Doctors who prescribe radioactive iodine therapy are usually endocrinologists or nuclear medicine specialists. Radioactive iodine treatment is an option for some people with papillary
Papillary thyroid cancer
Papillary thyroid cancer or papillary thyroid carcinoma is the most common type of thyroid cancer, representing 75 percent to 85 percent of all thyroid cancer cases. It occurs more frequently in women and presents in the 20–55 year age group. It is also the predominant cancer type in children with thyroid cancer, and in patients with thyroid cancer who have had previous radiation to the head and neck. It is o…
Thyroid Cancer
A cancer that develops in the cells of thyroid gland.
Full Answer
Can papillary thyroid cancer take up iodine?
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 cancer to take up iodine is required for RAI therapy to work but is not an indication for therapy.
What is the Mayo Clinic doing to treat thyroid cancer?
Mayo Clinic doctors and scientists are actively researching new ways of diagnosing and treating thyroid cancer. Mayo Clinic thyroid cancer research includes investigations into common types of the disease, such as papillary thyroid cancer, and rare types of thyroid cancer, such anaplastic thyroid cancer.
What is the best first treatment for papillary thyroid cancer?
For papillary thyroid cancer (and all of the different types (variants) of papillary thyroid cancers that exist within this group), surgery, by far, is the most common first treatment.
Can radioactive iodine be used to treat anaplastic thyroid cancer?
Radioactive iodine therapy cannot be used to treat anaplastic (undifferentiated) and medullary thyroid carcinomas because these types of cancer do not take up iodine. For RAI therapy to be most effective, you must have a high level of thyroid-stimulating hormone (TSH or thyrotropin) in the blood.
How long is radioactive iodine treatment for thyroid cancer?
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.
Who is the best doctor for thyroid cancer?
Who treats thyroid cancer?A surgeon: a doctor who uses surgery to treat cancers or other problems.An endocrinologist: a doctor who treats diseases in glands that secrete hormones.A radiation oncologist: a doctor who uses radiation to treat cancer.More items...
What is the cost of radioactive iodine treatment for thyroid cancer?
For patients without health insurance, thyroid cancer treatment typically costs from about $20,000-$40,000 for surgery and up to $4,000 for radioactive iodine treatment, which is often recommended for thyroid cancer.
What kind of doctor do you need for thyroid cancer?
Endocrinologists are the primary treating MD for thyroid cancer. Oncologists can assist the endocrinologist when targeted chemotherapies are needed for the rare aggressive thyroid cancers.
How do I choose a thyroid surgeon?
5 Questions to Help You Choose the Best Thyroid SurgeonIs this a procedure you do often? How many per week? ... How many years have you been doing this? ... Where do you do the procedure — hospital or surgery center? ... How many patients are admitted to the hospital after this procedure? ... How will I be treated?
Can papillary thyroid cancer be cured?
Although papillary thyroid cancer often spreads to lymph nodes in the neck, the disease responds very well to treatment. Papillary thyroid cancer is highly curable and rarely fatal.
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.
Where do you stay after radioactive iodine treatment?
The iodine-131 will wash out in the laundry....To decrease the radiation dose to others:You should sleep in a separate bed. ... Remain in your home for the first four days.Do not hold young children or spend much time near a pregnant woman.Family members should stay about six feet or more from you.More items...•
Do you lose your hair with radioactive iodine treatment?
Radioiodine does not cause hair loss.
What is the best hospital for thyroid cancer?
Mayo Clinic in Rochester, Minn., Mayo Clinic in Phoenix/Scottsdale, Ariz., and Mayo Clinic in Jacksonville, Fla., are ranked among the Best Hospitals for cancer by U.S. News & World Report.
What is iodine treatment for thyroid cancer?
Radioactive iodine (RAI) treatment involves swallowing a capsule or liquid form of radioactive iodine that thyroid cells take up (absorb), destroying them. It's effective because healthy cells in the body don't usually absorb the radioactive iodine.
What are the risks of radioactive iodine treatment?
Possible long term side effects include:Ability to have children (fertility) Some women may have irregular periods after radioactive iodine treatment. ... Inflammation of the salivary glands (where spit is made) ... Tiredness. ... Dry or watery eyes. ... Lower levels of blood cells. ... Lung problems. ... Second cancers.
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 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.
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 ...
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 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.
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 key hole in the thyroid?
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 thyroid cells in the process of producing the body’s thyroid hormone. Although papillary thyroid cancer rarely produces ...
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.
How to treat papillary thyroid cancer?
While RAI treatment can be effective for preventing the recurrence of papillary thyroid cancer, it is not appropriate for every patient. RAI may be considered if: 1 Papillary thyroid cancer has spread beyond the thyroid gland capsule and invaded nearby soft tissues 2 Papillary thyroid cancer has spread to lymph nodes in the neck 3 It is necessary to destroy additional thyroid tissue that is producing thyroglobulin 4 Papillary thyroid cancer has spread to a distant site, such as the lungs, liver or bones
What is the first targeted therapy for thyroid cancer?
The first targeted therapy developed for any type of cancer, radioactive iodine (RAI) treatment for papillary thyroid cancer is a form of internal radiation therapy that capitalizes on a unique characteristic of thyroid cells.
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.
How long after thyroid surgery can you use iodine?
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. Radioactive iodine is a safe therapy because the radioactive iodine is primarily absorbed by ...
How to get rid of radioactive iodine in urine?
Drink plenty of water. This will stimulate the removal of radioactive iodine through your urine. 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.
What does it mean when a thyroid scan shows iodine?
If the scan shows that the iodine was absorbed in your neck, that means there are remnants of your thyroid left. In the great majority of cases—95%, in fact—there are thyroid remnants that remain after thyroid surgery. 1. A pretherapy scan may or may not be obtained before the actual radioactive iodine treatment.
What happens if you take radioactive iodine after a day?
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.
How long before thyroid iodine is used?
After being deprived of iodine from your diet, all thyroid cells will be more likely to absorb the radioactive iodine. 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.
How long before radioactive iodine therapy can you raise TSH?
But to raise TSH levels, you need to stop taking T4 hormone replacement therapy before radioactive iodine therapy is set to begin (it's usually about 5 weeks before). This decrease in thyroid hormones triggers the pituitary gland to release more TSH. Higher TSH levels will make you temporarily hypothyroid.
What happens when thyroid cells absorb radioactive iodine?
When the thyroid cells absorb the radioactive iodine, the cells are destroyed (ablated, ablation). Before RAI or RRA, you and your doctor have a choice about how treatment is administered: (1) with Thyrogen ® [Genzyme Corporation], or (2) Traditional RAI/RRA. The purpose of both treatments is to destroy remaining thyroid cells after thyroid cancer ...
When is thyrogen given?
When Thyrogen is utilized to test/diagnose possible thyroid cancer recurrence, the injection is given on days 1 and 2. On day 3 RAI is administered, and on day 5 a blood test with or without a whole body scan. Of course, similar to any medical test, there is the risk for a diagnosis to be missed. Side effects may include: nausea, fatigue, vomiting, ...
How long to stop thyroid hormone replacement?
RAI or RRA requires you to stop taking your thyroid hormone replacement medication (eg, levothyroxine). Medication may be withheld for 4 to 6 weeks.
What is the most common radioactive iodine?
The common type of radioactive iodine is I-131 ( iodine 131). It is administered in capsule form taken by mouth and swallowed. The exact dose of I-131 is determined by your doctor. Today, most patients have their treatment in an outpatient setting and are allowed to go home the same day.
Can you take levothyroxine after radioactive iodine?
Thyrogen allows you to keep taking your thyroid hormone replacement medication (eg, levothyroxine) before, during and after radioactive iodine therapy or radioiodine remnant ablation. You can avoid experiencing the signs or symptoms of hypothyroidism, which can improve quality of life.
Can thyrogen be used for thyroid cancer?
Furthermore, Thyrogen may be used in the diagnosis of recurrence of well-differentiated thyroid cancer with RAI or RRA. Well-differentiated means the cancer cells resemble normal cells and grow more slowly than undifferentiated cancer cells (abnormal looking cells). Thyrogen allows you to keep taking your thyroid hormone replacement medication (eg, ...
Can you take thyroid medication without thyroid medication?
The purpose of withholding thyroid hormone replacement medication is to increase your level of thyroid-stimulating hormone (TSH). It may be necessary for you to go without your thyroid hormone replacement medication for weeks. Furthermore, some doctors recommend a low-iodine diet for several weeks prior to radioactive iodine therapy ...
What is the treatment for papillary cancer?
Papillary cancer and its variants. Most cancers are treated with removal of the thyroid gland (thyroidectomy), although small tumors that have not spread outside the thyroid gland may be treated by just removing the side of the thyroid containing the tumor (lobectomy).
What is the treatment for cancer that shows up on a radioiodine scan?
If the cancer shows up on a radioiodine scan (meaning the cells are taking up iodine), radioactive iodine (RAI) therapy may be used, either alone or with surgery. If the cancer does not show up on the radioiodine scan but is found by other imaging tests (such as an MRI or PET scan), external radiation may be used.
Why is thyroid hormone therapy needed after surgery?
Nearby lymph nodes are usually removed as well. Because the thyroid gland is removed , thyroid hormone therapy is needed after surgery. For MTC, thyroid hormone therapy is meant to provide enough hormone to keep the patient healthy, but it does not reduce the risk that the cancer will come back.
How long after thyroidectomy can I take levothyroxine?
If RAI treatment is planned, the start of thyroid hormone therapy may be delayed until the treatment is finished (usually about 6 to 12 weeks after surgery).
What is the first surgery to remove cancer?
If cancer is confirmed, a completion thyroidectomy is done. A thyroidectomy may be done as the first surgery if there are signs the cancer has spread or if the patient wants to avoid having more surgery later. As with papillary cancer, some lymph nodes usually are removed and tested for cancer.
What is RAI therapy?
RAI therapy is often given for more advanced cancers such as T3 or T4 tumors, or cancers that have spread to lymph nodes or distant areas. The goal is to destroy any remaining thyroid tissue and to try to treat any cancer remaining in the body.
Why do you need to remove lymph nodes?
Because removing the lymph nodes allows them to be checked for cancer, this surgery also makes it easier to accurately stag e the cancer. If cancer has spread to other neck lymph nodes, a modified radical neck dissection (a more extensive removal of lymph nodes from the neck) is often done. Treatment after surgery depends on the stage of the cancer:
Preparing for treatment
Because treatment requires that the thyroid absorb as much of the radioactive iodine as possible, your doctor may order medications and a special diet to boost absorption.
Treatment and safety precautions
Taking RAI typically means ingesting pills or a small amount of liquid that makes you radioactive temporarily. You may be given medicine beforehand to counter any nausea the RAI may cause.
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.
What is Mayo Clinic's research?
Research. Mayo Clinic doctors and scientists are actively researching new ways of diagnosing and treating thyroid cancer. Mayo Clinic thyroid cancer research includes investigations into common types of the disease, such as papillary thyroid cancer, and rare types of thyroid cancer, such anaplastic thyroid cancer.
Where is Mayo Clinic located?
Mayo Clinic has one of the largest and most experienced practices in the United States, with campuses in Arizona, Florida and Minnesota. Staff skilled in dozens of specialties work together to ensure quality care and successful recovery.
Is Mayo Clinic a cancer center?
The Mayo Clinic Cancer Center receives funding from the National Cancer Institute and is designated as a comprehensive cancer center — recognition for an institution's scientific excellence and multidisciplinary resources focused on cancer prevention, diagnosis and 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…
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. In the great majority of cases95%, in fa…
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.