Confused about getting RAI or not

[Justin1967]

I've got stage 1 pap/follicular thyroid cancer and it hasn't spread to the lymph nodes.
I'm supposed to see my endo on Wednesday. My GP seems to think it is good idea.
He said my Tg is less 1 or negative.
I read somewhere that RAI isn't necessary for Stage 1 cancers and is possibly harmfull. I guess I will learn more on Wednesday. What made up your mind with RAI?

[JoBa]

I haven't had RAI yet, so I can't help you out. I have read that total thyroidectomy is pretty successful for microcarcinomas, but I think that ultimately the decision will depend on what you feel most comfortable with. I was not really presented with a choice, which is fine with me. There are others on this forum who have gone through the RAI and it sounds as if the toughest part is having to be hypothyroid for a couple of weeks. It's not fun, but it's not the worst as far as treatments go. Here is a link to a website that I found particularly helpful in describing the procedure and exactly what happens. I am on Cytomel, so I only need to be off of the meds for two weeks. If you are on Synthroid, then I think you need to be off of the meds for at least 5 weeks.
http://cpmcnet.columbia.edu/dept/thyroid/RAI.html

I'm sure you will make whatever decision is right for you, but if the doc recommends RAI, then I would probably lean that way.

[Justin1967]

Hi
I went to my endo on Wednesday and he is recommended RAI, but he also said it is very borderline case  because the cancer is so small and whether RAI is really necessary.

Whats your view on RAI and was it successful for you?

[JoBa]

My understanding is the same as kipland's, i.e. RAI is recommended regardless of lymph node involvement. Part of the reasoning is that it is difficult to surgically remove all thyroid tissue, so the RAI is used to knock out whatever is left. My surgeon does not even remove lymph nodes unless they are "clinical" because she says that the RAI will take care of anything that has spread, but is not actually causing lymph node enlargement. The exception would probably be with microcarcinomas, which have good outcomes with surgery alone. But there may be other arguments against RAI that I am not aware of.

[kipland]

I had TT on 8/6/07 for papillary cancer, stage 1.  They took 7 lymph nodes and all tested negative (thank goodness).  I go back in the week of September 17th for the RAI.  The first three days, they give small doses of the RAI and do whole body scans looking for thyroid tissue.  It's my understanding that depending on how much they find will depend on how large my treatment dose is - which comes on Thursday.  I do know that the surgeon left some thyroid tissue on purpose, because it was very close to and wrapped around a nerve when he was trying to remove it.  I guess I assumed that this (RAI) is standard procedure for thyca, and figured they wouldn't do it if it weren't necessary.

Let us know what you find after Wednesday!

Lori