IoN Study (Iodine or Not)
The IoN (Iodine or Not) study is a large national study in the UK. We would like to see whether low risk patients need radioactive iodine (RAI) ablation to reduce the chance of the cancer coming back, when they have already had the two other upfront usual treatments for thyroid cancer, which are total thyroidectomy (whole thyroid gland removed) and thyroid stimulating hormone suppression (TSHS) therapy. In the IoN study, all patients would have these two upfront treatments, then half of them would also receive RAI ablation, and the other half would not.
For all patients in the study the whole thyroid gland would have been removed by a specialist surgeon. In addition, patients are followed up regularly and very closely (every six months for five years) using a combination of clinical examination, modern sensitive blood tests, and neck scans. Other tests and scans would be performed when required.
The chance of the cancer coming back in these patients is low, less than 5% over five years and almost always in the neck (in fact, published research indicates that it is <2%). Even if the cancer does come back in this small number of cases, they are readily detected early by the tests and scans used in the IoN study, and are adequately treated and almost always cured. This avoids unnecessary treatment of up to 98% of patients with upfront radioiodine.
If the chance of the cancer coming back is similar between patients who had RAI ablation and those who did not, then future patients can avoid RAI therapy, and its potential side effects.
IoN has been approved and funded by Cancer Research UK.
About 30 hospitals across the UK are taking part in the trial, and the following clinicians and hospitals are already recruiting patients:
Bristol - Bristol Haematology & Oncology Centre (Dr Matthew Beasley)
Cambridge - Addenbrooke's (Dr Sarah Jeffries)
Canterbury - Kent and Canterbury Hospital (Dr Elena Macias Fernandez)
Cardiff - Velindre Cancer Centre (Dr Laura Moss)
Chelmsford – Broomfield Hospital (Dr Abdel Hamid)
Cheltenham - Cheltenham General Hospital (Dr Charles Candish)
Edinburgh – Royal Infirmary Edinburgh (Dr Mark Strachan)
Exeter - Royal Devon & Exeter Hospital (Wonford) (Dr Andy Goodman)
Glasgow - Beatson Oncology Centre (Dr Nicholas Reed)
Guildford - Royal Surrey County Hospital (Dr Stephen Whitaker)
Ipswich - Ipswich Hospital (Dr Christopher Scrase)
Leeds - St James's Hospital (Dr Georgina Gerrard)
Leicester - Leicester Royal Infirmary (Dr David Peel)
London - Royal Marsden Hospital (Dr Kate Newbold)
London - St Mary's Hospital (Dr Danielle Power)
London – Guy’s Hospital (Dr Hosahalli Mohan)
Maidstone - Kent Oncology Centre (Dr Nick Rowell)
Manchester - The Christie (Prof Nicholas Slevin)
Middlesbrough - James Cook University Hospital (Dr John Hardman)
Newcastle - Freeman Hospital (Dr Ujjal Mallick)
Norwich - Norfolk & Norwich University Hospital (Dr Tom Roques)
Nottingham - Nottingham Hospital (Dr Sally Morgan)
Poole - Poole Hospital (Dr Perric Crellin)
Portsmouth – Queen Alexandra Hospital – (Dr Dae Kim)
Sheffield - Weston Park Hospital (Dr Jonathan Wadsley)
Southend-on-Sea - Southend Hospital (Dr Krishnaswamy Madhavan)
Wolverhampton - New Cross Hospital (Dr Mano Joseph)
Additional centres may have been added since this information was put on the website so if you would like to take part in this trial please speak to your clinician.