Radioactive Iodine for Thyroid Cancer

Overview

Radioactive iodine is one of the many steps in treating thyroid cancer also called thyroid ablation or thyroid cancer treatment. Radioactive iodine ablation (RAI) is indicated when treating differentiated thyroid cancer that has spread beyond the thyroid. Thyroid cancer can be staged with the AJCC/UICC or with the NTCTCSG system which can predict disease mortality and help to plan for possible radioactive iodine.

In differentiated thyroid cancer, several classification and staging systems are available (See below)all of which reliably predict disease-specific mortality. However, they usually are not designed to adequately predict recurrence for individual patients. In addition, the estimates of the risk of recurrence and death usually do change over time depending upon how well the patient responds to initial therapy.

The risk of recurrence, however, follows a continuum across the three discrete risk categories (low, intermediate, and high). (See below)

Initial risk assessments are actively modified based on data obtained during follow-up that reflect the individualized patient's response to therapy. This dynamic risk assessment approach allows for more accurate risk assessments than either a static estimate of risk based on the TNM staging system or the ATA risk of recurrence classification system.

It should be recognized that no staging system predicts outcome in individual patients with 100 percent accuracy; as a result, clinicians should use individual clinicopathologic characteristics to determine the specific treatment for a given patient.

Following a low iodine diet during the 2-3 week period prior to radioactive iodine therapy will make the treatment more effective. This treatment uses radioactive iodine (131I) to destroy leftover microscopic thyroid cancer cells as well as any normal thyroid tissue that might remain after surgery. Destroying these cells makes it easier for doctors to follow patients for signs of thyroid cancer recurrence. Radioactive iodine treatment is used in most patients with differentiated papillary, follicular and Hurthle cell thyroid cancers. There are specific precautions to take after radioactive iodine is given. There are common side effects of radioactive iodine.