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radiotherapy

Safe use of controlled doses of radiation to treat disease, especially cancer.  Usually given by pointing an X-ray machine at the part of the body to be treated, but can also be given by drinking liquid, having an injection or having a radioactive implant put into your body (brachytherapy).

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Northern Centre for Cancer Care

Meta-iodobenzylguanidine (MIBG) Treatment

Contact: 0191 2137035 - Ward 35

This information sheet has been designed to provide you with some useful information about your admission to the Northern Centre for Cancer Care for MIBG treatment.

This leaflet explains:

  • Where you will have your treatment
  • How your treatment is given
  • Special precautions that will need to be taken
  • Possible side effects
  • Discharge arrangements

IntroductionShow [+]Hide [-]

Why am I having MIBG?

MIBG is used to treat neuroendocrine (carcinoid) tumours, adrenal tumours (neuroblastoma in children and phaeochromocytoma) and on rare occasions, it can be used to treat thyroid cancer.

Your consultant will have discussed the reasons why you have been advised to have MIBG, including what would happen if you chose not to have this treatment. If you have any further questions then you should discuss these with your consultant, or one of their team, before you come to hospital.

Before your treatmentShow [+]Hide [-]

Where will I have my treatment?

After deciding on the date for your admission, you will receive a letter asking you to come to ward 35 at the Northern Centre for Cancer Care. You will be advised to arrive on the ward at 10am where you will be met by the ward clerk or one of the nursing staff and then be shown to the radioiodine treatment room.

Am I nursed in a special room?

Yes, you will usually be nursed in a room that has been specially adapted to care for patients receiving MIBG.

Why do I need to be nursed in a single room?

MIBG is a form of internal radiation therapy and once you receive your treatment special precautions must be taken. This is because your bodily fluids will contain the radioactive material and radiation, similar to x-rays, will be emitted from your body.

The levels of radioactivity in your body will decrease quickly over a period of days as most of the material is eliminated from the body in your urine. For a few days we care for you in a single room to reduce other people’s exposure to radiation.

Regulations state that members of the public should not receive radiation doses greater than one millisievert (1mSv) in any year as a result of medical exposure to others (Statutory Instrument 1999). To put these risks into context a person living in Newcastle is exposed to two millisieverts (2mSv) of background radiation a year.

What is in my room?

The room has the following facilities:

  • An en-suite bathroom, which includes a toilet and walk-in shower.
  • Toiletries are provided including soap, shampoo, bath gel, toothpaste, toothbrush and shower cap. Disposable razors, sanitary items and top-up items are available on request.
  • Towels are also available but you may wish to bring your own. We are happy for you to use hospital towels as bath mats.

Please be careful not to splash urine outside the toilet basin. It is suggested that male patients sit down to urinate while in hospital.

While you are in hospital it is advisable to:

  • Have a shower each day.
  • Drink between two to three litres of fluid a day
  • Empty your bladder regularly e.g. every three to four hours.
  • Empty your bowels each day.

These measures will help to remove unwanted radioactive iodine from your body.

A small kitchen area. You may be asked to share your kitchen facilities with another patient, who is having the same or similar treatment.

You may be asked to share your kitchen facilities with another patient, who is having the same or similar treatment.

Meals will be delivered to your room. We ask that you dispose of any waste food using the waste disposal unit in the kitchen area and NOT in the rubbish bin, then rinse the crockery and cutlery before it is left for collection by the ward staff. There is a refrigerator in the kitchen area and you may wish to bring a supply of mineral water, squash or fruit. Tea and coffee making facilities are also available. We advise that you drink between two to three litres of fluid / day as this helps to flush any excess radioactive iodine out of your body, in your urine.

Patient line. At present this is not available in your room, but there is a large television with a good selection of channels, also a DVD player. Please feel free to bring your own DVDs from home.

Please feel free to bring a mobile telephone, but please check with the ward staff that it is ok to use it.

Loan equipment. A hairdryer and CD player are available for you to use while you are in hospital. Please feel free to bring your own CDs from home.

During your treatmentShow [+]Hide [-]

When will I have my treatment?

You will have been sent some Potassium Iodate tablets with your admission letter.

Before we can give you your treatment we will need to check that you have taken two tablets each day for three days before your admission. If you have not taken these tablets you will not be able to have your treatment.

Your treatment will be given to you in your room on the day of your admission.

How is MIBG treatment given?

MIBG is given directly into the blood stream. We usually need to place a ‘cannula’ into a vein in your left arm. (A cannula is a fine tube that is placed into a vein using a needle). The drug is then administered slowly into the cannula, usually over about an hour and a half.

MIBG is given directly into the blood stream. We usually need to place a ‘cannula’ into a vein in your left arm. (A cannula is a fine tube that is placed into a vein using a needle). The drug is then administered slowly into the cannula, usually over about an hour and a half.

What are the visiting arrangements?

Daily visiting is between 2pm to 4pm and 6pm to 8pm however other visiting times can be arranged if you speak with the ward sister. Under 18’s and pregnant women should not visit as they are more sensitive to the effects of radiation.

The daily dose rate measurements, recorded by the nuclear medicine staff, are used to calculate how long your visitors may stay each day. Visiting is usually restricted to around 30 minutes per visitor on the first day of treatment but this will increase during the period of your stay. The nuclear medicine staff will provide you with information regarding daily restrictions and this will be recorded on a white board outside your room.

Although visitors may enter your room they must stay on the blue floor area. It is important that you do not give your visitors anything to take out of your room.

Will I experience any side effects with MIBG treatment?

As raised blood pressure can be a rare side effect of MIBG, the nurse will monitor your blood pressure every 10 minutes while you are receiving the treatment and then every 20 minutes for two hours after your injection.

You may feel nauseous during the first 24 hours after your injection. Please tell the nursing staff if you experience any side effects as they can provide advice and may give you some medication to ease any discomfort.

How can I try to prevent myself from becoming bored?

You or your visitors can bring in items from home e.g. books (not library books), magazines, newspapers games and jigsaws. Although sewing and knitting are permitted, items should not be passed onto anyone else for several weeks.

After your treatmentShow [+]Hide [-]

What will happen after I have had my treatment?

You must stay in your room. The usual stay is three to four days, but can be up to a week, and the nuclear medicine staff will take a radiation measurement, using a hand held monitor, to help us to determine how much radioactivity is left in your body. These measurements are used to help us decide when you can leave hospital.

Due to the possible long-term risks associated with being regularly exposed to patients receiving radiation therapy, the nursing staff will reduce the amount of time they spend with you after you have received your treatment. On the day of your admission the nurse will discuss ways in which we can provide 24 hour surveillance and establish how regularly you would like us to check on your condition, during the day and night. We will however try to ensure that one nurse is responsible for your care each day.

What will happen on the day I am due to leave hospital?

On the day you are due to leave hospital we will ask you to take a shower and place hospital towels into the laundry bag provided. You can take your own clothes and towels home with you. Just wash them separately when you get home in order to remove any traces of radioactivity.

The nursing staff will generally make sure you have two weeks supply of Potassium Iodate tablets to take home with you and a letter for your GP with information regarding your treatment, contact details and proposed follow up arrangements. An appointment will be sent to you to return to the clinic approximately six weeks after you have been discharged from hospital.

When you leave hospital you will still have a small amount of radioactive iodine in your body and because of this the nuclear medicine staff will provide you with individualised information regarding close contact with others. You will probably be advised to avoid close, prolonged contact with other people for a few days and asked to avoid close, prolonged contact with small children and pregnant women for up to two weeks.

What if I experience problems when I go home?

If you experience any problems within seven days of leaving the hospital then we would advise that you contact your consultant’s secretary during normal working hours, via the hospital switchboard. At all other times please contact the nursing staff on ward 35.

Hospital Switch Board Telephone 0191 2336161. Ward 35 Direct Dial 0191 2137035

If you have any further questions regarding your forthcoming admission please do not hesitate to contact your consultant’s secretary or the staff on ward 35.

Useful contacts Show [+]Hide [-]

Macmillan Cancer Support is a registered charity providing information about all aspects of cancer as well as emotional support for cancer patients and their families.   Further information is available is available on their website Macmillan Cancer Support
Telephone: 0808 808 0000 

The North of England Cancer Network provides basic and easy to understand information on subjects of interest to cancer patients, their families, friends and carers.

They have also set up a number of Patient Information Centres with a Centre Manager and trained volunteers to give support and advice. The Cancer Information Centre is based at the Northern Centre for Cancer Care and is situated in the main patient waiting area. 

Telephone: 0191 213 8611 during office hours (answer phone service at all other times).

National Cancer Institute coordinates the United States National Cancer Program. They conduct and support research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer, rehabilitation from cancer, and the continuing care of cancer patients and the families of cancer patients. Their website offers the general public and health professionals consumer-oriented information on a wide range of topics National Cancer Institute.

References
Statutory Instrument (1999) No 3232 The Ionising Radiation Regulations 1999. London. HMSO. Ionising Radiation Regulations.
 

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