Thyroid cancer is one of the most common endocrine, or hormonal system cancers in the society and its treatment is planned individually by surgical method. Radioactive iodine therapy is used to destroy invisible cancer cells that may be left behind after surgery. Radioactive iodine therapy in thyroid cancer is applied to patients who have been diagnosed with thyroid cancer and have undergone surgery to support treatment. Prof. Dr. Akın Yıldız and Dr. Mehmet Bozkurt from the Department of Nuclear Medicine at Memorial Bahçelievler Hospital gave information about Radioactive Iodine Therapy. Dr. Mehmet Bozkurt gave information about Radioactive Iodine Treatment.
What is Radioactive Iodine Therapy (Atom Therapy)?
Radioactive iodine therapy, popularly known as "Atom Therapy", is a treatment method used to destroy possible cancer cells that remain in the neck area after thyroid surgery or that are not visible to the eye. RAI is administered by taking a radioactive Iodine (I-131) molecule by mouth (medicated liquid or capsule). The treatment consists of introducing radioactive iodine into the body in case there are live thyroid cells, directing it towards the cells, taking the cells inside and destroying them by irradiation (beta ray). This stops the growth and proliferation of cancerous thyroid cells. Radioactive iodine can be used not only in the treatment of thyroid cancer, but also in the treatment of thyrotoxicosis - hyperthyroidism (colloquially called toxic goiter), a condition characterized by excessive hormone production by the thyroid gland.
Stages of Radioactive Iodine Treatment
The radioactive iodine treatment process usually involves the following steps:
Preparation: Before starting treatment, doctors assess the patient's storyand perform the necessary tests. During this process, the patient's blood tests are ordered and any necessary imaging, such as ultrasonography, is examined.
Medication discontinuation: In some cases, the thyroid medication the patient is taking may be temporarily stopped before treatment. This helps iodine to accumulate more effectively in the thyroid tissue.
Administration of radioactive iodine: The patient takes I-131 in capsules or liquid orally. This is usually performed in a hospital and the dose of treatment is determined by the physician according to the patient's condition.
Isolation period: After receiving radioactive iodine, the patient needs to be isolated for a short time. This is because the patient can emit radiation into the environment until the body eliminates the radioactive waste. The duration of isolation varies depending on the treatment dose and the patient's condition.
Follow-up and evaluation: After treatment, doctors monitor the patient's recovery and may perform additional tests or treatments as needed. At this stage, thyroid hormone levels, radioactive iodine scans and other necessary tests may be performed.
Long-term follow-up: After radioactive iodine treatment, patients are regularly checked and followed up. This process may continue for many years, although it may vary depending on the condition of each patient and the success of the treatment.
What are the Side Effects of Radioactive Iodine Treatment?
- Temporary thyroid hormone imbalance: Low or high thyroid hormone levels may occur after treatment.
- Radiation side effects: Mild symptoms such as nausea, vomiting and changes in the sense of taste.
- Swelling and pain in the salivary glands: RAI can affect the salivary glands and cause swelling.
- Dry mouth and eyes: There may be a decrease in saliva and tear production.
- Fatigue and weakness: Temporary fatigue and weakness may occur after treatment.
- Headache: Headache may occur after RAI treatment.
- Effects on fertility and pregnancy: RAI treatment may have an effect on fertility and pregnancy. RAI treatment should not be administered during pregnancy.
- Risk of radiation exposure: There is a risk of radiation exposure to people in your immediate environment during and after treatment. Therefore, they need to restrict contact with other people for a certain period of time.
Side effects may be different for each patient and in some cases more serious side effects may also occur. Therefore, the process should be followed together with the doctor before and after treatment.
What Should Be The Post-Treatment Follow-Up and Care?
Follow-up and care after radioactive iodine treatment should be as follows:
- Doctor's advice: During and after treatment, follow the doctor's advice and instructions.
- Isolation After radioactive iodine treatment, you should stay away from others for a short time to prevent the spread of radiation. Your doctor will determine the appropriate duration for you.
- Hygiene: Urinate frequently and drink plenty of water to accelerate the excretion of radioactive iodine. Hands should be washed frequently and personal items cleaned regularly.
- Diet: If recommended by the doctor, a low iodine diet can be followed.
- Medications: The medications prescribed by the doctor should be used regularly and in case of any side effects, the doctor should be consulted again.
- Regular controls: After radioactive iodine treatment, your doctor may order regular thyroid function tests, blood tests and imaging studies.
- Monitor symptoms: Any abnormal signs or symptoms should be reported to a health care provider.
- Lifestyle changes: Reducing stress, maintaining sleep patterns and adopting a healthy lifestyle can contribute to the healing process.
Since each patient's condition is different, the post-treatment care and follow-up process may also vary from person to person. Therefore, attention should be paid to the doctor's recommendations and treatment protocols to be applied individually.
What Are The Advantages of Radioactive Lodine Therapy?
Radioactive iodine therapy is used to treat thyroid diseases such as thyroid cancer and hyperthyroidism. With this treatment, it is aimed to effectively destroy possible invisible cancer cells that may remain in the neck area after thyroid cancer surgery. Therefore, treatment success is high and it is a direct targeted treatment. It has fewer side effects than other treatment methods. RAI is among the prioritized treatments according to many studies in the US and Europe.
Comparison of Radioactive Iodine Therapy and Other Treatment Methods
In addition to radioactive iodine treatment to be applied after surgery for thyroid cancer, there are also medication, surgery and external radiation therapy.
Here is a comparison of these methods:
Radioactive iodine therapy:
- Advantages: It is not an invasive procedure and may cause less damage to surrounding tissues.
- Disadvantages: Temporary side effects. Isolation is required due to radiation emission. It is not suitable for every patient. It should not be preferred during pregnancy or breastfeeding.
Drug therapy (antithyroid drugs):
- Advantages: It is not an invasive method. Fast and effective. It also provides efficacy control with dose adjustment.
- Disadvantages: Side effects may occur with long-term use. The duration of treatment may be long and in some cases may not provide a permanent solution.
Surgery (Thyroid lobectomy, Total thyroidectomy):
- Advantages: Permanent solution. Quick recovery is achieved by completely removing the cancerous tissue.
- Disadvantages: It is a surgical procedure. A scar may remain in the form of a thin line in the neck area. Anesthesia risk and surgical complications of the operation may occur.
External radiation therapy (Radiotherapy):
- Advantages: It is not an interventional treatment. It destroys cancerous cells and targets them locally.
- Disadvantages: Long-term treatment may be required, side effects may occur. It can damage healthy tissues and may not help to completely destroy cancerous cells.
The choice of treatment method is based on the patient's age, general health status, type and stage of thyroid disease and potential risks. Treatment options and risks should be discussed in detail with the doctor and the most appropriate treatment method should be decided together.
Frequently Asked Questions About Radioactive Iodine Therapy
Frequently asked questions and answers about radioactive iodine therapy (RAI)
What is radioactive iodine therapy and what is it used for?
Radioactive iodine therapy can be used to control overactive thyroid (hyperthyroidism) or as a targeted radiation therapy to treat thyroid cancer.
How is radioactive iodine treatment administered?
Radioactive iodine is given as an oral capsule or liquid. Iodine is transported directly to the thyroid gland and destroys overactive or cancerous cells.
What are the side effects of radioactive iodine treatment?
Side effects include temporary salivary gland inflammation, nausea, taste disturbance, dry mouth and fatigue. In the long term, the risk of hypothyroidism (underactive thyroid) may increase.
What precautions should be taken after radioactive iodine treatment?
Measures such as short-term isolation, attention to hygiene rules, drinking plenty of water, a low-iodine diet and using medications recommended by the doctor should be taken.
How long does radioactive iodine treatment work?
The effect of the treatment may vary depending on the individual. In hyperthyroidism, recovery can take several weeks to several months. Treatment for thyroid cancer can take effect within a few months and is evaluated with follow-up tests.
Is radioactive iodine treatment suitable for every thyroid patient?
RAI is not suitable for every thyroid patient. For example, RAI is not recommended for patients who are pregnant or breastfeeding and for some types of thyroid cancer. The doctor will determine the most suitable treatment method for you.
How safe is radioactive iodine treatment?
RAI is generally a safe and effective treatment. But like any treatment, it can involve some risks and side effects. These risks can be minimized by taking precautions before and after treatment.
These answers are intended to provide general information and may vary according to each patient's situation.
Prepared by the Medical Editorial Board. Our health library contents have been prepared for informational purposes only and with the scientific content on the registration date. For all your questions, concerns, diagnosis or treatment about your health, please consult your doctor or health institution.