Treatment with radioactive iodine

When papillary carcinoma Carcinoma - how to prevent disaster?   thyroid was small and did not have time to spread to other parts of the body, thyroidectomy may be enough to remove cancer cells from the body. But for large tumors and metastatic papillary thyroid cancer may require additional treatment - radioactive iodine therapy.

Usually this kind of treatment is used for one or two months after surgery. The objective of treatment is to destroy cancer cells that may remain after thyroidectomy.

Preparing for treatment

Radioactive iodine therapy is a safe treatment option, since radioactive iodine absorbed tireoiodnymi cells, so other cells are not exposed to it. As a result of the absorption of the substance thyroid cells, both healthy and cancer, are destroyed.

However, thyroid cancer cells do not absorb the radioactive iodine as easily as healthy cells. To improve absorption doctor may recommend the following methods:

Increased thyroid-stimulating hormone (TSH). Healthy cells of thyroid iodine was used to produce thyroid hormones in cancer cells but other tasks and they absorb only a small amount of iodine. High levels of TSH causes them to actively absorb iodine. To increase the level of TSH, there are two ways. First - this interrupt replacement therapy of thyroid hormones Thyroid hormones: mechanism of action and physiological effects . After thyroidectomy many patients have to take medication containing hormones

triiodothyronine (T3) and thyroxine Thyroxine - the main thyroid hormone   (T4) to compensate for the lack of thyroid hormone, produced naturally. However, in order to raise the level of TSH, replacement therapy is recommended to interrupt - typically 5 weeks prior to initiation of therapy with radioactive iodine. Reduced levels of T3 and T4 causes the pituitary gland to secrete more than TSH.

As a result, the patient develops temporary hypothyroidism and to relieve the symptoms and can be recommended intake of drugs containing only T3; it is necessary to stop two weeks prior to initiation of treatment with radioactive iodine.

Another way to raise the level of TSH - receiving two doses of synthetic recombinant human TSH.

The reduction of iodine in the body through diet. Once a person eliminate iodine from the diet, all thyroid cells, including cancer, are better absorb radioactive iodine. It is generally sufficient to begin to stick to this diet for two weeks prior to treatment, to how to prepare the body for treatment.

Treatment

Once the body has been properly prepared for the treatment, the patient gives the physician a very small amount of iodine - a need to determine whether there are any more fragments of thyroid tissue. After a day exploring the patient's neck using a special camera. If imaging shows that iodine is absorbed in the neck, then, so there are still remnants of the thyroid gland. In the vast majority of cases - about 95% - after total thyroidectomy detect thyroid tissue fragments.

In some cases, before starting treatment, the pre-scan. The doctor gives the patient a small dose of radioactive iodine (exact dosage depends on each individual case), and conducting a survey, in which is revealed as the residual tissue left in the neck, and she got beyond that area, where the thyroid gland. Based on the results of the study physician to calculate the dose appropriate for the patient and for 72 hours, usually begins radioactive iodine therapy. It will destroy the remnants of the thyroid in the neck cells and those cells that may have time to spread to other parts of the body. After 10 days after the end of therapy is carried out another survey to assess the results.

Radioactive iodine is in pill form, so patients do not require hospitalization. One dose is usually enough to kill any remaining cells are potentially dangerous. Treatment with radioactive iodine for the full treatment of papillary thyroid cancer The thyroid gland - is responsible for your hormones   It may take from several weeks to several months.

Cautions

During treatment, the patient must take special precautions to avoid exposure of radiation to other people. The following general recommendations to bring the patients, but sometimes doctors give special instructions, and that they need to follow the first.

• During the first 3-5 days after administration of radioactive iodine one patient to sleep.
• Avoid close contact with people in the first 3-7 days after initiation of therapy. In the first three days it is recommended that the distance with other people not less than 1.8 m. By this time, the possibility to avoid public places.
• In the first three days after you took radioactive iodine use personal towels, linens, do not give anyone your clothes and other personal belongings. Wash your clothes and wash your utensils separately from other family members. Take a shower at least once a day, and wash your hands frequently. Wipe the toilet seat each time after go to the toilet.
• Drink plenty of water. This stimulates the output of radioiodine in the urine.

Follow-up

In addition to regular monitoring, which is necessary for all patients undergoing treatment for cancer, after the treatment of papillary thyroid cancer is necessary each year to pass X-rays of the breast. In addition, be sure to monitor the level of thyroglobulin. At primary diagnosis of cancer it is practically useless, but when differentiated carcinoma thyroglobulin can give very important information. High level tireoglobinulina that was previously reduced due tereoidektomii, in many cases turns out to be an accurate indicator of recurrence of papillary thyroid cancer. Thyroglobulin level above 10 ng / ml, almost always refers to cancer recurrence, even if scanning radioiodine gives negative results.

Diagnosis of papillary thyroid cancer

Basic diagnostic procedures used for diagnosis of papillary thyroid cancer:

• Fine-needle aspiration biopsy

As with all other types of cancer, papillary thyroid cancer is diagnosed by biopsy. To determine whether the thyroid node malignancy using fine needle aspiration biopsy (FNA). Usually this first diagnostic procedure prescribed for suspected cancer of the thyroid gland - and, in some cases only.

During the procedure, the doctor introduces a thin hollow thyroid knot the game and makes collection of cells (to take samples from the exact site, the movement of the needle is monitored by ultrasound). Sometimes this operation is repeated several times in order to take samples of cells from different areas of the site. The cells were then examined under a microscope and determining whether they are malignant or not.

• Medical imaging

Medical imaging may be used, so that the doctor can better see the thyroid gland. Ultrasound examination - one of the most frequently used methods of medical imaging in the diagnosis of papillary thyroid cancer. During the procedure, the skin over the thyroid lead a small tool that sends ultrasound waves, by which the image is displayed.

Ultrasound can show filled with liquid thyroid nodes or not (dense nodes are more often malignant). This procedure is safe, quick and painless. But by using only one ultrasound can not accurately determine whether the node thyroid cancer. If the ultrasound at the doctor saved the suspicion that it could be cancer, usually assigned TAB.

If there is a possibility that papillary thyroid cancer has already spread to other organs in the process of diagnosis can also be used computed tomography (CT).

• Blood test

Using the blood test can not diagnose papillary thyroid cancer Thyroid cancer: it is curable But may determine the level of thyroid hormones. These data will help the doctor understand how well the overall functioning thyroid, as well as to determine thyroid nodes are patient to the type of "hot" or "cold". Hot thyroid nodes produce excessive amounts of thyroid hormones Thyroid hormones: mechanism of action and physiological effects Without receiving appropriate "team" of the pituitary gland, but they are rarely cancerous. Cold nodes, in contrast, do not produce the hormones, but they are much more likely to be cancerous.

Complications and treatment success

Complication papillary thyroid cancer is considered to be the resumption of tumor growth even after successful treatment. Recurrent cancer can make itself felt in a few years or even decades after treatment. Fortunately, this cancer is also amenable to therapy.

Patients from the first and second stages of papillary thyroid carcinoma in 85% of cases achieve complete remission after the first course of therapy. Five-year survival for patients in the stage 1 is 80%, the second - 55%. In patients with stages 3 and 4 of papillary thyroid cancer five-year survival is approximately the same - between 15% and 35%.

The most common recurrent papillary thyroid cancer occurs in the lymph nodes of the neck; its appearance is also possible, for example, bone and lung.

To prevent a relapse, or identify it as early as possible, doctors recommend to undergo regular checkups after treatment. Usually in the first two years need to be tested every six months, then - once a year. In the course of these surveys used ultrasound and tumor markers.

Prevention

Since the exact causes of papillary thyroid cancer remain unknown, and there is no guaranteed way to prevent it. However it is possible to some extent to reduce the likelihood of developing the disease.

• People with a normal level of risk

For those who have no major risk factors for the development of papillary thyroid cancer The thyroid gland - is responsible for your hormones There is only one way to prevent cancer - to reduce the impact of radiation on the body - especially in childhood. So, without the urgent need for a child should not be given X-ray examination. Although the risk associated with exposure to X-ray radiation is small, if possible, should be avoided.

• People with high risk

Scientists have identified several genetic mutations that greatly increase the likelihood of ill papillary thyroid cancer. Patients that have such a mutation, one would remove thyroid, even if the symptoms of cancer Fifteen signs of cancer that women ignore   It has not yet emerged. However, the standard has not yet developed a genetic test to determine the risk of papillary thyroid cancer.

If your family history of the disease are associated with a high risk of cancer, you should regularly undergo a thorough medical examination.

Those who live within a radius of 15 km from the nuclear power plant could plunge to dangerous levels of radiation. Such people are advised to take drugs containing potassium iodide. In the event of an emergency at the station it will help reduce the impact of radiation on the body and prevent the development of papillary thyroid cancer.

Yet it should be understood that very often the cancer can not be prevented. However, the strength of each person to observe his own body and immediately contact the doctor if you have any suspicious symptoms. The earlier received adequate treatment, the greater the likelihood that the person will soon return to normal, healthy life.