Life after treatment with radioactive iodine for the thyroid gland. Complications after treatment with radioactive iodine of the thyroid gland. Where is radioiodine therapy treated in Russia, and what is the cost of therapy?

Radioactive iodine is alternative method, which is used subject to complete removal of this organ. This therapy is effective for differentiated forms of cancer and other diseases of this organ. In some cases, this method is the patient’s only chance for a favorable outcome. The feasibility of the procedure is determined by a qualified specialist based on the established diagnosis.

Radioactive iodine 131 - what is it?

Iodine is an important element in the human body, which has the ability to accumulate and be retained by cells thyroid gland. This allows the organ to use the component to produce thyroid hormones necessary for the normal functioning of vital important organs and body systems.

Radioactive iodine 131 is a synthetically synthesized isotope of iodine. The substance is tasteless, colorless and odorless. In medicine, this component is used to treat various diseases thyroid gland. The therapeutic effect is based on the fact that when radioactive iodine enters the body, it self-disintegrates within 8 days and forms xenon, as well as beta and gamma radiation. This feature of the substance is the main goal of treatment, as it helps to destroy tumor cells.

90% of the therapeutic effect is achieved thanks to beta particles, which have high speed movement and short distance in tissues (2 mm). Their radioactivity helps destroy residual thyroid cells and tumors that have spread beyond its boundaries.

Gamma particles do not have a therapeutic effect, but are characterized by high penetrating ability. Thanks to this, using special gamma cameras, it is possible to detect the presence and location of metastases in which accumulation of radioactive iodine is detected.

The essence of the radioiodine therapy method

This method of treatment is used for patients who have undergone surgical removal thyroid gland. The procedure is used after 4 weeks after surgery.

When radioactive iodine is introduced into the body, residual organ cells and tumors capture and accumulate it. Thanks to this, they are destroyed, which makes it possible to stop the development of the disease. As a result, the function of the thyroid gland is completely suppressed. The isotope does not affect adjacent tissues.

The required dosage of the substance is selected by an experienced specialist based on the form and stage pathological process.

Indications for use

Radioiodine therapy for the thyroid gland is prescribed only when its effectiveness is fully justified.

Main indications for the procedure:

• hyperthyroidism due to increased activity of the thyroid gland;
• thyrotoxicosis;
• nodular goiter;
• papillary, follicular, anaplastic cancer;
• presence of metastases.

Experts divide all patients suffering from thyroid cancer into three main risk groups. Each of them means the degree of likelihood of re-development of the disease, as well as the appearance of metastases.

Based on these data, the required dosage of radioactive iodine in millicuries is determined, as well as the feasibility of the procedure.

1. Low risk group. The size of the tumor does not exceed 1-2 cm, so the tumor does not extend beyond the thyroid gland, and there are no metastases. Radioiodine therapy is not prescribed in this case.
2. Medium risk group. The diameter of the tumor exceeds 3 cm, so it has grown into the capsule. The dosage of radioactive iodine is 30-100 mCi.
3. Group high risk. The size of the tumor rapidly increases, which leads to its growth into neighboring tissues, and distant metastases are also present. The amount of radioactive iodine is prescribed from 100 mCi.

Contraindications

According to reviews, treatment of the thyroid gland with radioactive iodine is very effective, but this therapy is not useful for everyone.

Main contraindications:

• pregnancy;
• large or multinodular goiter;
• individual iodine intolerance;
• lactation;
• thyroiditis after childbirth;
• psychiatric diseases;
• hepatic, renal failure;
• severe form of decompensated diabetes mellitus;
• hypoplastic, aplastic anemia;
• stomach ulcer, duodenum during the period of exacerbation.

Radioiodine therapy is only permitted for patients over 18 years of age.

Benefits of radioiodine therapy

Judging by the reviews, treating the thyroid gland with radioactive iodine has a number of advantages. This is confirmed by experts who claim that using this method it is possible to target the thyroid gland and tumors present in it without involving adjacent tissues in the process.

The main advantages of radioiodine therapy:

• no need for anesthesia;
• low relapse rate;
• no scars remain after the procedure;
• minimal number of contraindications;
• short rehabilitation period.

Preparation for the procedure

In order for the therapy to be as effective as possible, it is necessary to prepare the patient in advance for the use of the isotope. The main role in the effectiveness of treatment is given to thyroid-stimulating hormone (TSH), which is synthesized by the pituitary gland. Since it is he who is responsible for the accumulation of iodine by the thyroid gland.

Malignant cells have a lower absorption capacity, so it is necessary to create an increased TSH level in the body to improve the uptake of radioactive iodine by the tumor.

There are two main ways to increase the level of thyroid-stimulating hormone to the required level.

1. Suspense replacement therapy. You should stop taking medications 3-6 weeks before radioiodine therapy. In this case, TSH reaches 30 or higher, which is much higher than the normal range. The disadvantage of this method is the appearance of hypothyroidism, accompanied by unpleasant symptoms.
2. Injections of "Thyrogen" (recombinant human TSH). The drug is administered several days before the isotope is used, which can significantly accelerate the increase in hormone levels.

Both ways increased TSH are effective, but which one to choose is determined by the doctor, depending on the individual characteristics of the patient.

In addition, it is necessary to comply with some general recommendations to prepare the body for the effects of isotrope.

1. Eliminate external exposure to iodine. This means that you should not swim in salt water, breathe sea air, or lubricate wounds with iodine. All these requirements must be met for four days before starting radioiodine therapy.
2. Stop taking vitamins hormonal drugs and nutritional supplements 1 month before the procedure.
3. Women should be examined for pregnancy, as the isotope negatively affects the development of the fetus.
4. Stop taking medications for hyperthyroidism 7 days before the procedure.

Necessary diet

Adjusting nutrition is also an important condition for preparing a patient for radioiodine therapy. The diet implies a significant reduction in the diet of foods containing iodine. This is a necessity to create a deficiency of this component in the body. As a result, this will lead to active absorption of radioactive iodine by tumor cells.

You must adhere to the diet for 2 weeks before therapy and for 5-7 days after it.

Acceptable products:

• fresh meat (no more than 140 g per day);
• fresh apples, oranges, lemons, grapefruits;
• pasta;
• egg whites.

It is also allowed to eat unsalted nuts, vegetable oil, sugar, honey, fruit jam, tea, raisin compote, peanut butter.

Prohibited products during this period:

• any seafood;
• egg yolks;
• chocolate;
• dairy products;
• iodized salt;
• soy and products based on it;
• sausage;
• all products that have an orange, brown and red tint;
• coffee;
• ice cream.

How is the treatment carried out?

Radiotherapy is carried out in a hospital setting. The patient must swallow the capsule or water solution radioactive iodine and drink plenty of water (at least 400 ml).

After this, the patient is isolated in a separate room, since the radiation from it poses a danger to others. Therefore, initially you need to take a minimum of things with you, since they are subsequently subject to disposal.

Within 2 hours after the procedure, solid food is prohibited, since during this period iodine is actively absorbed by the thyroid gland and tumor cells.

Radiation measurements are carried out at least once a day, and until this indicator drops to normal level, the patient will be isolated from others. On average, this period lasts from 3 to 7 days.

Side effects

The consequences of treatment with radioactive iodine for the thyroid gland can be different. In each person they are expressed differently depending on age and the volume of the injected isotrope.

The most likely side effects of radioiodine therapy for the thyroid gland are:

• nausea;
• vomit;
• general weakness;
• decreased appetite;
• swelling in the neck.

Radiotherapy is accompanied by inflammation in 30% of patients salivary glands. This unpleasant symptom appears 24 hours after the procedure and is often caused by the introduction of a large amount of isotrope against the background of residual thyroid tissue.

According to reviews, treatment of the thyroid gland with radioactive iodine causes a change in taste sensations in a third of patients. In this case, the food becomes tasteless or acquires a metallic taste. This symptom goes away on its own after 10-15 days.

The use of an isotrope may provoke an exacerbation chronic diseases such as cystitis, pyelonephritis, gastritis. To eliminate unpleasant consequences, symptomatic therapy is prescribed.

There is still no substantiated evidence that radioiodine therapy has a negative effect on conception and pregnancy. But planning for children is recommended only a year after this procedure.

Recovery period

The duration of rehabilitation after radioiodine therapy for the thyroid gland is about 1 month. During this period, a person must adhere to the doctor’s recommendations, which will help protect others from the possibility of radiation exposure, and also speed up the patient’s recovery.

1. It is necessary to increase water consumption to 1.5-2 liters per day, which will speed up the process of removing the isotope from the body.
2. You need to shower at least 2 times a day.
3. You should approach others and pets no more than 1 m; kissing and hugging children is prohibited.
4. You should sleep alone and in a separate room.
5. Men should urinate while sitting.
6. After visiting the toilet, you must flush the tank twice with used toilet paper, and also wash your hands thoroughly with soap.
7. All personal hygiene items should be kept in a plastic bag.
8. It is recommended to use separate dishes.
9. Bed linen and clothing must be washed daily.
10. If possible, limit contact with loved ones for the entire period of rehabilitation.
11. The doors of your room should be kept closed.

All restrictions are temporary; after 30 days, the person will be able to return to their usual lifestyle.

The method of using radioiodine therapy dates back to 1934. US endocrinologists were the first to use this method to treat the thyroid gland. Only seven years later did radioactive iodine begin to be used in other countries.

Patients undergoing treatment in America or Israel receive outpatient care because it is cheaper. In Russia and Europe, patients are treated in clinics.

Radioactive iodine is used when treatment of the thyroid gland is necessary to prevent further development of the disease.

The main goal when this method Therapy of the thyroid gland with radioactive iodine involves the destruction of thyrocytes and atypical cells of malignant neoplasms of the organ. This procedure eliminates radiation exposure to the entire body. The isotope I-131 is used, which is created artificially. Take it once or in a course to reduce hyperactivity of the gland.

This method is used when diseases associated with thyroid hyperactivity are identified:

1. Hyperthyroidism is a phenomenon in which the formation of small benign nodes occurs.
2. Thyrotoxicosis is a complication of hyperthyroidism.
3. Diffuse toxic goiter.
4. Treatment of thyroid cancer using radioiodine therapy is the most effective. When cancerous lesions occur complete removal lesions, but radioiodine therapy is recommended after surgery. The fact is that even after removal of lesions, new ones, both benign and malignant, are possible.

The isotope I-131 leaks into thyroid cells, which have increased activity, destroys diseased cells. Only the thyroid gland is affected, and during this period the functions of the thyroid gland are suppressed. Therapy can be carried out as a one-time method or carried out in a certain course. The decision is made by the attending physician based on the condition of the organ. The isotope does not affect other organs during the procedure.

The administered isotope I-131 is immediately captured by the active cells of the organ and begins to destroy them. Since the isotope is collected exclusively by thyroid cells, destruction occurs only in this organ.

1. After surgical intervention.
2. When the patient’s body does not perceive well or does not respond at all to medications.
3. Patients over 60 years of age.
4. If a relapse occurs, for example, during the treatment of cancer or diffuse goiter.
5. Patients who, for some reason, cannot undergo surgery and drug treatment has no effect.
6. Patients with serious cardiovascular problems.

Radioiodine therapy gives a good effect only if highly differentiated cancer is detected: follicular and papillary. For other forms, other methods of therapy are selected. Before prescribing radioactive iodine treatment, the patient is prescribed full examination. Indicators of the state of the thyroid gland are needed to determine the required isotope concentration.

The goal pursued when preparing a patient for radioiodine therapy is to increase the amount of thyroid-stimulating hormone, which performs a controlling function in normalizing the functioning of the thyroid organ. The higher the TSH level before radioiodine therapy, the more effective the treatment will be, because the activity of cancer cells contributes to their fastest destruction.

Increased level TSH in the blood activates the thyroid gland to synthesize its own hormones and activates the organ to absorb the iodine-containing component. The same hormone stimulates the growth of cancer cells. When there are high TSH levels, the absorption process increases, but their destruction process also increases accordingly.

There are two ways to increase thyroid-stimulating hormone:

1. Introduce an artificial drug - recombinant TSH. This drug has not been tested in Russia. It can only be used where it has already been officially registered: Finland, Estonia, Ukraine.
2. Stop taking thyroxine 3-4 weeks before the procedure. The body is no longer able to access iodine-containing products.

The preparatory process itself can last a month, and sometimes more.

When a decision is made to use radioactive iodine in the treatment of the thyroid gland, the patient is asked before the start of the course, approximately 2 to 4 weeks, not to take medications that are hormone substitutes.

Before this method of therapy, even after removal of the thyroid gland, thyrotoxin is not prescribed in order to carry out radioiodine therapy. Withdrawal of thyrotoxin creates conditions for cancer cells to absorb radioactive iodine.

Therefore, when I-131 begins to enter the body, they begin to actively capture it. Cells damaged by cancer do not understand what kind of iodine they absorb. Therefore, the more active they are, the faster they will die.

It is recommended that patients adhere to an iodine-free diet. In fact, this is a vegetarian diet. Purpose of the diet: conditions must be created for maximum absorption of radioiodine by thyroid cells. The preparatory process for radioiodine therapy necessarily includes the use of a low-iodine diet.

During this period it is necessary to exclude from use:

• seafood;
• seaweed, including cabbage;
• any milk products;
• products using egg yolks;
• soy products;
• legumes, colored red;
• some fruits: persimmons, apples, grapes;
• sea ​​fish;
• Hercules porridge.

Should not be consumed food supplement E127. It is added to some canned meats, raw smoked sausages, and canned fruits such as strawberries and cherries. It is found in sweets that have pink color. During this period, you should not eat a lot of greens grown in iodine-rich soils.

This restriction is temporary; you only need to observe it for the recommended 3 to 4 weeks.

During this period, no additional health problems should occur. As soon as the period is over, the doctor will allow the patient to switch to his usual diet.

When following a diet, you should adhere to the following rules:

1. The daily diet should provide physical activity person.
2. The menu must include only permitted products.
3. The number of products is limited, but not minimal, and should not provoke deterioration of health.
4. When following a diet, do not use semi-finished products.
5. Use regular salt.
6. It is better to cook noodles and bread at home without using yolks and milk. Egg whites can be consumed.

An iodine-free diet helps prepare the body to take the drug. However, it was noticed that the process of recovery of the body itself after therapy is faster. In addition, following a diet allows the body to get relief. It is easily tolerated.

Treatment with radioactive iodine may consist of a one-time consumption of a capsule, but sometimes a course of administration is prescribed. The drug may be in capsule form or in liquid form. Once the diagnostic process is complete, a capsule of the required dose is created. It is made individually and the entire manufacturing process lasts about a week.

The patient takes the capsule and can go home. However, it is better that the patient is under the supervision of specialists for five days. On the day of taking the isotope, you should refrain from food two hours before taking it, as well as after taking it. You can only drink liquid in large quantities. The liquid will help remove the isotope from the body.

After taking the capsule, the patient is a weak source of radiation for several days, which should not be exposed to other people. At first, children and pregnant women are not allowed to enter the room where the patient who has taken the capsule is located.

Bedding is changed every day. The toilet must also be thoroughly cleaned after each use. The fact is that sweat and saliva, as well as other body secretions, will initially be a source of radiation in small quantities.

The effectiveness of this method of therapy is quite high: 98% of patients experience improvements.

However, the consequences of therapy may have side effects that are short-term:

• tingling on the tongue;
• discomfort in the neck;
• feeling of dry mouth;
• sore throat;
• haunted by nausea and vomiting;
• taste sensations may change;
• swelling.

Many patients are terrified of this treatment method, citing possible radiation exposure as the reason for their fear. This is completely unfounded. Treatment with radioactive iodine is a unique alternative to surgery. If all recommendations and requirements of the doctor are followed, the procedure brings its own benefits. positive results.

You should know that even after a successful operation, a small part of the thyroid gland remains. Radioactive iodine treatment is used to destroy any remaining tissue or tumor cells.

The thyroid gland is the only organ in our body that absorbs and retains iodine. This property is used when treating the thyroid gland with radioactive iodine. Read more about the principles of therapy, risks and consequences for the patient in the material.

Radioactive iodine (synonyms l131, radioiodine, iodine-131) is one of the isotopes of simple iodine (I126).

It has the ability to decay (spontaneously), which produces a fast electron, gamma radiation, quantum and xenon:

1. Beta particle(fast electron) can reach very high speeds. It is capable of penetrating and destroying biological tissue with a radius of 0.6-2 mm in the zone of isotope accumulation. This explains medicinal properties I131 for thyroid cancer, diffuse toxic goiter (for these diseases, patients are often prescribed radioiodine therapy for the thyroid gland).
2. Gamma radiation can easily penetrate through human body. It does not have a therapeutic effect, but it has diagnostic significance: with the help of special gamma cameras it is possible to detect areas of increased accumulation of iodine-131. This makes it possible to assess the functional activity of the thyroid gland or determine the presence of metastases in case of malignant organ damage.

Thyroid scintigraphy

Let's look at how to test the thyroid gland using iodine, and what the patient needs to know about the specifics of the test. Scintigraphy, or radioisotope scanning of the thyroid gland, is a method of functional study of the organ’s functioning, based on its ability to absorb radioactive iodine molecules.

Using scintigraphy you can evaluate:

• anatomical structure and location of the organ;
• size of the thyroid gland;
• diffuse or focal changes organs associated with a violation of its functional activity;
• the presence of “cold” and “hot” nodes in the thyroid gland.

Note! In addition to the I131 isotope, iodine-123 can also be used to diagnose thyroid problems (preference is given to it if it is then planned to treat the organ with radioactive iodine) or technetium Tc99.

Indications for the procedure

Most often, radioisotope examination of the thyroid gland is prescribed for:

• an increase in the size of an abnormally located thyroid gland;
• retrosternal goiter;
• thyroid nodules diagnosed by ultrasound (to determine their functional activity);
• thyrotoxicosis for differential diagnosis type of disease;
• well-differentiated thyroid cancer to detect distant metastases.

Also, according to the doctor’s indications, the procedure is carried out to monitor the treatment of thyroid diseases, evaluate the results of the operation, and provide medical examination to patients being observed for thyroid cancer.

Preparing for scintigraphy: what you need to know before the study

The instructions for the procedure do not imply any special preparation for it.

However, doctors warn about the importance of following two simple rules:

• if the patient is taking iodine preparations, they should be discontinued a month before the study;
• after 3 weeks any diagnostic studies requiring intravenous administration of a radiopaque contrast agent.

How is radioisotope scanning performed?

The procedure is painless, takes 15-25 minutes and is carried out in several stages:

1. Oral (by swallowing gelatin capsules) or intravenous administration radiodrug containing microdoses of I123, I131 or Tc99.
2. The distribution of radioiodine isotopes with the bloodstream throughout the body and their accumulation mainly in the tissues of the thyroid gland.
3. Placing the patient in a gamma chamber, in which the radiation force is read by the cells and radioactive iodine accumulates.
4. Transferring the received information to a computer, processing it and producing the finished result.

It is important to know. Price this study largely depends on the clinic in which it is performed. average price scintigraphy in private research centers - 3000 rub.

Evaluation of the results obtained

Normally, isotopes of radioactive iodine accumulate evenly in the tissues of the thyroid gland, and on a scanogram the organ looks like two ovals with clear contours. Signs of pathology that can be diagnosed during the study are presented in the table below.

Table: Signs of thyroid pathology during radioisotope scanning:

Note! Radioisotope scanning is not a reliable diagnostic method malignant neoplasm thyroid gland. A doctor can make a diagnosis of cancer only after performing a fine-needle biopsy and subsequent morphological examination of the obtained biomaterial.

Just something complicated

Radioactive iodine is used to treat hyperthyroidism; it gradually reduces the volume of the thyroid gland until it is completely destroyed. The treatment method is much safer than it seems and, in fact, it is more reliable and has a stable result, unlike taking antithyroid drugs.

During the operation, the surgeon carefully removes the gland tissue. The difficulty lies in the very close location of the nerve of the vocal cords and it is necessary to act extremely carefully to prevent damage. The operation is complicated by even more blood vessels in endocrine gland tissue.

What is ablation?

Radioactive iodine can destroy either the entire endocrine gland or part of it. This property is used to reduce the symptoms accompanying hyperthyroidism.

Ablation means destruction or erosive ulceration. Ablation with radioactive iodine is prescribed by a doctor after accurately establishing the dose of the microelement. Uptake is determined during a scan and the doctor monitors the activity of the endocrine gland and the amount of radioactive iodine it takes up. In addition, during the examination, the specialist “sees” diseased and healthy tissues.

When determining the optimal dose of iodine, important criteria are:

• thyroid gland size;
• absorption test result.

Accordingly, the dose of radioactive iodine is increased depending on the size of the thyroid gland and the more it absorbs, the more its amount is reduced.

How it works?

The isotope spontaneously decays to form several substances. One of them is a beta particle, which penetrates biological tissue with enormous speed and provokes the death of its cells. The therapeutic effect is achieved using this type of radiation, which has a targeted effect on tissues that accumulate iodine.

The penetration of gamma radiation into the human body and organs is recorded in gamma cameras, which reveal areas of accumulation of the isotope. The glowing areas recorded on the images indicate the location of the tumor.

The cells of the thyroid gland are arranged in an orderly manner, forming spherical cavities of A-cells (follicles). An intermediate substance is produced inside the organ, which is not a full-fledged hormone - thyroglobulin. This is a chain of amino acids that contains tyrosine, which captures 2 iodine atoms.

Reserves of ready-made thyroglobulin are stored in the follicle; as soon as the body feels the need for endocrine gland hormones, they immediately release into the lumen of the blood vessels.

To start therapy, you need to take a pill and a large number of water to speed up the passage of radioactive iodine through the body. You may need to stay in a hospital in a special unit for up to several days.

The doctor will explain in detail to the patient the rules of behavior to reduce the impact of radiation on others.

Who is prescribed treatment?

Among the applicants are patients:

• with diagnosed diffuse toxic goiter;

The popularity of the method is ensured by its high efficiency. Less than half of patients with thyrotoxicosis receive adequate care when taking tablet medications. Treatment of the thyroid gland with radioactive iodine is an excellent alternative to radical treatment.

Principle of therapy

Before starting the process, the patient will have to go through the following steps:

• Collection of tests and studies of the thyroid gland.
• Calculate the approximate date of radioiodine therapy and stop taking antithyroid drugs 2 weeks before.

The effectiveness of treatment during the initial session reaches 93%, with repeated therapy 100%.

The doctor will prepare the patient in advance and explain what awaits him. On the first day, vomiting and nausea are possible. Pain and swelling appear in areas where radioactive iodine accumulates.

Very often the first to react salivary glands, a person feels dryness of the mucous membranes of the mouth and a disturbance of taste. A few drops of lemon on the tongue, lollipop or chewing gum can help correct the situation.

Short term side effects include:

• neck sensitivity;
• swelling;
• swelling and tenderness of the salivary glands;
• headache;
• lack of appetite.

Goiter

In the toxic form of goiter (nodular or diffuse), hormones are present in excess, which predisposes to thyrotoxicosis. In case of diffuse damage to the endocrine gland, hormones are produced by the entire tissue of the organ; in case of nodular goiter, the formed nodes produce hormones.

The goal is, when radioactive iodine is used, to treat the thyroid gland by exposing its areas to radiation from the isotope. Gradually, it is possible to “curb” the excess production of hormones and form a condition.

Treatment of diffuse toxic goiter with radioactive iodine will lead to a decrease in hydration eyeball. This is an obstacle to wear contact lenses, so you will have to give them up for a few days.

• After therapy, the patient needs to consume large amounts of water to quickly flush radioactive iodine from the body.
• When visiting the toilet, you should adhere to the rules of hygiene as much as possible so that urine with isotope residues does not end up anywhere except the toilet flush.
• Hands are washed with detergent and dried with disposable towels.
• Be sure to change your underwear frequently.
• Take a shower at least 2 times a day to thoroughly rinse off sweat.
• The clothes of a person who has received radioactive iodine therapy are washed separately.
• The patient is required to respect the safety of other people, in connection with which: do not be for a long time nearby (closer than 1 meter), avoid public crowded places, avoid sexual contact for 3 weeks.

The half-life of radioactive iodine lasts 8 days, during which time the thyroid cells are destroyed.

Cancer

Cancerous tumors are mutated normal cells. As soon as at least one cell acquires the ability to divide at a high speed, they talk about the formation of oncology. Interestingly, even cancer cells are able to produce thyroglobulin, but in much lower concentrations.

The thyroid gland in your body absorbs almost all the iodine that enters the body. When a person takes radioactive iodine in capsule or liquid form, it becomes concentrated in her cells. Radiation can destroy the gland itself or its cancer cells, including metastases.

Treating thyroid cancer with radioactive iodine is justified by the small effect it has on the rest of your body. The radiation dose used is much higher than with scanning.

The procedure is effective when it is necessary to destroy the thyroid tissue that remains after surgery after treatment for thyroid cancer, if affected The lymph nodes and other parts of the body. Radioactive treatment of the thyroid gland improves survival in patients with papillary and follicular cancer. This is standard practice in such cases.

Although the benefit of radioactive iodine therapy is considered less obvious for patients with minor cancerous damage to the thyroid gland. Surgical removal of the entire organ is considered more effective.

For effective treatment For thyroid cancer, the patient must have high levels of thyroid-stimulating hormone in the blood. It stimulates absorption cancer cells and organ cells of radioactive iodine.

If an endocrine gland is removed, there is a way to raise TSH levels - stop taking pills for several weeks. Low level hormones will force the pituitary gland to activate the release of TSH. The condition is temporary; it is artificially induced hypothyroidism.

The patient must be warned about the occurrence of symptoms:

• fatigue;
• depression;
• weight gain;
• constipation;
• muscle pain;
• decreased concentration.

As an option, thyrotropin injections are used to increase TSH before radioactive iodine therapy. The patient is advised to refrain from consuming foods containing iodine for 2 weeks.

Risks and side effects

Patients taking therapy should be warned about the consequences:

• Men who receive large total doses of radioactive iodine will have a reduced number of active sperm. Very rarely, there are cases of subsequent infertility, which can last up to 2 years.
• Women after therapy should abstain from pregnancy for 1 year and be prepared for violation menstrual cycle, since radioiodine treatment affects the ovaries. Accordingly, breastfeeding should be avoided.
• Anyone who has undergone isotope therapy has an increased risk of developing leukemia in the future.

After treatment with radioactive iodine, the patient needs regular medical supervision throughout his life. Radioiodine therapy has undeniable advantages over another radical solution - surgery.

The price of the procedure varies slightly in different clinics. Instructions have been developed that take into account all safety and efficiency requirements.

Radioiodine treatment allows you to painlessly and quickly eliminate the cause of thyroid disease. This is a modern way to regain lost well-being with minimal risk to health.

The clinic of the Federal State Budgetary Educational Institution of Further Education RMANPE of the Ministry of Health of the Russian Federation is one of the few medical centers, offering radioactive iodine treatment in Moscow in particular and in Russia in general. For patients with oncological diseases thyroid gland since 2017, in our clinic you can undergo treatment with radioactive iodine under the VMP program (high-tech health care) on the basis of Decree of the Government of the Russian Federation No. 1403 of December 19, 2016.

The RMANPO clinic has the right to provide treatment not only with radioactive iodine, but also with other isotopes approved for use in the Russian Federation. We also offer patients with thyroid diseases other types of therapy, such as remote therapy, etc.

The decision about which regimen is most suitable in each specific case is made by the doctor after a face-to-face consultation and the necessary diagnostics.

Treatment of thyroid cancer

Why are only a limited number of clinics treating the thyroid gland with radioactive iodine (131I) in Moscow and other cities? The fact is that the treatment method, which is painless, safe for the patient and has fairly high effectiveness in a number of diseases, involves the use of open sources ionizing radiation, which requires medical institution taking strict radiation safety measures. In particular, special rooms with special sewerage, ventilation and air circulation systems are provided for patients, and all radioactive waste is disposed of in accordance with radiation safety standards. The activities of clinics where radionuclide therapy is carried out are strictly licensed. That is why there are very few medical centers where they can provide appropriate treatment - they are represented in Moscow, Obninsk and several other cities.

In our center we accept patients under the FREE VMP PROGRAM (HIGH-TECH MEDICAL CARE), as well as under the VOLUNTARY MEDICAL INSURANCE program, making this therapy available to the widest range of people.
Mainly, the cost of radioiodine therapy is determined by the price of the drug and the length of hospital stay. At the same time, it is difficult to say in advance exactly how many days the patient will have to spend in a special ward, since the cleansing of the body from the radioisotope proceeds at different speeds for everyone. In any case, our doctors will calculate the exact activity of 131I, which, on the one hand, will be the most effective, and on the other hand, will allow you to return to normal life as quickly as possible.

Features of radioiodine therapy for the treatment of thyroid diseases

Radioiodine therapy shows the greatest effectiveness in diseases such as diffuse toxic goiter (Graves disease), toxic thyroid adenoma. In most cases, patients diagnosed thyroid cancer Treatment with radioactive iodine is indicated.

The action of the method is based on the fact that it is thyrocytes (normal thyroid cells, as well as cells of well-differentiated thyroid cancer) that accumulate iodine, while iodine-131 destroys them.

Therapy takes place with a minimum number of side effects, such treatment is increasingly being found wide application worldwide.

Staying in the ward during radioactive iodine treatment

The peculiarities of being in a hospital during radioiodine therapy are explained by the fact that after taking the drug, patients become a source of gamma radiation for a short time. That is why they must stay in special rooms that have separate ventilation and sewage systems, as well as a special air circulation system

For obvious reasons, visits from relatives to such wards are not provided, and the list of what you can take with you is quite limited and is discussed with the clinic specialists. Remember that most things will be subject to disposal, with the exception of those of material (equipment) or medical (for example, crutches) value. However, they will be returned to you only after their radiation background returns to normal.

Despite the strict rules regarding safety, otherwise we tried to make your stay in the ward as comfortable as possible. Our specialists have 7 wards (12 beds) at their disposal for those receiving radioiodine therapy. Each room has a TV, refrigerator, kettle, Internet access, shower, and bathroom. The furnishings, high-quality renovations and delicious food also make an extremely favorable impression.

Radioactive iodine, which is used in medicine, is an isotope of iodine I-131. Treatment with radioactive iodine in Moscow is carried out in many clinics. It has the unique ability to destroy thyrocyte cells of the thyroid gland and malignant tumor cells. In this case, total radiation exposure to the entire body is not created. When is radioactive iodine treatment appropriate? What rules must be followed when conducting it? We will consider these and other questions in today's article.

Treatment of the thyroid gland with radioactive iodine

The use of iodine I-131 helps in the therapy of:

• hyperthyroidism - increased hormonal activity of the thyroid gland caused by the appearance of benign nodes;
• thyrotoxicosis - intoxication caused by a persistent increase in the production of thyroid hormone.

Cancer is also treated with radioactive iodine.

Possible complications of using radioactive iodine

In some cases there may be side effects, you need to know about them if you are planning treatment with radioactive iodine. Reviews from patients who have used this therapeutic technique indicate various complications that manifest themselves:

• inflammation of the salivary glands, which causes dry mouth and sore cheeks;
• metallic taste in the mouth;
• sore throat;
• neck pain;
• nausea, vomiting;
• fatigue;
• flushes of blood;
• abnormally high and abnormally low levels of thyroid hormones.

Contraindications

Treatment with radioactive iodine cannot be carried out during pregnancy. Pregnant women have an increased risk of developing serious complications, and the procedure may harm the fetus. Nursing mothers should avoid breastfeeding baby.

The use of radioactive iodine for thyrotoxicosis and hyperthyroidism

Getting rid of thyrotoxicosis or hyperthyroidism with radioactive iodine is much safer and easier than with surgery: there is no need to endure painful sensations, the effect of anesthesia, to get rid of unaesthetic scars, you just need to drink a certain dose of iodine 131.

The radiation dose received even in large quantities of I-131 does not extend to the entire patient’s body. The approximate radiation dose has a permeability of 2 mm. Treatment of the thyroid gland with radioactive iodine gives positive results 2-3 months after the start, although there are cases of faster results. Complete recovery is indicated by a significant decrease in the production of thyroid hormones.

Preparing for treatment

• The doctor may recommend a special diet to increase the effectiveness of treatment.
• One month before the procedure, you should stop taking hormonal medications. For 5-7 days, you must stop using other medications used to treat hyperthyroidism.
• 2 hours before the procedure, it is recommended to avoid eating and drinking (except clean water).
• For a woman of childbearing age, a doctor is required to conduct a pregnancy test.
• Before starting treatment, a test is performed to determine the absorption of iodine by the thyroid gland. Based on the results of this study, the required dose of I-131 is calculated. If identified malignant tumor, complete removal of the thyroid gland is required.

What is the essence of the procedure

Treatment with radioactive iodine is as follows. The patient receives several tablets containing radioactive iodine, which he will have to swallow with 1-2 glasses of clean water (not juice). Iodine naturally penetrates the thyroid gland. In exceptional cases, a specialist may prescribe a liquid form of radioiodine that has similar characteristics. In this case, after taking the medicine, you should rinse your mouth thoroughly with water and swallow it immediately. If the patient wears removable dentures, they will be advised to remove them before using liquid iodine.

How dangerous is radioactive iodine to others?

Radiation used for treatment brings tangible benefits to the patient. However, it is harmful to those who come into contact with it. To reduce the risk of radiation exposure to others, the patient will be placed in a separate room or a room with patients who have a similar disease. Medical personnel will be able to remain in the room with such patients only during the necessary procedures and will have to protect themselves with special clothing and gloves.

Is it possible to receive visitors

After taking radioiodine, all visitors are excluded. That is, the patient will not be able to have any physical contact with other people. Communication is possible only through medical staff. It is prohibited to transfer anything outside the medical facility, including leftover food, drinks, clothing, and printed materials.

Actions after radioiodine treatment

After treatment with radioactive iodine, certain recommendations should be followed:

• You should not eat solid food for at least two hours after using radioactive agents. It is recommended to drink plenty of fluids.
• Limit contact with other people. Do not enter the premises with children. You should stay at least 3 meters away from other people. You should not be near another person for more than a few minutes. Do not sleep near other people for 48 hours after using radioactive drugs.
• After using the toilet, double flush the water.
• Wash your hands thoroughly and frequently with soap.
• Be sure to wash your toothbrush thoroughly after each use.
• When vomiting, you should use plastic bags or a toilet and be sure to notify the staff on duty.
• You should not use reusable cloth handkerchiefs; you must have disposable paper napkins.
• It is recommended to shower daily.
• The entrance door to the room must always be closed.
• It is prohibited to feed animals and birds through open windows.
• You are allowed to resume taking thyroid medications 48 hours after the procedure.

After 4-6 weeks of treatment, a visit to the doctor is required. The use of radioactive iodine can cause hypothyroidism (low thyroid function). This disorder can occur at any time after treatment. Your thyroid should be checked every few months until your thyroid hormone levels stabilize.

Patients treated with radioactive iodine should adhere to the following rules after discharge:

• At work or at home, try to stay at least one meter away from others.
• During the first week of therapy, avoid kissing and sexual contact.
• Be sure to use the most acceptable means of contraception (for women for 6-12 months, for men - at least for the first 2 months). Additionally, you can consult your doctor about this.
• If a woman was breastfeeding her baby before using radioactive iodine, after therapy lactation is stopped and the baby is transferred to artificial nutrition.
• All personal clothing used during a hospital stay is washed separately, placed in a separate plastic bag and not used for a month and a half.
• In order to quickly cleanse the salivary glands of radioactive iodine, it is recommended to consume sour sucking candies, lemon, and chewing gum as often as possible.
• After discharge from the medical facility, radioactive iodine will continue to be released in small quantities. Therefore, bed linen, towels, washcloths, and cutlery must be strictly individual. In this case, there is no need to wash the patient’s clothes separately.

Please remember that for any questions regarding treatment or recovery period, you can always consult your doctor.

Treatment with radioactive iodine: cost of the procedure

Radioiodine therapy is carried out in many clinics both in Russia and other countries. Treatment with radioactive iodine in Moscow will cost approximately 45-55 thousand rubles.

Conclusion

From this article you learned more about radioactive iodine treatment. Reviews about this therapeutic technique from both patients and doctors are mostly positive. But treatment, of course, is prescribed strictly on an individual basis by a highly qualified specialist. Be healthy!