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What are the possible side effects from radioiodine?

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  • 1. Department of Nuclear Medicine Information booklet about your treatment for thyroid cancer using radioiodine This leaflet provides information about your treatment with radioiodine. It explains what this treatment is and how it is given. It also answers some of the most common questions people ask about this treatment. If any of the information is not clear or if you have questions not answered by this leaflet, then please ring the Department of Nuclear Medicine on 02920 316237. 1
  • 2. What is radioiodine? Radioiodine is a radioactive form of iodine. Iodine is part of each of our diets and is needed for the thyroid gland to work normally. What does the thyroid gland do? The thyroid gland controls the speed (metabolic rate) at which our body works. How does radioiodine work? Like ordinary iodine, radioiodine is taken up by any thyroid cells left after your thyroid operation. The radioactive form of iodine is used to destroy any remaining thyroid cells. How do you know if I need treatment? The doctor may recommend that you have a radioiodine scan to help plan your radioiodine treatment. Is a radioiodine scan always done? No. In some cases it is not necessary to do the radioiodine scan and you may be advised to have radioiodine treatment based on the information known from your operation. Only a low dose of radioiodine is needed to carry out a radioiodine scan. This can be given to you as an outpatient and is usually in a capsule form. 2
  • 3. If I am advised I need it, where will my radioiodine therapy be done? If you are advised to have radioiodine therapy you will need to be admitted to the isotope cubicle. This is a single room with a bathroom on the Princess Margaret Ward, Velindre Hospital. This room has been specially adapted because of the high dose of radiation involved in treatment. The treatment dose of radioiodine is also given as a capsule. I have been told I will need to stop my thyroid tablets before my radioiodine, why is this? Thyroid hormone tablets interfere with the radioiodine treatment. We will ask you to stop taking these tablets before and during your treatment to make sure the thyroid cells left in your body take up the radioiodine. These tablets include T4 (thyroxine) and T3 (Tri-iodothyronine). Are there any side effects associated with stopping the tablets? You may feel tired or weak when not taking these tablets. This is normal and the effects will disappear once you start taking them again. When do I start taking the thyroid hormone tablets again? If you have the treatment dose you will usually start taking your tablets again on the day you leave the ward. 3
  • 4. If you don’t need a treatment dose you will usually start taking your tablets again on the day we get the results from the initial test of you thyroid. What are the possible side effects from radioiodine? Many patients do not experience any side effects with radioiodine. However the following side effects can occur; • dry mouth • tender or swollen saliva glands • taste changes • sore throat • altered sensations around your thyroidectomy scar • swelling of your thyroid area if a significant amount of thyroid tissue is present • feeling sick (this is uncommon) Can I have the treatment if I am pregnant? No. We will ask if you are pregnant before we give you the radioiodine capsule. If there is any doubt then a pregnancy test will be done. You will need to avoid becoming pregnant for six months after your radioiodine treatment. Can I father a child? You will be advised to avoid fathering a child for four months after your treatment. 4
  • 5. Can I eat and drink as normal before I have the radioiodine? We encourage you to drink plenty of fluids, as this will help clear the radioactivity from your body more quickly. The doctor will ask you to cut down on certain foods that contain significant amounts of iodine for seven days before you receive your radioiodine. Your doctor will discuss this with you in clinic. We will give you a diet sheet to help. Is radioiodine dangerous to others? We try and keep unnecessary radiation exposure to others to a minimum. We will advise you on how to achieve this with your family and friends. Staff will not stay with you for any longer than is necessary to attend to your needs. Staff will also wear gloves and other special clothing whilst in your room on the ward. What happens if I have to come as an outpatient for the initial thyroid scan? You will have an appointment at Velindre Hospital’s outpatient department. The doctor will explain the investigation and possible treatment plans. You will have the chance to ask any questions you may have. We will ask you to sign a consent form. Then you will have a blood test. On the following Monday the physicist will give you the radioiodine capsule in the Nuclear Medicine department. We will explain everything to you and will also give you a letter explaining the things you need to do afterwards. 5
  • 6. We usually ask you to come back to the Nuclear Medicine department three days later. This time you will have a scan and we will measure the amount of radioactivity in the area of the thyroid gland. This simply involves you lying down on a bed for the scan and sitting on a chair for the neck measurement. When will I know the results of the scan and measurements? As soon as possible, once the doctor has seen them. He or she will then decide whether you need to have radioiodine treatment as an in-patient. If this is recommended, we usually ask you to come into hospital the following week. What happens if I have to come in as an in-patient? You need to go to Princess Margaret ward. You will be seen by the ward doctor, a nurse and a physicist. They will take some details from you, then take you to the isotope cubicle. The physicist will come to the cubicle and give you the radioiodine treatment capsule. After an hour the physicist will come back to the cubicle to measure the level of radiation inside of you. We will ask you to lie on the bed while a special monitor inside the cubicle does this. This will be repeated each day. The measurement does not hurt you. How long will I be in the hospital? Most people are in hospital for three to four days. Whilst you are in the cubicle we will ask you to drink as much as possible. This helps flush the remaining radioactivity out of 6
  • 7. your body. Once the radioactivity level in your body is low enough you will be able to go home. Does anything else need to be done before I go home? Before you go home you will be taken to the Nuclear Medicine department for a scan. We will ask you to shower and change into some clothing that you have not worn during your stay in the cubicle. The scan is in two parts. Each part takes about 30 minutes and looks at where the radioiodine has gone into your body. You have to follow some instructions after leaving hospital, but we will explian these to you. What happens to the clothing I have worn whilst in the cubicle? You can either leave it in the cubicle for us to dispose of, or you need to wash it separately from everyone else’s when you go home. Can I have visitors whilst in the isolation cubicle? You can have visitors but unfortunately children, pregnant women or breast-feeding women cannot visit you whilst in the isolation cubicle. Other visitors will not be allowed to come into your cubicle but you can speak to them via a phone in your room and another in the corridor. You will be able to see each other through a special window whilst you are talking. All visitors must speak to the ward staff before they visit. 7
  • 8. What can I do to help? • When washing, and particularly when brushing your teeth, please take care not to splash the water outside the hand basin. • Rinse your toothbrush thoroughly after each use. • Take care not to splash urine outside the toilet pan and flush the toilet twice after use. • If possible take a daily shower. What things do I need to bring in with me? • Washing items for example towel, soap, toothbrush, toothpaste, shaving kit, hair brush or comb. Please bring small travel size bottles as we suggest you leave all unused toiletries in the cubicle when you go home. • Several changes of clothing • Magazines and paperback books. Please do not bring in hardback or library books. • Soft drinks (small bottles 650mls or cans) You should also bring enough money to pay for any newspapers or phone calls you may wish to make. The money for any newspapers will be collected before you go into the cubicle. You can take money into the isotope cubicle for any phone calls you might wish to make. There is a telephone in your room which will take incoming calls. We will give you the extension number when you come in. Your family and friends will be able to contact you via the main switchboard on 029 2061 5888 then ask for your extension number. 8
  • 9. What facilities does the isotope cubicle have? As well as the usual furniture, the isotope cubicle has the following facilities: • A small fridge • TV / DVD • Radio / CD player / clock • Hairdryer We ask that you do not bring your own electrical items into the hospital if possible. This is because we have to check them for safety. Will I have to have another treatment? You will have a clinic appointment a few weeks after your treatment. The doctor will examine you, and discuss the scan that you had whilst you were an in-patient. Some patients will need further treatment doses of radioactive iodine. We will discuss any need for further scans and treatment with you in out-patients. 9
  • 10. We hope you have found this leaflet helpful. If you have any questions or want further information, please phone the Department of Nuclear Medicine on 029 2031 6237. 10
  • 11. Velindre Cancer Centre Velindre Road Whitchurch Cardiff CF14 2TL Phone: 029 2061 5888 11
  • 12. This leaflet was written by health professionals. The information contained in this leaflet is evidence based. It is reviewed and updated every 2 years. Written December 2003 Reviewed June 2009 12

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