Studies recommend maintaining current protocol for radioactive iodine treatment of thyroid cancer

Though a significant body of research recommends that all patients who have been given radioactive iodine-131 (I-131) for thyroid cancer be hospitalized overnight, two new studies suggest keeping the procedure outpatient.

The reports, which appear in the Journal of Nuclear Medicine (JNM), indicate that the patient-management benefits of sticking to current regulations - which recommend immediate outpatient I-131 treatment for thyroid cancer - outweigh any threat that the therapy poses to public health.

The case in favor of early I-131 treatment and release comes primarily from a statistical analysis of 198 Japanese cases of thyroid cancer, all of which were ablated with radioactive iodine.

Researchers found that individuals who were given the medication more than 180 days after being diagnosed with metastatic thyroid cancer had a risk of death more than four times higher than those treated with I-131 before the 180-day mark.

Essentially, using I-131 as soon as possible to ablate cancerous thyroid tissue improved the chances of survival after metastasis.

The study's authors noted that in Japan, strict regulations on I-131 and long waiting periods make treatment with radioactive iodine relatively rare. In the U.S., I-131 is a common therapy for thyroid cancer, especially following a thyroidectomy.

Furthermore, the pair of studies suggested that patients be released from the hospital the day of I-131 treatment instead of being held overnight.

This proposal, they said, may seem to contradict a recommendation recently made by the American Thyroid Association, which stated that patients who have recently been given I-131 pose a moderate risk of irradiating others during the first few days following administration.

However, the authors of the JNM studies said that hospitalizing patients overnight could lead to holdups in I-131 therapy, similar to those in Japan. By keeping I-131 ablation an outpatient procedure, medical authorities will preserve public health while preventing unnecessary delays in thyroid cancer treatment, the group concluded.

In the U.S., nearly 45,000 people are diagnosed with thyroid cancer every year, the National Cancer Institute states.
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