Radioactive Iodine (RAI) . Ablation also aims to eliminate any thyroid cancer cells that may have spread to other parts of the body. Eliminating the remnant of normal thyroid tissue will make it easier to do the ongoing monitoring for any possible recurrence. RAI ablation has also been shown to improve survival rates if the cancer has spread to the neck or other parts of the body. Whether or not RAI is recommended depends upon certain factors involved in tumor staging. Your doctor will discuss the benefits and risks with you. RAI is usually not recommended for low- risk patients (see the section on Staging). If RAI is part of your treatment, you will probably receive it between 3 and 6 weeks after your surgery. You will swallow the RAI in the form of either one or more capsules (pills) or a liquid. RAI works because the thyroid gland needs iodine and absorbs it from the bloodstream. When you swallow the RAI (the isotope I- 1. The radiation destroys thyroid cells, both cancerous and normal thyroid cells, with minimal effects on the rest of your body. The dosage of I- 1. The dose for remnant ablation may range from 3. Sometimes the dose is higher (1. Very rarely, the dose may be larger still.
It is also worth noting that RAI is usually safe in patients allergic to seafood or X- ray contrast dyes, both because the allergy generally results from the protein or compound containing iodine, not iodine itself, and also because the amount of iodine in RAI is very small compared to iodine in other sources. Return to top of page. Preparation for RAI, Including the Low- Iodine Diet. Raising Your TSH Level. Your TSH level (thyroid- stimulating hormone, or thyrotropin) must be well above the normal range for RAI treatment to be the most effective. This is because TSH stimulates the thyroid tissue, both normal and cancerous, to take up iodine, including the RAI. Another reason to increase your TSH level is that thyroid cancer cells do not take up iodine as well as normal thyroid cells do. Increasing your TSH level before your RAI treatment helps the cancer cells better absorb the RAI. There are two ways to increase your TSH level. The two ways are equally effective. How do I find a good thyroid doctor? Finding a good thyroid doctor is key to your healing. Here are 30 online resources to help you locate a good one in your area.Certain foods can further. Your doctor may have reasons for recommending one option over the other, related to your situation. Stopping the pills will cause your TSH to rise to a level of 3. You will be significantly hypothyroid. You will probably feel symptoms of hypothyroidism. OR2. Receiving injections of this drug a few days prior to ablation raises your TSH level rapidly. Therefore, you do not experience weeks of hypothyroidism. Return to top of page. What It May Feel Like To Be Hypothyroid During Withdrawal from Thyroid Hormone Replacement. Although the hypothyroid state resulting from option 1 (withdrawal) is temporary, lasting a few weeks, it can cause one or more symptoms. These can include tiredness, weight gain, sleepiness, constipation, muscle aches, reduced concentration, emotional changes resembling depression, and others. Some people experience mild symptoms. Other people experience severe symptoms. During withdrawal from thyroid hormone, to reduce symptoms of hypothyroidism, your doctor may prescribe a short- acting thyroid hormone called Cytomel. You will be required to stop taking it for about 2 weeks before receiving RAI to make sure your TSH level is high enough for the RAI treatment. As noted above, both methods of increasing TSH have shown comparable success rates for remnant ablation. As a result, Thyrogen. A short- term low- iodine diet, recommended by Thy. Ca medical advisors and other thyroid cancer specialists, as well as the American Thyroid Association, increases the effectiveness of the radioactive iodine treatment. Guidelines and Details: Return to top of page. Shortly Before You Receive Your RAISome doctors routinely prescribe anti- nausea medication before you receive the RAI. This is because some people experience nausea the first day after receiving I- 1. You also may request anti- nausea medication if it is not given routinely. Return to top of page. After Your RAI — In Hospital or at Home. After you receive your RAI treatment dose, you may be sent home immediately, or you may stay in the hospital for one or more days, depending on factors such as the dose you receive. In some centers, patients stay for a few hours after receiving RAI and then go home later in the same day. Your center may give you written information about its guidelines for release. Your home circumstances, such as whether there is an infant or a young child at home, may affect the decision about going home or staying in the hospital for a day or more after your treatment dose. The RAI that is not taken up by the remaining thyroid tissue is eliminated from the body through your perspiration, saliva, feces, and urine. Most radiation from the RAI is gone in about one week. The First Day. Ask your doctor about ways to protect your salivary glands, which also absorb the RAI. Ways include sucking on sugar- free lemon candy or eating certain foods. Your doctor will have instructions on what to do, and when to do it. Ask also about how much fluid to drink. Research is under way on these topics. Thy. Ca’s web site will add information as it becomes available from our medical advisors. In the Days After RAITips and Precautions. Below are tips and precautions to take during and after the RAI ablation treatment to help protect yourself, your family members, your co- workers, and other people from being unnecessarily exposed to the radiation. The precautions listed below are for the days after your RAI. More guidelines and tips are on www. Thy. Ca by our medical advisors, and in guidelines from the American Thyroid Association and in the reference book Thyroid Cancer: A Guide for Patients. Please note that your physician and hospital may have different guidelines. Discuss any questions and concerns with your doctor. While You Are Isolated in the Hospital or at Home. You will remain in your hospital room with the door closed until you are released from isolation by the radiation safety officer. If you are on medication, please let your doctor know. You will probably start taking your thyroid hormone pills one to two days after your RAI. You will likely remain on the low- iodine diet. If you’re in the hospital, consider bringing some low- iodine foods such as fruit and unsalted nuts, in case the hospital meals include some high- iodine foods. The hospital may not have any choices. You may be able to order kosher, vegetarian, or diabetic diets. The dishes and eating utensils will stay in the room with you, probably to be placed in plastic bags provided. You may want to bring some reading materials such as newspapers or magazines that can be left behind. The hospital room will probably have a television. You may bring your eyeglasses, contact lenses, or personal medically- related equipment. Do not bring items such as a laptop computer, because it may become contaminated and have to stay in the hospital for pick up at a later date. Being isolated after RAI may feel lonely and emotionally difficult, although it should not be physically painful. It is helpful to prepare for the experience. We encourage you to use the telephone to communicate with your friends and family. Your nurse will check in with you frequently by telephone or intercom to assess how you are doing. To avoid any contamination of your own clothes by perspiration please wear a hospital gown and slippers during your hospital stay. You may be given instructions on fluid intake. You may be advised to take laxatives in order to reduce the amount of radiation exposure to your intestinal tract. You may be asked to shower and wash your hair frequently to help remove the radiation excreted through perspiration. Traveling Home, and When at Home. Use the following guidelines regarding distance, time, and hygiene: Stay at least 3 feet away (about 1 meter) from everyone except for short periods totaling less than 1 hour each day, for approximately the first 5 days. Stay at least 6 feet away most of the time. Stay this distance from small children or pregnant women for 8 days. Keep your distance from pets as well. Do not kiss anyone. Your doctor should give you more specific guidelines on how long to avoid close contact. The number of days will depend on whether you have small children at home, pregnant women at your workplace, and other factors. Do not sit next to someone in an automobile or public transportation for more than one hour. Sit in the back seat of an automobile, on the opposite side from the driver, if possible. Sleep in a separate room, or at least 6 feet away from any other person. Use separate bath linen and launder these and underclothing separately for one week. Use separate eating utensils or disposable eating utensils. Wash eating utensils separately for one week. Do not prepare food for others. Rinse the sink and tub thoroughly after using them. Shower every day. Wash your hands with soap and plenty of water every time you use the toilet. Flush the toilet each time you use it, and wash the toilet seat. Males should sit when urinating to avoid splashing urine for one week. Discuss with your doctor how long you should wait before starting a pregnancy after your treatment (usually at least two months for males and 6 to 1. If you are breastfeeding, it should be discontinued before receiving RAI, and should not be resumed. However, breastfeeding can be done after subsequent childbirths. If you need to travel by plane or other transportation after receiving RAI, carry an information card or letter of explanation from your doctor. This is because radiation detection devices used at locations such as airports, bus and train stations, trash collection sites, and some international borders and in some buildings may detect low radiation levels. Carry the card or letter with you for at least 3 months after receiving RAI. Your Home Dental Care After RAIFollow- up care after RAI is important to neutralize the changed acidity of your saliva.
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