Treatment of Cancer of the Thyroid
The most common cancer found in the thyroid is Papillary Thyroid Cancer. The main treatment is surgical removal followed by radioactive iodine ablation therapy (RAI). Once surgery removes the cancer in the thyroid, as well as any surrounding lymph nodes to determine local spread of cancer, the stage of cancer can be determined. For cancers 1-1.5 cm or greater, cancers that are in multiple locations in the thyroid, or cancers that show spread to surrounding lymph nodes, RAI is recommended. RAI is done by a nuclear medicine physician, either in a radiology department of a hospital, or in an imaging center.
This involves preparing the body by starving any remaining thyroid cells for iodine and thyroid hormone. The thyroid medications are adjusted, and often patients are changed to a short acting medication temporarily. At approximately 4 weeks after surgery, a low iodine diet will begin and will continue through the treatment. The treatment begins first with a set of blood tests and possibly a diagnostic scan to plan treatment. The dosage of radiation is then determined, and patients return to take the radiation pill. Once the pill is taken, patients are considered radioactive. There will be specific precautions to observe during the following 5-7 days that there is danger of radiation exposure. Please note, this treatment is fairly safe for the patient, but the danger will be to those around you who still have their thyroid. This is particularly true for children and animals. Specific precautions are given by the nuclear medicine doctor, and are unique to each patient. There is a post-treatment scan done several days after the radiation is given and this scan will determine if cancer has spread anywhere in the body. Approximately 7 days after the radiation pill is given, patients are instructed to re-start the thyroid hormone.
Most patients will not feel normal while they are preparing for this treatment. This is a temporary feeling, and the long term risks of this treatment are minimal. The most common side effect is dry mouth due to irritation of the salivary glands. Usually patients are instructed to use lemon and other such things that stimulate saliva. Nausea and vomiting are also possible, but this only lasts for a few days after the treatment is given.