Treatment of thyroid cancer with radioactive iodine is an alternative method, which is used if this organ is completely removed. This therapy is effective for differentiated forms of cancer and other diseases of this organ. In some cases, this method is the only chance for the patient to have a favorable outcome. The appropriateness of the procedure is determined by a qualified specialist based on the established diagnosis.
Radioactive iodine 131- what is it?
Iodine is an important element in the human body that has the ability to accumulate and be retained by thyroid cells. This allows the body to use the component to produce thyroid hormones necessary for the normal functioning of vital organs and body systems.
Radioactive iodine 131 is a synthetically synthesized isotope of iodine. The substance has no taste, color or smell. In medicine, this component is used to treat various thyroid diseases. The therapeutic effect is based on the fact that when it enters the body, radioactive iodine self-decays within 8 days and forms xenon, as well as beta and gamma radiation. This feature of the substance is the main goal of treatment, as it contributes to the destruction of tumor cells.
90% of the therapeutic effect is achieved thanks to beta particles with a high speed of movement and low mileage in the tissues (2 mm). Their radioactivity contributes to the destruction of residual thyroid cells and tumors, which have spread beyond its borders.
Gamma particles do not have a healing effect, but are characterized by high penetration. Thanks to this, with the help of special gamma cameras it is possible to detect the presence and location of metastases in which the accumulation of radioactive iodine is recorded.
The essence of the radioiodine therapy method
This treatment method is used for patients who underwent surgical removal of the thyroid gland. The procedure is used after 4 weeks after surgery.
With the introduction of radioactive iodine into the body, the residual cells of the organ and tumors capture and accumulate it. Due to this, their destruction occurs, which allows to stop the development of the disease. As a result, thyroid function is completely inhibited. The effect of the isotope does not extend to adjacent tissues.
The required dosage of the substance is selected by an experienced specialist based on the form and stage of the pathological process.
Indications for
Thyroid radioiodine therapy is prescribed only when its effectiveness is fully justified.
The main indications for the procedure:
- hyperteriosis with increased activity of the thyroid gland;
- thyrotoxicosis;
- nodular goiter;
- papillary, follicular, anaplastic type of cancer;
- the presence of metastases.
Specialists divide all patients with thyroid cancer into three main risk groups. Each of them means the likelihood of a re-development of the disease, as well as the appearance of metastases.
On the basis of these data, the required dosage of radioactive iodine in millicure is determined, as well as the expediency of the procedure.
- Low risk group. The tumor size does not exceed 1-2 cm, therefore, the neoplasm does not extend beyond the thyroid gland, and there are also no metastases. Radioiodine therapy in this case is not prescribed.
- Medium risk group. The diameter of the tumor exceeds 3 cm, so it sprouted into a capsule. The dosage of radioactive iodine is 30-100 mCi.
- High risk group. The size of the tumor is rapidly increasing, which leads to its germination in neighboring tissues, and distant metastases are also present. The amount of radioactive iodine is assigned from 100 mCi.
Contraindications
According to reviews, treatment of the thyroid gland with radioactive iodine is very effective, but this therapy is not useful to everyone.
The main contraindications:
- pregnancy;
- large or multinodular goiter;
- individual intolerance to iodine;
- lactation;
- thyroiditis after childbirth;
- psychiatric illnesses;
- hepatic, renal failure;
- severe decompensated diabetes mellitus;
- hypoplastic, aplastic anemia;
- stomach ulcer, duodenal ulcer during exacerbation.
Carrying out radioiodine therapy is allowed only to patients who have reached the age of 18 years.
The benefits of radioiodine therapy
Judging by the reviews, treatment of the thyroid gland with radioactive iodine has several advantages. This is confirmed by experts who argue that using this method it is possible to pointly affect the thyroid gland and neoplasms present in it, without involving adjacent tissues in the process.
The main advantages of radioiodine therapy:
- no need for anesthesia;
- low relapse rate;
- no scars remain after the procedure;
- minimum number of contraindications;
- short rehabilitation period.
Preparation for the procedure
In order for the therapy to be most effective, it is necessary to prepare the patient in advance for the use of the isotope. The main role in the effectiveness of treatment is given to thyroid-stimulating hormone (TSH), which is synthesized by the pituitary gland. Since it is he who is responsible for the accumulation of iodine by the thyroid gland.
Malignant cells are less absorbent, therefore, it is necessary to create an increased level of TSH in the body in order to improve the uptake of radioactive iodine by the tumor.
There are two main ways to increase the level of thyroid stimulating hormone to the required rate.
- Suspension of replacement therapy. Taking medication should be stopped 3-6 weeks before radioiodine therapy. In this case, the TSH reaches 30 and above, which is much higher than the level of the normal range. The disadvantage of this method is the appearance of hypothyroidism, accompanied by unpleasant symptoms
- Tyrogen Injection (Human TSH Recombinant). The drug is administered several days before the use of the isotope, which can significantly accelerate the increase in hormone levels.
Both methods of increasing TSH are effective, but which one to choose is determined by the doctor, depending on the individual characteristics of the patient.
In addition, it is necessary to follow some general recommendations for preparing the body for the effects of an isotropic.
- Eliminate the effects of iodine from the outside. This means that you should not swim in salt water, breathe the sea air, lubricate the wounds with iodine. All these requirements must be met for four days before the start of radioiodine therapy.
- Stop taking vitamins, hormones and nutritional supplements 1 month before the procedure.
- Women are screened for pregnancy, since the isotope negatively affects the development of the fetus.
- Stop taking medications for hyperteriosis 7 days before the procedure.
Necessary diet
Nutrition adjustment is also an important condition for preparing the patient for radioiodine therapy. Diet means a significant decrease in the diet of products containing iodine. This is a necessity to create a deficiency of this component in the body. As a result, this will lead to active absorption of radioactive iodine by the tumor cells.
It is necessary to adhere to a diet 2 weeks before therapy and within 5-7 days after its implementation.
Valid Products:
- fresh meat (no more than 140 g per day);
- fresh apples, oranges, lemons, grapefruits;
- rice
- pasta;
- egg whites.
Unsalted nuts, vegetable oil, sugar, honey, fruit jam, tea, raisins based compote, peanut butter are also allowed.
Prohibited products during this period:
- any seafood;
- egg yolks;
- chocolate;
- dairy products;
- iodized salt;
- soy and products based on it;
- sausage;
- all products with an orange, brown and red tint;
- coffee;
- ice cream.
The strict implementation of recommendations for preparing the body for the effects of radioactive iodine increases the effectiveness of treatment and reduces the likelihood of relapses.
How is the treatment going?
Radiotherapy is carried out in a hospital. The patient must swallow a capsule or an aqueous solution of radioactive iodine and drink plenty of water (at least 400 ml).
After this, the patient is isolated in a separate room, since radiation from him is a danger to others. Therefore, initially it is necessary to bring along a minimum of things, since subsequently they are subject to disposal.
Within 2 hours after the procedure, the ingestion of solid food is prohibited, since during this period there is an active absorption of iodine by the thyroid gland and tumor cells.
At least once a day, radiation is measured, and until this indicator drops to a normal level, the patient will be isolated from others. On average, this period lasts from 3 to 7 days.
Side effects
The consequences of treatment with thyroid radioactive iodine can be different. For each person, they are expressed differently depending on the age and volume of the introduced isotropic.
The most likely side effects of thyroid radioiodine therapy:
- nausea;
- vomiting
- general weakness;
- decreased appetite;
- swelling on the neck.
Radiotherapy in 30% of patients is accompanied by inflammation of the salivary glands. This unpleasant symptom manifests itself 24 hours after the procedure and is often caused by the introduction of an isotropic in large quantities against the background of residual thyroid tissue.
To eliminate sialodenitis, it is recommended to use lollipops, heavy drinking, chewing gum, lemons.
According to reviews, treatment of the thyroid gland with radioactive iodine in a third of patients causes a change in taste. In this case, the food becomes tasteless or acquires a metallic taste. This symptom disappears on its own after 10-15 days.
The use of an isotropic can trigger an exacerbation of chronic diseases, such as cystitis, pyelonephritis, gastritis. To eliminate the unpleasant consequences, symptomatic therapy is prescribed.
There is still no reasonable evidence that radioiodine therapy has a negative effect on the conception and bearing of a child. But child planning is recommended only a year after this procedure.
Recovery period
The duration of rehabilitation after radioiodine therapy of the thyroid gland is about 1 month. During this period, a person should adhere to the doctor’s recommendations, which will help protect others from the possibility of radiation, as well as accelerate the recovery of the patient.
- It is necessary to increase water consumption to 1.5-2 liters per day, which will speed up the process of removing the isotope from the body.
- Take a shower at least 2 times a day.
- Closer to others and pets should be no more than 1 m, it is forbidden to kiss and hug children.
- You should sleep alone and in a separate room.
- Men should urinate while sitting.
- After visiting the toilet, flush the tank twice with the used toilet paper, and wash your hands thoroughly with soap and water.
- All personal hygiene items should be kept in a plastic bag.
- Separate utensils are recommended.
- Bed linen and clothes must be washed daily.
- If possible, limit contact with loved ones for the entire rehabilitation period.
- The doors of your room should be kept closed.
All restrictions are temporary, after 30 days a person will be able to return to his usual way of life.
Reviews on the treatment of thyroid gland with radioactive iodine
Opinions of specialists about radioiodine therapy are different. But they all agree that this method allows you to effectively deal with thyroid diseases. Opponents, however, argue that this method of treatment has not been thoroughly studied, and therefore can be a threat to humans.
The expediency of using radioactive iodine 131 in each case can only be determined by a doctor based on the individual characteristics of the patient. At the same time, he will certainly explain the conditions of the procedure and warn about possible health risks.