What is Radioactive Iodine Therapy (Atom Therapy)?
The internal balance of the body is provided by the endocrine system formed by glands that secrete hormones. One of the main glands that make up the endocrine system is the thyroid gland. The thyroid gland is located in the front part of the neck and has a butterfly-like shape. It secretes hormones such as thyroxine, triiodothyronine, calcitonin. It can control many functions in the body with these hormones. Its main tasks include controlling the metabolic rate, which includes the process of converting food into energy, and adjusting the amount of calcium in the blood.
An overactive or underactive thyroid gland brings with it a number of problems. When the gland is overactive for various reasons, more thyroid hormones are produced than the body needs. This condition is called hyperthyroidism. Hyperthyroidism can also lead to an accelerated metabolism. Conversely, hypothyroidism occurs when thyroid hormones are not secreted in sufficient amounts. With hypothyroidism, metabolism can also slow down. Goiter is a condition in which the thyroid gland grows much larger than normal and usually occurs in iodine deficiency. Finally, thyroid cancer can be mentioned among thyroid diseases. Thyroid cancer is caused by cells dividing uncontrollably in the thyroid tissues.
Radioactive iodine therapy, also known as atomic therapy, is a treatment method used in thyroid diseases. Based on the fact that the thyroid gland needs iodine to function, a small amount of radioactive iodine (I-131) is given to the patient during treatment. Radioactive iodine emits both gamma and beta rays until it is removed from the body. Gamma rays make it easy to locate by measuring devices. Beta rays help to kill or destroy cells. In other words, gamma rays have a diagnostic effect and beta rays have a healing effect. The radiation applied here only targets the thyroid gland. This means that healthy tissues in the rest of the body are not affected too much by the radiation.
Radioactive iodine therapy (RAI) has multiple uses. For example, it can be used to destroy cancerous thyroid tissue or metastasized cancer cells that cannot be removed by surgery. This treatment can be used to destroy thyroid tissue that cannot be removed by surgery or to treat some types of thyroid cancer that have spread to the lymph nodes and other parts of the body. Radioactive iodine therapy is used to treat papillary or follicular thyroid cancer that has spread to the neck or other body parts and is now standard practice in such cases. RAI treatment is not an alternative to surgery. If the cancer has not spread and can be removed with surgery, trying to treat it with RAI may reduce the effectiveness of the treatment. Radioactive iodine therapy cannot be used to treat anaplastic and medullary thyroid carcinomas because these types of cancer do not retain iodine.
Which diseases is radioactive iodine therapy (atom therapy) used to treat?
Radioactive iodine therapy, also known as atomic therapy, has multiple uses. RAI treatment may be preferred in the following cases:
- To destroy the remaining tissues from the tumor, most of which are removed by surgical methods
- Destroying cancer cells that have spread to other parts of the body
- Goiter
- To destroy thyroid tissue that is not removed by surgical methods
The thyroid gland needs iodine to produce its secretions. In radioactive iodine therapy (RAI), radioactive iodine is injected into the body to damage or destroy thyroid cells. RAI can be taken in oral capsule form and does not require hospitalization unless the dose is high. You can return home after taking your treatment dose. After treatment, you need to drink plenty of water to remove radioactive iodine from the body. You may also need to eat a non-iodized diet for at least seven days. In such a case, your doctor and dietitian will inform you about this.
In the treatment of hyperthyroidism, a few doses may be sufficient. In the treatment of thyroid cancer, higher doses of radioactive iodine may be needed. In thyroid cancer, it may not be enough to apply only RAI. However, it may be preferred to destroy the remaining mass after a large part of the cancerous cell has been removed by surgery. A “tracer” dose of radioactive iodine can be administered to monitor the remaining cancerous tissue or cells that have metastasized to other cells. The purpose of this dose is to determine the need for RAI or to see where else the cancer has metastasized.
While RAI treatment is the best option in some cases, in other cases other treatment options may be preferred. For example, if you have a tumor that can be completely removed surgically, the RAI option may not be the right decision for you. For this reason, it is useful to talk in detail with your doctor about treatment options and which one is best for you.
What are the Options for Radioactive Iodine Therapy (Atom Therapy)?
There are several forms of radioactive iodine given in atom therapy. These are pills, liquids or intravenous injections. You may also be given anti-nausea medication before the procedure to prevent nausea. Together with your doctor, you can decide which form is more convenient and comfortable for you.
Risks and Side Effects of Radioactive Iodine Therapy (Atom Therapy)
Today, thanks to advances in technology, there is more than one treatment option for most diseases. One of these treatment options may be better than the other. Which treatment option is better may vary from person to person. It is normal for each method to have some risks and side effects. Before choosing any treatment method, it is useful to have detailed information about all options and to question the risks and side effects in detail. Some of the side effects of RAI treatment are as follows:
- Tenderness or swelling in the neck
- Nausea
- Swelling or tenderness in the salivary gland
- Dryness in the mouth
- Taste changes
- Dry eyes due to decreased tear formation
- Decreased sperm count in men
- Irregular menstrual cycles in women
The effect of radioactive iodine treatment before or after pregnancy is also often of interest. Pregnancy is not recommended for at least 6 months and usually for 1 year after RAI treatment. No side effects have been found in the children of patients who have been treated in the past. In addition, since radioactive iodine can pass into breast milk, it is not preferred for breastfeeding women. Although rare, long-term complications of RAI treatment include an increased risk of developing leukemia, stomach cancer or salivary gland cancer. If you have any further questions, it is best to contact the relevant department of a hospital you trust, make an appointment and talk to your doctor.
Radioactive Iodine Therapy (Atom Therapy) Room (2 isolated) in our hospital
For RAI treatment to be fully effective, there must be a high level of thyroid stimulating hormone (TSH) in the blood. Excess TSH allows radioactive iodine to be taken up by the thyroid tissues. For this reason, the first step in thyroid removal is to increase the amount of TSH. One way to do this is by injection of thyrotropin. The other way is to stop or reduce the dose of the pills you started taking after your thyroid was removed. Both methods will cause the amount of TSH in the body to increase. You may also need to follow an iodine-free diet for a few days, depending on your doctor’s request (3).
RAI treatment is usually administered in a special department of an outpatient clinic or hospital called nuclear medicine. After receiving radioactive iodine, your body will continue to emit radiation for some time. Depending on the dose you receive, you may need to stay in special isolated rooms in the hospital for a few days to prevent radiation exposure to your surroundings. If you are allowed to go home after the procedure, you will be given information on how to protect others from radiation exposure. It is better for the health of your loved ones if you avoid close contact with people after treatment, especially pregnant women and young children. Iodine that cannot be absorbed is removed from the body within a few days, mainly through the urinary tract, saliva, sweat, tears or feces.
Hisar Hospital has 2 isolated radioactive iodine treatment rooms under the nuclear medicine unit. You can contact the hospital for more detailed information about the treatment process carried out by specialized doctors and their team.
How is the drug prepared in radioactive iodine therapy (atom therapy)?
It is common knowledge that for treatment to be effective, the right medication must be taken at the right dose. However, the correct preparation of medicines can often be overlooked. However, the preparation process of the drug is just as effective on its effectiveness. The concept of robotic drug preparation, which emerged with the developing technology, helps to prevent human errors. Today, maximum hygiene can be applied thanks to medicines prepared fully automatically and within the device. With robotic drug preparation, the process can be tracked from the moment the doctor prescribes the drug until it reaches the patient. This provides the opportunity to retrospectively question the medication. Patient safety is at maximum level with robotic drug preparation method.
After having an idea about what radioactive iodine treatment is and how it is applied, another curious topic, radioactive iodine treatment fees, may come to mind. RAI treatment fees may vary depending on the health institution you prefer or what you expect. It is useful to contact your health institution for more detailed information about whether the treatment is covered by the SSI and the process.