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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

Radioiodine (I131) Treatment for Thyroid Cancer

This information has been designed to provide you with useful information regarding your admission for Radioiodine (RI) treatment. This page explains:

  • where and when you will have your treatment 
  • how your treatment is given 
  • special precautions that will need to be taken 
  • possible side effects
  • discharge arrangements
  • low iodine diet.

Why am I having radio iodine treatment? Show [+]Hide [-]

If you are a patient and have been advised to have RI, your consultant will have discussed the reasons why you have been advised to have RI - this includes the option of not having this treatment. You will also have been given an information pack in clinic and provided with an opportunity to visit the Nuclear Medicine Department and Ward 35 at the Freeman Hospital where you will be having your treatment.

If you have any further questions then you should discuss these with your consultant or one of their team, before you come into hospital for your treatment.

RI is 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). RI 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.

When will I have my treatment?Show [+]Hide [-]

When you attend your first NCCC (Northern Centre for Cancer Care) Outpatients clinic appointment, radio iodine treatment will be discussed with you and consent taken. You will then be given dates by the Thyroid Cancer Nurse Specialist (CNS) for when you will receive your treatment, and advice of preparation for this.

After deciding on the date for your admission, you will receive a letter from the Nuclear Medicine Department regarding your admission and the whole body scan taken after treatment.

Preparation for Radio Iodine treatmentShow [+]Hide [-]

In your first appointment, the consultant will discuss preparation required before treatment. This may involve stopping your thyroid hormones for two weeks or continuing your thyroid hormones with two injections of thyrogen 24 hours and 48 hours prior to radio iodine treatment. 

You must not stop taking any medications unless you are advised to do so by a member of the team.

Where will I have my treatment? Show [+]Hide [-]

On the day of admission you will need to attend the Nuclear Medicine Department at the Freeman for blood samples. For females with childbearing capacity a sample of blood will be taken to exclude pregnancy. Pregnant women and those who are currently breast feeding must not be given radioiodine treatment.

After you are reviewed in the Nuclear Medicine Department you can make your way to Ward 35. You will be met by the ward clerk or one of the nursing staff and then shown to the radioiodine suite. The nurses and doctor will then admit you to the ward, taking blood pressure, pulse and temperature. 

Am I nursed in a special room?

Yes, you will usually be nursed in a suite that has been specially adapted to care for patients receiving RI. You can find pictures of the treatment cubicle at www.butterfly.org.uk

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

RI 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 the radioiodine suite 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 the radioiodine suite?

The suite has:

An en-suite bathroom, which includes a wash basin, toilet and shower.

We would advise that you bring travel size toiletries (eg soap, shampoo, bath gel, bath gel, toothpaste, tooth brush, make-up and disposable shaving kit) as these can be discarded with minimal wastage when you are discharged from hospital. 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.

There is also air conditioning in this suite which can be noisy, so you may wish to bring ear plugs.

While you are in hospital we would advise that you undertake the following measures to help remove unwanted radioactive iodine from your body:

  • Have a shower each day
  • Drink between two to three litres of fluid a day (after taking the RI capsule to flush your system)
  • Empty your bladder regularly eg every three to four hours, while also being careful not to splash urine outside the toilet basin
  • Empty your bowels each day (mild laxatives can be prescribed if required).

A small kitchen area

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

Meals will be placed on the bench in the entrance of your cubicle. A sink, washing up liquid and bowl are provided in the kitchen for you to wash your own cutlery and crockery before it is collected by the ward staff.

Unwanted food should be disposed of using the waste disposal unit in the kitchen sink.

There is a small refrigerator in your cubicle and you may wish to bring a supply of mineral water, squash, fruit or other items that you are able to eat while on a low Iodine diet. Although tea and coffee-making facilities are available in your room, including a kettle, please advise the ward staff if you require any additional supplies of tea, coffee, milk or sugar. You will have been advised by your Consultant to eat a low Iodine diet for two weeks before and 48 hours after you treatment. Although in most cases you will be able to select your meals from the ward menu this may be influenced by any additional special dietary requirements you may have eg vegetarian. Please contact the ward before your admission if you have any additional dietary requirements which they will need to take into account during your stay. 

Patient Line

Unfortunately Patient Line is not available in your cubicle. However, there is a TV and DVD player in your cubicle which you do not need to pay to watch. You can also bring your mobile telephone, but please check with staff that this is ok to use.

Wifi available

Please ask staff on the ward about this free service. A laptop is also available in the room.

Loan equipment

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

When will I have my treatment?

Your treatment will be given to you in your room on the afternoon of your admission, usually at about 3.00pm.

How is I131 treatment given?Show [+]Hide [-]

The nurses will ask you to eat and drink nothing for two hours before and after your treatment. The Nuclear Medicine 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 will happen after I have had my treatment? Show [+]Hide [-]

You must stay in the radio iodine suite. The length of admission will depend on your dose of radio iodine treatment. This can vary from one night to three nights. Each day the Nuclear Medicine staff will take a radiation measurement using a hand held monitor to help 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 try to ensure that one nurse is responsible for your care each day.

What are the visiting arrangements? Show [+]Hide [-]

Visiting hours are between 2.00pm and 4.00pm, or 6.00pm and 8.00pm. Under 18s and pregnant women should not visit, as they are more sensitive to the effects of radiation.

The daily radiation 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 about 30 minutes per visitor on the first day of treatment, but this will increase during your stay. The Nuclear Medicine staff will give you 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 in the blue area marked on the floor, which is inside the first door leading to your suite. It is important that you do not give your visitors anything to take out of your room.

Will I experience any side effects with RI treatment? Show [+]Hide [-]

Although side effects due to RI are uncommon some patients find 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 but this usually improves several days or weeks after your treatment. Citrus fruit sweets, which encourage the production of saliva, can often help, but these should only be used 24 hours after you have taken your RI capsule.

If you are advised to stop your thyroid medication you may experience symptoms commonly associated with hypothyroidism:

  • tiredness
  • constipation
  • weight gain and puffy eyes
  • dry skin and hair
  • cold swollen hands and feet
  • mood changes
  • physical mental slowness
  • aching muscles and joints
  • unsteadiness and slurred speech.

How can I try to prevent myself from becoming bored?Show [+]Hide [-]

You or your visitors can bring in items from home eg 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 on the day I am due to leave hospital?Show [+]Hide [-]

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. Wash separately on a normal wash when you get home to remove any traces of radioactive iodine. 

A member of staff from the Nuclear Medicine Department will visit you on the ward in the morning to record your radiation level. As you will still have a small amount of radioactive iodine in your body, this measurement will be used to provide you with personalised information which will be given to you on a card. You will probably be advised to avoid close, prolonged contact with other people for another day or two (eg: sleep in a separate bed from a partner), and to avoid close, prolonged contact with small children and pregnant women for a few days.

You will also be advised to avoid having any blood samples taken for four weeks after your treatment, unless they are absolutely necessary. You will be given a letter containing this information which you must give to your GP.

If you are planning any long-distance travel, especially by air, in the next month or so, please discuss this with your Nuclear Medicine team.  

The nursing staff will give you thyroxine tablets that have been prescribed by your consultant. They will also give you a letter for your GP with information regarding your treatment and contact details. Your follow-up will be approximately eight weeks later and will be arranged prior to your discharge.

You will be asked to return to the hospital a week after your treatment to have a body scan, which will take approximately 50 minutes to complete.

Going back to workShow [+]Hide [-]

If you are planning on going back to work, it is important to discuss this with a member of the Nuclear Medicine Department to establish when it will be safe to do so. You can also discuss with your GP to assess how you feel and whether you are fit for work. If possible, patients are often advised to return to work gradually.

What if I experience any problems when I go home?Show [+]Hide [-]

If you experience any problems within seven days of leaving the hospital then we would advise that you contact either the Thyroid Nurse Specialist or your Consultant’s secretary during normal working hours. At all other times please contact your GP. 

  • Thyroid Nurse Specialist, tel: 0191 213 7112
  • Dr Mallick’s secretary, tel: 0191 213 8467
  • Ward 35, tel: 0191 213 7035
  • Nuclear Medicine Department, tel: 0191 213 8200
  • Hospital switchboard, tel: 0191 233 6161.

Family planningShow [+]Hide [-]

Men 

If you are considering have a family in the future please tell your doctor as this treatment can sometimes affect fertility. If your partner is of childbearing age, we would advise that you use contraceptives for six months after your treatment as RI may harm a developing baby.

Women

As RI may harm a developing baby if you are of childbearing age we would advise that you use contraceptives before and for six months after your treatment. You should inform your hospital doctor if your period is late and you think you may be pregnant either before, or within six months of having had your treatment.

Useful contactsShow [+]Hide [-]

If you have any further questions regarding your forthcoming admission, please contact your Thyroid Nurse Specialist, your Consultant’s secretary or staff on ward 35.

Useful contacts

  • Butterfly Thyroid Cancer Trust is the first registered charity in the UK solely dedicated to the support of people affected by Thyroid Cancer. The charity has a network of thyroid cancer patients who can offer information, support and encouragement to others affected by the disease. A member of the organisation is usually available in the oncology Thyroid Clinic. Tel: 01207 545469; email: enquiries@butterfly.org; web: www.butterfly.org.uk 
  • The British Thyroid Foundation is a patient-led charitable organisation dedicated to helping those with thyroid disorders. Web: www.btf-thyroid.org
  • The British Thyroid Association is a Society of Health Care professionals who care for patients with thyroid disease in the United Kingdom who also provide information to patients via their website: www.british-thyroid-association.org
  • Northern Centre for Cancer Care, Macmillan Information and Support Centre. Tel: 0191 213 8611 (out of hours: voicemail service); Opening hours: Monday to Friday from 9.00am to 4.30pm.
  • Macmillan Cancer Support: Freephone 0808 800 0000; web: www.macmillan.org.uk
  • Maggie's Centre (Newcastle): tel: 0191 233 6600; email: newcastle@maggiescentres.org; web: Maggie's Centre
  • The Patient Advice and Liaison Service (PALS). Tel: 0800 032 0202; address: FREEPOST, RLTC-SGHH-EGXJ, North of Tyne PALS, The Old Stables, Grey’s Yard, Morpeth, NE62 1QD; email: northoftynepals@nhct.nhs.uk

If you would like further information about health conditions and treatment options, you may wish to visit the NHS Choices website.

On the NHS Choices website, there is an information prescription generator which brings together a wealth of approved patient information from the NHS and charity partners which you may find helpful.

The National Cancer Institute co-ordinates the United States National Cancer Program which conducts and supports research, training, health information dissemination, and other programmes 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. The National Cancer Institute website offers the general public and health professionals consumer-oriented information on a wide range of topics

Recommended diet for two weeks before appointments for Thyroid tests and treatmentsShow [+]Hide [-]

A diet which is rich in iodine may reduce the effectiveness of the treatment and/or the result of the diagnostic test. We recommend a well-balanced diet that is low in Iodine, not no iodine. Therefore for two weeks before your appointment please follow the advice given below:

Do eat  Try not to eat 
Fresh and frozen fruit and vegetables Seafood and Fish
Fresh and frozen meats Cow’s / goat’s milk, cheese, ice cream, yoghurt and butter
Rice, pasta and potatoes Egg yolks
Soft drinks, fruit juices, beer, wine, tea and coffee Some cough mixtures and health foods (such as seaweed, kelp, cod liver oil, vitamins and mineral supplements) contain iodine. If the label lists iodine, do no take the supplement while on this diet
Plain fats and oils (non-diary) Avoid food from restaurants, fast-food chains and      takeaways
 Olive oil spread  
 Fresh and homemade bread  
The best way to ensure to make sure of the iodine content is to prepare your food from fresh ingredients listed in the box. Table salt and sea salt with no added iodine may be used.  Please do not stop taking any of your regular medicines without speaking to your Thyroid Team.  

 

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