Easy On The Radioactive Iodine

Some papillary thyroid cancers may not need to be treated with radioactive iodine

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) It’s understandable that doctors want to treat cancer with every weapon in the arsenal. But, in the case of the most common type of thyroid cancer—the big guns may not be necessary.

A recent study looked at multiple factors and treatments for thyroid cancer patients for 19 years. Success rates were great for a lot of cases without the use of radioactive iodine.

"Talk to your doctor about all treatment options."

Iain Nixon, MD, from the Memorial Sloan Kettering Cancer Center in New York City, led the investigation.

Current treatment for well-differentiated thyroid cancer includes the use of radioactive iodine on tumors less than 4 cm or evidence that the cancer has spread to the lymph nodes—also known as nodal metastases.

New research challenges this treatment plan.

According to American Thyroid Association (ATA) Program Co-Chair, Elizabeth Pearce, MD, “Though radioactive iodine has a place in the treatment of papillary thyroid cancer, new data show that it should not be a blanket treatment for all patients.”

“Instead, clinicians must make the decision on whether to recommend adjuvant radioactive iodine to manage thyroid cancer.”

For the study, researchers reviewed the records of 1,129 patients who had their entire thyroid surgically removed between 1986-2005. Some of the patients received radioactive iodine and others did not.

Each patient record was analyzed using the GAMES method to evaluate risk and classify the thyroid tumor. GAMES is an anagram for Grade, Age, Metastases, Extent and Size.

Dr. Nixon’s team found that certain patients with early primary disease and low-volume metastatic disease in the neck had terrific outcomes without the use of radioactive iodine. All of the patients were alive after 5 years, and the disease didn’t recur in 92 percent of the folks during the same timeframe.

Even some subgroups within the advanced local disease category were successfully treated without the use of radioactive iodine. Over a 5-year period, 98 percent of patients were still living, and 87 percent had not seen the disease return.

As a result of these findings, study authors recommend treatment of thyroid cancer with radioactive iodine should be done on a case-by-case basis.

This research was presented at the 82nd Annual Meeting of the American Thyroid Association September 19-23, 2012 in Quebec City, Canada. All research is considered primary until it has been published in a peer-reviewed journal.

Reviewed by: 
Review Date: 
September 18, 2012
Last Updated:
September 20, 2012