I131 Radioactive Iodine to Treat Thyroid Cancer - UW Medicine - radioactive pill to kill thyroid

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• (1) radiation therapy for hyperthyroidism
• (2) thyroid radiation pill precautions
• (3) radioactive pill for thyroid scan
• (4) radioactive treatment for thyroid cancer

UW MEDICINE | PATIENT EDUCATION

|| I13 1 Radio active Io d in e to Tre at || Th yro id Can ce r
W hat to expect and how to prepare

This handout gives instructions for patients who will receive radioactive iodine to help treat thyroid cancer.

What is radioactive iodine?
Radioactiv e iodin e (also called Iodin e-131 or I131) is a substan ce th at is used to treat thyroid cancer. Both thyroid cancer and thyroid tissue absorb iodine. This helps us fin d and treat areas of active thyroid cancer.

How does it work?

We will ask you to swallow a capsule that contains a dose of I131. It will enter your bloodstream very quickly.

Your thyroid gland and any thyroid cancer tissue will absorb the I131 from your blood. Most of the I131 that is not absorbed will leave your body in your urine over the next 24 to 48 hours. The I131 absorbed by your thyroid or thyroid cancer will stay in your body longer.

Th e I131 in your th yroid tissue will give off beta particles (tiny particles that som e radioactive atom s give off). These beta particles will enter your thyroid tissue or cancer sites, very close to where they are given off (within about 1 m illim eter).

These images, taken with a special camera, show dark areas where I131 is absorbed by the body.

The beta particles dam age tissue, and this dam age will cause your thyroid gland and any thyroid cancer cells to die over tim e. It takes up to a few m onths for this treatm ent to have its full effect.

What can I expect?
Before you have I131 therapy, you m ust have a th yro id can ce r s u rve y. (Please read the handout "Thyroid Cancer Survey Using I123" or "Thyroid Cancer Dosim etry Using I131.")
If you are having treatm ent for residual thyroid tissue or residual sites of thyroid cancer:
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UWMC Im agin g Services | Box 356113 1959 N.E. Pacific St., Seattle, WA 98 19 5 | 20 6.598 .620 0

You will return to Nuclear Medicine either on the sam e day or within 3 days of your thyroid cancer survey scan. At that tim e, you will swallow 1 or more sm all capsules that contain a dose of I131.
I131 treatm ent can be done as an outpatient procedure. But, you m ay have to stay in the hospital if the radiation safety precautions will be hard to follow at hom e. There will be radiation in your body and body fluids after your treatm ent. It can be hard to protect the people you live with from this radiation. We will talk with you about what will work best for you.
W h a t s h o u ld I kn o w a bo u t I13 1 tre a tm e n t?
This treatm ent has som e side effects. You m ay have:
? Nausea
? Soreness in your neck and salivary glands
? A m etallic taste in your m outh, which m ay last 2 to 3 weeks
We will give you tips on how to lessen these sym ptom s. If you stay in the hospital overnight, we will treat your sym ptom s. If you go hom e after your treatm ent, we will give you prescriptions for anti-nausea m edicine.
Special Notes for Wom en
? If you are of childbearing age, you m ust have a pregnancy blood test before taking I131.
? If you are pregnant, you cannot receive radioactive iodine, since it would harm your unborn baby. You m ust tell us if you are pregnant, even if you do not plan to com plete the pregnancy.
? You m ust also tell us if you are breastfeeding. If you are breastfeeding, you m ay not have I131 therapy. The radiation will collect in your breast m ilk. It will pass to your child and also expose your breasts to high levels of radiation. You m ust stop breastfeeding for 3 m onths before you take your I131 dose.
Lo w -Io din e Die t
Startin g 1 w e e k be fo re your diagnostic thyroid cancer survey and I131 therapy, you m us t follow a low-iodine diet. For in structions, visit w w w .thy ca.org/ rai.htm # diet. If you do not use the internet, ask your doctor or nurse for a printed copy of these instructions.
D a y o f Yo u r I13 1 D o s e
At H o m e
? Fo r 2 h o u rs be fo re an d afte r yo u r d o s e , do n o t eat any solid foods or drink anything but water.
? You m ay have breakfast before you com e to the hospital, if it is m ore than 2 h ours before your I131 dose.
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? Water is OK to drink. We encourage you to drink plenty of water to help flush the radiation from your body.
What to Bring to the Hospital
? You m ust have 2 form s of ID, including at least 1 with your photo, such as a driver's license.
? If you will be staying in the hospital after your dose, also bring:
- Any m edicines you usually take. Bring only enough to last 3 days.
- Sour hard candy, such as lem on drops.
- A set of clothes to wear hom e.
? You m ay also bring your laptop, cell phone, and other electronic devices, if other people do not use them . If you bring these things, you can cover them with plastic to keep them from being exposed to contam ination from radioactive m aterial. You m ay also bring your wedding ring, eyeglasses, contact lenses, and personal m edical devices.
W h at to Le ave at H o m e
? Do n o t bring valuable personal item s.
? If other people use your laptop, cell phone, or other electronic devices, do n o t bring them with you.
At the H o spital
? Go to Nuclear Medicine at your scheduled tim e. Nuclear Medicine is on the 2nd floor of the hospital, near the Pacific elevators.
? If your thyroid cancer survey is on the sam e day as your I131 dose, you will have the survey first.
? You will then m eet with a Nuclear Medicine doctor and Radiation Safety officer. They will talk with you about your treatm ent and radiation safety. They will decide how m uch I131 to order based on your scan.
Outpatients
After your I131 dose is decided , we will order your custom dose from th e radiopharm acy in Seattle. It takes 1? to 2 hours for this dose to be prepared and delivered.
If you will not be staying overnight the hospital, we will ask you to return to Nuclear Medicine about 1? to 2? hours after your scan. A Nuclear Medicine doctor will give you your dose at this tim e.
In p a t ie n t s
If you will be staying overnight in the hospital after your treatm ent:
? Check in at about 12 noon at Adm itting Reception in the lobby on the m ain (3rd) floor of UWMC, just behind the Information Desk.
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? Plan to stay in the hospital up to 3 days.
Your room will be on the 6th or 7th floor. Your room looks like other hospital room s, but it was specially designed to pr otect against radiation. Your door will be open, but visitors m ay n o t com e into the room . Visitors can bring you item s and talk with you from the doorway.
You will likely receive your I131 dose in th e aftern oon .
Afte r Yo u r D o s e
Diet
? Fo r 2 h o u rs afte r yo u s w allo w th e caps u le : Do n o t eat any solid foods. An em pty stom ach helps your body absorb the radioactive iodine. Drink o n ly water.
? Fo r 3 d ays afte r yo u s w allo w th e caps u le : Follow your low-iodine diet. You m ay resum e your norm al diet after 3 days.
? Fo r 1 o r 2 d ays afte r yo u r d o s e : Avoid fatty or rich foods to help ease any nausea. We suggest taking an antacid like Zantac or Prilosec for nausea. You can buy these without a prescription at m ost d r u gs t o r es .
Oth e r Gu ide lin es
? Startin g 12 h o u rs after your dose: Start eating sour hard candy, such as lem on drops. This will m ake your salivary glands secrete som e of the radioactive iodin e they m ight have picked up. This will help m ake your neck less sore. D o n o t s tart e arlie r th an 12 h o u rs .
? Fo r 2 4 h o u rs after your dose:
- Drink at least 1 glass (8 ounces) of clear fluids such as w ate r o r ju ice e ve ry h o u r. Keep drinking plenty of clear fluids such as water or juice for at least the first 3 days.
- Flu s h th e to ile t 2 tim es every tim e after you urinate.
? Fo r 8 to 12 h o u rs after your dose: Em pty your bladder every hour.
? Th e firs t n igh t after your dose: Get up at least once during the n ight to em pty your bladder. After the first night, you do not need to do this.
? Fo r th e firs t w e e k after your dose: It is im portant to have regular bowel m ovem ents in the week after your treatm ent to clear the I131 from your colon. Constipation often occurs when your thyroid hormone is low.
Most laxatives will work well and are OK while you are on a low-iodine diet. Ask us about constipation and laxatives if you have any questions.
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Ra dia tio n Pre ca u tio n s Afte r Yo u r D o s e
W h e n Yo u Are Aro u n d Oth e r Pe o p le Follow each radiation safety precaution for the num ber of days shown:

Follow this precaution:
Do not travel by airplane or other public transportation such as a bus or train.
Do not travel on car trips longer than 4 hours with others in the car.
Sleep in a separate bed, at least 6 feet away from other adults.
Sleep in a separate bed, at least 6 feet away from pregnant wom en, infants, or children.
Stay at least 3 feet away from all adults. Allow only short periods of closer contact.
Stay at least 6 feet away from pregnant wom en, infants, and young children.

For this many days after your I131 dose:
3 days
3 days
Up to 6 days (depending on dose)
7 to 14 days (depending on dose)
4 days
Up to 7 days (depending on dose)

Body Fluid Precautions
This Body Fluid Precautions table gives basic precautions for m ost people who receive I131 treatm ent. You m ay have to follow special precautions if your situation is different. Follow each precaution the num ber of days shown:

Follow this precaution:

For this many days after your I131 dose:

Because there m ay be radioactivity in your saliva:
? Do N OT share silverware, glasses or cups, plates, food, etc. with anyone, e s pe cially ch ild re n .
? Do not let others handle your dishes or silverware.
? Rinse all of the silverware, glasses, cups, and dishes you use apart from other dirty dishes. After they are rinsed, they can be washed in a dishwasher with other dishes and silverware.
? Do n o t use disposable plates, utensils, cups, etc.

4 days

The bathroom you use should be for your use ON LY. No one else should use this bathroom . (Exceptions can som etim es be m ade for an adult-only household.)

2 days

Avoid any intim ate contact, including kissing and sexual relations.

7 days

Wash your hands well and often. Use soap and warm running water for at least 20 seconds.

7 days

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What are the long term side effects of radioactive iodine? Long term side effects of radioactive iodine treatment vary depending on: your age other medical conditions your dose of radioactive iodine

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