1.What is the thyroid gland?
The thyroid gland is the largest endocrine gland in the body, divided into two lobes, located in the front of the neck, below the thyroid cartilage (laryngeal node), in a butterfly shape, moving up and down with swallowing. The normal human thyroid gland weighs about 20-25 grams.
The functions of the thyroid gland: iodine uptake, synthesis of thyroid hormones (T3 and T4), and regulation by the pituitary gland (TSH). Interestingly, when the concentration of T3 and T4 increases, the concentration of TSH decreases (hyperthyroidism); when the concentration of T3 and T4 decreases, the concentration of TSH increases (hypothyroidism). Thyroid hormones play an important role in human growth and development and regulation of organ functions.
2.What is thyroid cancer?
Thyroid cancer is a malignant tumor originating from the thyroid gland and is more common in women than men. Most thyroid cancers can be in long-term remission after standard treatment.
3.How to detect thyroid cancer in early stage?
The common manifestations of thyroid cancer are thyroid nodules, swollen lymph nodes in the neck and hoarseness, among which thyroid nodules are the most common. Ultrasound, nuclear imaging and CT scan of thyroid gland can help to detect thyroid cancer at an early stage.
4.What are the types of thyroid cancer?
(1) Papillary thyroid cancer About 80% of thyroid cancers are papillary thyroid cancer with good prognosis.
(2) Follicular thyroid cancer
Hürthle cell carcinoma is a variant of follicular thyroid cancer and has a poor prognosis because of its poor uptake of iodine-131.
3) Medullary thyroid carcinoma
About 4% of thyroid cancers are medullary thyroid carcinoma, which originates from thyroid C cells (which produce calcitonin), and patients often have high levels of calcitonin and carcinoembryonic antigen in the blood. The tumor cells do not take up iodine-131 and the prognosis is poor. Medullary thyroid carcinoma includes
(1) Sporadic medullary thyroid carcinoma, commonly found in the elderly. (2) Familial medullary thyroid carcinoma, which starts at a young age.
(4) Undifferentiated thyroid cancer About 2% of thyroid cancers are undifferentiated thyroid cancers, which spread rapidly and have a poor prognosis.
(5) Thyroid lymphoma is less common.
(6) Thyroid sarcoma is less common, has strong aggressive ability and poor treatment effect.
(7) Squamous cell carcinoma of thyroid <1% of thyroid cancer is squamous cell carcinoma of thyroid, which is highly aggressive and has poor prognosis. Early surgery has better effect, and in some cases, iodine-131 treatment is effective and the prognosis is relatively good.
5.How to treat thyroid cancer?
Thyroid surgery + post-operative iodine-131 treatment.
6.What kind of thyroid cancer is suitable for Iodine-131 treatment?
Papillary thyroid cancer, follicular thyroid cancer, some squamous cell carcinoma of thyroid gland after surgery.
7.When is iodine-131 treatment not suitable?
1) Pregnant and nursing patients.
2）Patients with postoperative wounds that have not healed.
3) Those with white blood cells below 3.0×109.
4）Patients with severe impairment of liver and kidney function.
8.Why can iodine-131 treat thyroid cancer?
The cancer cells of papillary thyroid cancer, postoperative follicular thyroid cancer and some squamous cell thyroid cancer have the ability to take up iodine-131, which emits beta rays to kill the cancer cells, thus treating thyroid cancer.
9.Do I need to be hospitalized for iodine-131 treatment of thyroid cancer?
It is better to be hospitalized. Patients should rest in a special isolation ward for 7 days after taking the drug to avoid radiation effects on the surrounding people and environment.
10.What is the preparation before Iodine-131 treatment?
The procedure is as follows.
11.How effective is iodine-131 treatment for thyroid cancer?
It is reported that the 15-year survival rate of patients treated with iodine-131 is 87.4%, which is significantly higher than that of those who did not use iodine-131 (only 64.2%).
12. Other benefits that can be obtained by patients with thyroid cancer treated with iodine-131
1) It can kill undetected occult metastases and metastatic focal cancer cells, and reduce recurrence and metastasis.
2) The activity of cancer cells can be accurately known through blood sampling for thyroglobulin (Tg), which reduces the cost of examination in long-term cancer follow-up.
13.What are the side effects of iodine-131 treatment for thyroid cancer?
The most likely side effects of iodine-131 treatment include: ① laryngeal edema, which should be prevented by applying prednisone, ②
(2) Salivary gland radiculitis. Chewing gum every 1-2 hours after taking iodine-131 can avoid this side effect.
14.What do I need to pay attention to after iodine-131 treatment for thyroid cancer?
(1) Patients should go to nuclear medicine department for thyroid cancer metastasis imaging and thyroid hormone supplementation one week after taking iodine-131 (medication guided by physician).
2) Do not take foods or drugs with high iodine content for one month after taking iodine-131.
3) Visit our outpatient clinic one month after taking iodine-131 for guidance on future treatment plan.
4) Patients are forbidden to have close contact with infants and children one month after taking iodine-131.
15.When can I have children after iodine-131 treatment?
We recommend that conception can take place six months after iodine-131 treatment for men and one year after treatment for women.