RAI?

[lawteddy]

I had a total thyroidectomy almost 2 weeks ago and my final path showed pap carc of the left lobe of thyroid gland measuring .7cm in greatest dimension and 1 of the 9 lymph nodes removed was positive for metastatic pap carc. The peripheral margins of resection were uninvolved by carc. The right lobe was clean.  I am an otherwise active and healthy 31 year old mother of 2.  I see my endo on April 6 but do you think RAI is my only option or can they just monitor me closely for reoccurance? They put me on 100 mcg of synthroid after my surgery and I feel great. I am concerned for the safety of my 2 small children if I get RAI and the other risks for other types of cancer for me as a side effect of RAI.  If I were your patient would your recommend RAI?  If so, do I have other options?  What are my risks if RAI is recommended and I opt to postpone it until my children are a little bit older?

Thanks so much for your time!

[Mark Lupo, M.D.]

With the positive LN, RAI is indicated.  The risks of delaying treatment are uncertain, but not likely high.  I have a physician patient in a similiar situation and she is getting I-131 next month.  I usually recommend minimum of three days away from small children -- best to wait 5 days.  Talk to your endo regarding the details of this.  There is no risk of other cancers that has been proven for the dose you would receive for remnant ablation.

[Jennell]

RAI would be a wise choice. This is the only way the cancer can be targeted. You need to go on a Low Iodine Diet too. Wish I could help you a bit more, I actually come to the site about my advanced cancer probs and found your comment.