Why am I having I131?  
 
Your consultant will have discussed the reasons why you have been advised to have I131, including what would happen if you chose not to have this treatment. You will also have been given some national patient information about this type of treatment from the British Thyroid Association 2004. If you have any further questions then you should discuss these with your consultant, or one of their team, before you come to hospital.
  
I131 is often used to destroy any remaining normal thyroid tissue or microscopic deposits of thyroid cancer after surgery to the thyroid gland. In many studies this has been shown to reduce the risk of the cancer returning and improve survival
(Mazzaferri 1997, Mazzaferri & Kloose 2001).

I131 can also be used to treat cancer that has returned and still achieve a cure.
 
It is important to remember that the long-term survival for most patients with papillary or follicular thyroid cancer is excellent.  
 

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 37 at the Northern Centre for Cancer Treatment. In the letter you will be advised to ring the bed management co-ordinator early on the morning of the admission to check that a bed is available. You will be advised to arrive on the ward at 10 am where you will be met by the ward clerk or one of the nursing staff and then shown to your cubicle that has been specially adapted to care for patients receiving I131.  
 
Why do I need to be nursed in a cubicle?  
 
I131 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 cubicle to reduce other people’s exposure to radiation.

Regulations state that no person should 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 cubicle? 
 
The cubicle has the following facilities:
 
An en-suite bathroom, which includes a toilet, bath and shower. You may be asked to share your facilities with another patient, of the same sex, who is having the same or similar treatment. 
 
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.
 
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. Again, you may be asked to share your kitchen facilities with another patient, of the same sex, who is having the same or similar treatment.

Meals will be placed on the bench in your kitchen area. A sink, washing up liquid and bowl are provided to enable you to wash your own cutlery and crockery, which needs to remain in your room. There is a refrigerator in your cubicle and you may wish to bring a supply of mineral water, squash or fruit. Tea and coffee making facilities are also available. You will have been advised by your Consultant to eat a low iodine diet for two weeks before and 48 hours after you treatment. Unwanted food should be disposed of using the waste disposal unit in the kitchen. 
 
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 CD’s from home.  

Patientline. Patientline provides a variety of services including TV, radio, telephone / answering machine and games. Internet access and email will also be available in the future. You will need to contact the call centre from your cubicle to register and access any of these services. Although incoming calls and the radio are free to you, you will need to pay to watch the television, play games or make outgoing calls. Patient line cards can be purchased from a machine located beside the lifts on Ward 37 or alternatively you can contact the call centre and pay for the service using a major credit card. Discounted rates are available for the over 60’s and children under 16 can watch the television for free.

Please do not bring a mobile telephone as it may interfere with sensitive hospital equipment.

When will I have my treatment?  
 
Your treatment will be given to you in your room on the day of your admission.  
 
How is I131 treatment given? 
 
The nurses will ask you to eat and drink nothing for two hours before and after your treatment. The medical physics staff will give you a capsule, similar in size to an antibiotic capsule and ask you to swallow it with a drink. It is very important not to bite it.

What are the visiting arrangements?  
 
Daily visiting is between 2 to 4pm and 6 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 medical physics staff, are used to calculate how long your visitors may stay each day. Visiting is usually restricted to about 20 minutes per visitor on the first day of treatment but this will increase during the period of your stay. The medical physics staff will provide you with information regarding daily restriction and this will be recorded on a white board outside your room.
 
Although visitors may enter your suite they must stay behind the line marked on the floor of your bedroom. It is important that you do not give your visitors anything to take out of your room.  
 
Will I experience any side effects with I131 treatment?  
 
When you stop your thyroid hormone you can feel lethargic, weak and tired and we would advise that you take sufficient rest. Although side effects with I131 are uncommon, patients often say that their mouth, throat or neck feels swollen or sore.

If this happens it usually occurs on the second or third day of your stay. 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. Sometimes people find that their sense of taste is slightly altered. Citrus fruit sweets, which encourage the production of saliva, can often help so it is a good idea to bring some in with you.  
 
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.  

What will happen after I have had my treatment?     
 
You must stay in your cubicle. The usual stay is three to four days and each day the medical physics staff will take a radiation measurement, using a hand held monitor, to help us to determine how much radioactive iodine 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 radioactive iodine.  
 
You will be taken to the medical physics department for a neck scan and will then return to the ward.

The nursing staff will generally give you some thyroid hormone replacement tablets that have been prescribed by your consultant. These should be started 48 hours after you take your I131 capsule. They will also give you a letter for your GP with information regarding your treatment, contact details and proposed follow up arrangements. 
 
When you leave hospital you will still have a small amount of radioactive iodine in your body and because of this the medical physics 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.  
 
An appointment will be sent to you to return to the clinic approximately six weeks after you have been discharge from hospital. 
 
What if I experience any 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 37. 
 
Telephone:  (0191) 256 3537
 
 
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 37.
 

The British Thyroid Association is a professional body for clinicians and scientists who specialise in the thyroid and its diseases. Patient information is available via their website.  British Thyroid Association

ButterflyNorthEast is a network of thyroid cancer patients offering information, support and encouragement to others affected by the disease. A member of the
organisation is available in the Monday morning Thyroid Clinic at NCCT. 

Telephone: (01207) 545469

Email address:   Butterflynortheast@btopenworld.com  
 
The British Thyroid Foundation is a patient-led charitable organization dedicated to helping those with thyroid disorders.  British Thyroid Foundation

Cancer BACUP is a registered charity providing information about all aspects of cancer as well as emotional support for cancer patients and their families. 

Telephone: 0808 800 1234
Cancer BACUP
 
The Northern Cancer Network provides basic and easy to understand information on subjects of interest to cancer patients, their families, friends and carers.  Northern Cancer Network
 
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 Treatment and is situated in the main patient waiting area. 

Telephone: (0191) 256 3596 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 National Cancer Institute offers the general public and health professionals consumer-oriented information on a wide range of topics.