
How does RAI work?
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 don’t need to be hospitalized unless the dose is very high, which is rarely needed.
Can RAI cause hypothyroidism?
Permanent hypothy roidism (or underactive thyroid, when the thyroid does not produce enough hormones) is an expected side effect of RAI treatment for hyperthyroidism. Fortunately, hypothyroidism is much easier to treat than hyperthyroidism using hormone replacement therapy.
What does sarcoid mean?
Sarcoid?: It means that there is a slight uptake of radiolabeled sugar (glucose) in the middle of your chest. This may be normal, or may be nothing, or maybe sa ... Read More
What is contrast imaging?
Contrast imaging: I take it that you have had a contrast imaging of the knee. The term means that there is a filling defect in part of the knee (probably cartilage) th ... Read More
How long before radioactive iodine treatment can you eat?
Starting a low-iodine diet 2 weeks before radioactive iodine treatment is enough time to deplete your body's iodine levels and prepare it for radioactive iodine therapy. For low-iodine recipes, visit the Thyroid Cancer Survivors' Association Low-Iodine Cookbook. Receiving Radioactive Iodine Treatment. After preparing your body for radioactive ...
How long does it take for iodine to kill thyroid cancer?
One dose is usually enough to kill the remaining thyroid fragments and cancer cells. Radioactive iodine therapy can take anywhere from a few weeks to a few months to fully eliminate all papillary thyroid cancer cells. Special Considerations after Treatment.
What does TSH do to your thyroid?
Increase your levels of thyroid stimulating hormone (TSH). Healthy thyroid cells use iodine to make thyroid hormones, but cancerous thyroid cells absorb only a very small amount of iodine. What high levels of TSH do is stimulate the cancerous thyroid cells to absorb more iodine.
Which cells absorb iodine?
Thyroid cells are the main cells in the body that can absorb iodine, so no other cells are exposed to the radiation. When the thyroid cells —both healthy and cancerous—absorb the radioactive iodine, they are damaged or destroyed. Thyroid cancer cells, however, don't take up the radioactive iodine as easily as the healthy thyroid cells do.
How to raise TSH levels?
Another way to raise your TSH levels is by taking 2 doses of. Thyrogen ® (thyrotropin alfa for injection). This FDA-approved drug is specifically used to raise TSH levels before radioactive iodine treatment. Reduce iodine levels in your body with a low-iodine diet.
Is thyroidectomy safe?
If your papillary thyroid cancer (also known as papillary thyroid carcinoma) did not spread, and if your tumors were small, a thyroidectomy is often enough to remove the cancer from your body. But larger tumors and those that have spread (metastasized) to the lymph nodes and other parts ...
What is radioactive iodine ablation?
The process of destroying residual thyroid tissue is called radioactive iodine ablation. In patients who have an indication to undergo radioactive iodine ablation, there is currently no agreement regarding the best timing of administration.
What is differentiated thyroid cancer?
Differentiated thyroid cancers: Most thyroid cancers are differentiated cancers. The cells in these cancers look a lot like normal thyroid tissue when seen with a microscope. These cancers develop from thyroid follicular cells and include papillary and follicular thyroid cancers .
What is a total thyroidectomy?
When the entire thyroid is removed it is termed a total thyroidectomy. When less is removed, such as in removal of a lobe, it is termed a partial thyroidectomy. Excellent response: undetectable thyroglobulin (tumor marker) with negative imaging in thyroid cancer patients following treatment.
Does radioactive iodine kill thyroid cancer?
This is due to effective therapies, including surgery and, when needed, radioactive iodine therapy. Radioactive iodine works like a “magic bullet”, as it is taken up and destroys only thyroid cells, both normal and cancerous. The process of destroying residual thyroid ...
What are the posttreatment changes in head and neck cancer?
Posttreatment changes are affected by the type of surgery performed, reconstruction, neck dissection, and radiation therapy. Three types of flaps are used for reconstruction in the head and neck region: (a) the local flap, with geometric repositioning of adjacent tissue; (b) the pedicle flap, with rotation of donor tissue and preservation of the original vascular system; and (c) the free flap, with transfer of tissue that is revascularized by using microvascular surgical techniques. The posttreatment imaging findings in patients with head and neck cancer can be divided into four groups: altered anatomy secondary to surgical reconstruction, tumor recurrence, potential postsurgical complications, and possible postirradiation changes. Potential postsurgical complications are wound infection, abscess, fistula, flap necrosis, hematoma, chylous fistula, and serous retention. Possible postirradiation changes include mucosal necrosis, osteoradionecrosis, radiation-induced vasculopathy, radiation pneumonitis, radiation lung fibrosis, radiation-induced brain necrosis, and radiation-induced secondary malignancies. A familiarity with the imaging characteristics of posttreatment changes and of the potential complications caused by surgery and irradiation and an ability to differentiate these findings from tumor recurrence are essential for posttreatment surveillance and follow-up management of patients with head and neck cancer.
What are the different types of neck dissection?
The three major types of neck dissection are radical neck dissection, modified radical neck dissection, and selective neck dissection ( 1, 23 ). Radical neck dissection involves the removal en bloc of all of the ipsilateral lymph nodes (levels I–V), including the sternocleidomastoid muscle, internal jugular vein, submandibular gland, and spinal accessory nerve ( 1, 23 ). Indications for radical neck dissection are extensive cervical involvement or lymph nodes with gross extracapsular spread and invasion into the adjacent tissues. Modified radical neck dissection is the same as radical neck dissection but with preservation of one or more of the following structures: the sternocleidomastoid muscle, internal jugular vein, submandibular gland, or spinal accessory nerve. Modified radical neck dissection is indicated in patients with less spread and invasion. Modified radical neck dissection has some advantages; for example, preservation of the spinal accessory nerve prevents the development of adhesive capsulitis (frozen shoulder) ( 1, 18 ), and modified radical neck dissection causes less cosmetic deformity than radical neck dissection. Selective neck dissection has four common subtypes: the supraomohyoid type (levels I–III), the lateral type (levels II–IV), the posterolateral type (levels II–V), and the anterior compartment type (levels VI and VII) ( 1 ). Selective neck dissection preserves the functional and cosmetically relevant structures. Extended radical neck dissection is the same as radical neck dissection but includes the removal of additional nodes (levels VI and VII) and/or nonlymphatic structures such as the internal carotid artery, hypoglossal nerve, and vagus nerve.
How long does osteoradionecrosis last?
The exact definition of osteoradionecrosis has been controversial, but in general, it is a condition in which irradiated bone becomes devitalized and exposed through the overlying skin or mucosa, persisting without healing for at least 3 months ( 44 – 46 ). The reported incidence of osteoradionecrosis varies greatly in the literature, ranging from 0.4% to 22% in patients with head and neck cancer ( 45 – 47 ). Osteoradionecrosis often occurs 1–3 years after radiation therapy and most commonly occurs in patients who undergo radiation therapy after surgery. Osteoradionecrosis is unlikely to occur if the radiation dose is less than 60 Gy delivered by standard fractionation ( 44 – 46 ). Many risk factors for osteoradionecrosis have been reported; these include the irradiation technique, total radiation dose, photon energy, brachytherapy, field size, fractionation, xerostomia, periodontitis, preirradiation bone surgery, poor oral hygiene, alcohol and tobacco use, dental extractions, tumor location and stage, and proximity of the primary tumor to bone ( 44 – 46 ). With intensity-modulated radiation therapy, the dose to the mandible is controlled to reduce “hot spots” ( 24 ), and with the use of parotid-sparing techniques, the incidence of osteoradionecrosis should be reduced because xerostomia accelerates periodontal disease.
How long does it take for lung cancer to progress after radiation?
Radiation therapy for patients with head and neck cancer often includes the apical aspect of the thorax, to encompass the supraclavicular nodes and level IV nodal areas, and results in bilateral apical radiation-induced lung changes. Clinically, these changes may manifest as acute radiation pneumonitis or late radiation lung fibrosis. Radiation pneumonitis occurs within 1–3 months after completion of radiation therapy, and radiation fibrosis occurs within 6–12 months after radiation therapy and can progress for as long as 2 years before stability occurs ( 50 ). Radiation-induced lung disease rarely appears with a total radiation dose of less than 20 Gy. The symptoms are dyspnea, cough, and fever. Steroid therapy is commonly used as a treatment for symptomatic patients.
What are the complications of radiation therapy?
These complications include wound infection, abscess, fistula, flap necrosis, hematoma, chylous fistula, and serous retention. Multiple risk factors have been reported, including preoperative radiation therapy, preoperative chemoradiation therapy, prior tracheotomy, duration of surgery, type of flap, age, primary tumor stage, medical complications, malnutrition, anemia, tobacco use, and a history of habitual alcohol consumption ( 37, 38 ). The reported incidences of surgical complications in the head and neck after radiation therapy alone and after chemotherapy with radiation therapy are 37%–74% and 46%–100%, respectively ( 39 ).
How long does it take for a tumor to recur?
Tumors typically recur within the first 2 years after treatment. Tumors may recur within weeks after surgery, before adjuvant radiation therapy, because of accelerated repopulation. The most common locations for tumor recurrence are in the operative bed and at the margins of the surgical site ( Fig 10 ).
What is included in a neck CT?
Typically, the area imaged at neck CT extends inferiorly as far as the aortic arch and therefore includes the superior mediastinum. Visualized structures include the trachea, esophagus, aortic arch, and arch vessels, as well as the distal internal jugular veins, brachiocephalic veins, and superior vena cava. Under normal circumstances, the superior mediastinal fat should be homogeneous, without fat stranding or a pneumomediastinum. Residual thymic tissue should not be confused for disease, particularly in children and young adults ( 71 ). The vessels should exhibit normal opacification, without filling defects. The esophageal wall should not be thickened.
What is neck CT?
Interpreting findings seen at CT of the neck is challenging owing to the complex and nuanced anatomy of the neck , which contains multiple organ systems in a relatively small area. In the emergency department setting, CT is performed to investigate acute infectious or inflammatory symptoms and chronic processes. With few exceptions, neck CT should be performed with intravenous contrast material, which accentuates abnormally enhancing phlegmonous and neoplastic tissues and can be used to delineate any abscesses or necrotic areas. As part of the evaluation, the vascular structures and aerodigestive tract must be scrutinized, particularly for patency. Furthermore, although the patient may present because of symptoms that suggest non–life-threatening conditions involving structures such as the teeth or salivary glands, there may be serious implications for other areas, such as the orbits, brain, and spinal cord, that also may be revealed at the examination. With a focus on the emergency setting, the authors propose using an approach to interpreting neck CT findings whereby 12 areas are systematically evaluated and reported on: the cutaneous and subcutaneous soft tissues, aerodigestive tract and adjacent soft tissues, teeth and periodontal tissues, thyroid gland, salivary glands, lymph nodes, vascular structures, bony airspaces, cervical spine, orbits and imaged brain, lung apices, and superior mediastinum. The use of a systematic approach to interpreting neck CT findings is essential for identifying all salient findings, recognizing and synthesizing the implications of these findings to formulate the correct diagnosis, and reporting the findings and impressions in a complete, clear, and logical manner.
Where do vertebral arteries go?
The vertebral arteries course along the posterior neck, passing through the transverse foramina of the C2–C6 vertebrae. Atherosclerosis of the cervical arteries, particularly at the carotid bulbs, is extremely common in middle-aged and older adults and can be evaluated by using multiple modalities, including CT ( 50 ).
What are the subcutaneous tissues of the face?
The cutaneous and subcutaneous soft tissues include the skin, subcutaneous fat, and superficial muscles (eg, platysma muscle and facial expression muscles). The subcutaneous tissues may be the primary site of inflammation or an indication of adjacent inflammation. Primary cellulitis of the subcutaneous tissues of the face may be caused by disruption of the skin due to chronic skin conditions (such as eczema and psoriasis), infection of a hair follicle (folliculitis), a retained foreign body, or minimal trauma. On CT images, the subcutaneous fat and muscular structures should have sharp definition without infiltration of the subcutaneous fat.
Is cervical spine MRI or CT?
At standard CT evaluation of the neck, the craniocervical junction and the entire cervical spine are included, and abnormalities of the cervical spine are commonly seen. In the setting of suspected cervical spine disease, dedicated CT or MRI of the spine is preferred over neck CT. However, the symptoms of cervical spine disease may mimic those of extraspinal entities, prompting the use of neck CT with a soft-tissue protocol. Therefore, in the acute setting, careful inspection of the cervical spine is mandatory at neck CT.
What are the major salivary glands?
The major salivary glands include the parotid, submandibular, and sublingual glands. At CT, the attenuation of the parotid gland in adults is usually intermediate, between the attenuation of fat and that of muscle, owing to its fat content. In children and some adults, the parotid gland is isoattenuating to muscle. Intraparotid ducts typically are not visible unless they are dilated. The parotid gland is the only salivary gland that contains lymph nodes. Accessory parotid tissue often can be seen along the course of its duct (Stensen duct) superficial to the masseter muscle. The submandibular and sublingual glands have higher attenuation than does the parotid gland owing to their lower fat content.
Is MRI better than CT?
MRI is superior to CT for the diagnosis of discitis and osteomyelitis, particularly early in the course of disease, and should be performed if discitis or osteomyelitis is suspected. Infection of the spinal facet (zygapophyseal) joints is an uncommon cause of neck pain.
Treatment
Medical uses
- Though radioactive iodine therapy is commonly used as a follow-up treatment for larger, more aggressive tumors, it can also be used as a safeguard treatment for smaller tumors if there are worrisome features associated with the cancer, including an aggressive type, blood vessel (vascular) invasion, or multi-focal cancer.
Overview
- Radioactive iodine therapy, which your doctor may refer to as radioactive iodine ablation, is used about 1 to 2 months after you have papillary thyroid cancer surgery. The goal of this treatment is to kill any cancer cells that may remain after surgery.
Safety
- Radioactive iodine is a safe therapy because the radioactive iodine is primarily absorbed by thyroid cells. Thyroid cells are the main cells in the body that can absorb iodine, so no other cells are exposed to the radiation. When the thyroid cellsboth healthy and cancerousabsorb the radioactive iodine, they are damaged or destroyed.
Diagnosis
- After preparing your body for radioactive iodine therapy, your doctor will give you a very small amount of iodine to see if there are any pieces of thyroid remaining. After one day, your doctor will scan your neck with a special camera. If the scan shows that the iodine was absorbed in your neck, that means there are remnants of your thyroid left....
Results
- A pretherapy scan may or may not be obtained before the actual radioactive iodine treatment. If this is done, your doctor will give you a small dose of radioactive iodine (the exact dose will be determined by your doctor) and a scan will be obtained to see how much residual tissue you have in the neck and if there is spread outside the thyroid. Based on these findings, then your doctor …
Prevention
- When you return home after receiving radioactive iodine, you need to take into account a number of precautions to prevent radiation exposure to others. Below is a list of general guidelines. Keep in mind that your doctor's specific instructions always take precedence.
Preparation
- If you have any questions about having radioactive iodine as part of your papillary thyroid carcinoma treatment plan, don't hesitate to talk to your doctor. He or she will walk you through how this therapy safely and effectively treats your papillary thyroid cancer.