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Radioactive Iodine Treatment (RAI) |
RAI Part 2
Having radioactive iodine treatment
If you are advised to have radioactive iodine therapy, this will need to be
as an inpatient in a special cubicle known as an isotope or isolation
room.
This room is specially adapted because of the high dose of
radiation involved in treatment. Unlike a normal hospital ward you
will not be allowed to have visitors in the room. Adult visitors
(provided they are not pregnant) can visit but must stay in a
designated area outside the room.
You can talk to each other either through a protective window or possibly
by using a phone link. You cannot have children to visit.
The treatment dose of radioactive iodine is usually given as a capsule to swallow. The capsule is a similar size to a paracetamol capsule.
Many patients do not experience any side effects with radioactive iodine.
However the following side effects can occur:
- dry mouth
- tender or swollen saliva glands
- taste changes
- sore throat
- altered sensations around your thyroidectomy scar
- swelling in the thyroid area if a significant amount of thyroid tissue is still present
- feeling sick (although this is uncommon)
You will be asked if you are pregnant before the radioactive iodine
capsule is given to you. If there is any doubt then a pregnancy test
will be done as the treatment cannot go ahead if you are pregnant.
After the radioactive iodine dose has been given to you, you will need to
avoid becoming pregnant or fathering a child for several months.
Following Radioactive Iodine Treatment
The treatment will make you radioactive for a period of time
afterwards and therefore you will need to stay in the isolation
room whilst the levels of radiation are very high. The levels of
radiation will be monitored whilst you are in the room and once the
readings have fallen enough (often after 3-4 days) you will be
allowed to go home.
You will have a full body scan using a gamma camera (see
www.goingfora.com/radiology) after the treatment and this is done to see where the radioiodine has gone in the body.
If you were not already on thyroxine before your treatment this
needs to be started and you are likely to be given a prescription to
go home with.
You will still be radioactive when you go home therefore you will
still need to be careful and follow some guidelines (radiation
protection measures) in order to reduce the risks to those people
around you.
Here are some examples of what to expect when you go home:
- sleep alone
- try to keep more than 6 feet away from other people wherever possible
- avoid prolonged close contact with adults and particularly pregnant women and children
- avoid using public transport and going to the cinema/theatre, i.e, places where you may be seated next to the same person for prolonged periods
- flush the toilet twice
- avoid becoming pregnant or fathering a child for approximately 6 months
The length of time that you will need to follow the guidance varies
between patients but your hospital will give you precise instructions
and the date on which you can mix with adults normally and another
date for when you can mix with children and pregnant women.
If you are planning to travel by ferry or plane shortly after your treatment then it may be advisable to carry a letter stating that you have recently received radioactive treatment. This is to avoid any confusion that may be caused by sensitive radiation recording devices at airports and ferry terminals.
Other Radioactive Treatments
Some patients with medullary thyroid cancer may be suitable for radioactive treatment using different types of radioactive chemical. An example is mIBG (metaiodobenzylguanidine) treatment.
Although mIBG also uses radioactive iodine it is very different to the treatment explained above. This treatment is given in the isolation room but needs to be given through a drip into the bloodstream rather than as a capsule to swallow.
It is important to monitor blood pressure readings during this type of treatment and to give anti-sickness medicine before the treatment starts.
It is likely that the stay in the isolation room will be between 5 and 7 days and again a full body scan using a gamma camera will be done afterwards to see where the chemicals have gone in the body.
There is no need to stop thyroid hormones before this type of treatment. However some other medications may need to be changed or stopped before mIBG treatment and your hospital team will advise you on this issue.
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