Radioactive Iodine ?

[joe1234ab]

Hi everyone.  I am a 39 year old male.  I had an ultrasound that detected a 1.3 cm nodule.  It was cancerous so I had a total thyroidectomy 3 weeks ago.  The path report came back very good.  the cancer was 1cm in greatest diameter.  my lympth nodes were fine.  it said no multifocality, it said the extent of invasion was intrathyroidal), the path staging data (TNM) was T1, NO, Mx (not sure what hat means).  there was no other cancer on the margins, etc.  it appeared the cancer was encapsulated.  I am just not sure what to do next.  my surgean was excellent and I trust him very much.  he did a great job with the surgery- no nerve problem, parathyroid saved.  He recommended i get the radiation.  But I have a friend whos relative is a thyroid surgery and associate professor at a university.  he told me he i didnt need the radiation.  i also went to see an endo doc who told me he couldnt find any reason to give me radiation.  he told me the only thing is i was male and they typically have a worse prognosis but he said everything else led him that i didnt need the radiation.  So, I just cant make up my mind what to do.  after the surgery i was on cytomel to prepare me for radiation.  My thyroglobulin test revealed a 0.2 level which the endo said was very good.  So, I just cant make up my mind on the radiation.  It sounds like it may not help me too much.  Does anyone know if the radiation has any side effects.  i thought i read somewhere it may increase my risk of getting another cancer later by a small amount.  if this is the case i probably wouldnt take it unless it improved my chance of non-recurrence by a great deal.  Any thoughts? I appreciate any help.  Thank you

[utahmomma]

I didn't have the RAI immediately after my surgeries.  The only reason I had RAI three years after my initial diagnosis was because my thyroglobulin levels were rising.  The RAI treatment I had then found a recurrence in my thyroid bed.

Three of my sisters also have thyroid cancer/surgeries in 2004.  Two have never needed RAI as their thyroglobulin levels remain rock-solid and low.  The youngest sister has needed three RAI treatments due to recurrences (all found through increasing levels of thyroglobulin).  Today she is 5-years cancer free.

Since the cancer was contained most doctors would tell you to just get your levels (TSH, free T4, free T3 and thyroglobulin) checked every 2-3 months.  What they want to do is establish a baseline for your thyroglobulin now then watch for any increase in the numbers.  No increase - no need for RAI.

Best to you

Utahmomma

[MANmom]

I had papillary cancer, had a tumor 1.5 cm as well as 4 small 1-2 mm tumors.  I did have the RAI, I had no trouble at all with it.  Basically, RAI kills off all the remaining thyroid tissue they did not remove.  They have to "peel" the tissue from your nerves that control your vocal function so they will not damage them.  Inevitably tissue gets left behind, leaving you with a slight chance of the cancer recurring in the leftover tissue.  My small tumors were found in the thryoid tissue itself, I did not want to take any chances.  I believe that 1.5 cm is the threshhold for RAI, so you are right on the border.  The Mx means metastases, you have none, I believe the NO has to do with lymph node involvement, you have none.  My staging diagnosis was exactly the same as yours.  You could always wait and have it done later if your Thg levels go up which is an incication of recurrance.  I had 100 mlc. of RAI.  I have had no unusual things happen at all.  Now that I am on the right dose of medicine, I feel great. Lots of people do not get the radiation when they have small tumors that have not metastisized, then they watch the Thg levels closely.  

[Liz94]

I wouldn't do it.  My story is very similar to yours except I am female and I regret doing it.  It has caused me to have serious issues with my teeth and knowing what I know now, I would not have done it.  At the time my endo told me "You don't NEED it, but if you were my wife I would have you do it just as a precaution."  So I did it. And I just beat myself up over it everyday.