With the aim to improve patient safety, ensure uniformity in treatment and cut recurrent hospitalisation costs, besides minimising the side-effects of radioactive iodine, the American Thyroid Association (ATA) is coming out with a new set of guidelines for cancer patients. While the guidelines are yet to be published, it has come to light that new recommendations suggest that a safer, lower dose of radioactive iodine is just as effective as the higher dose at getting rid of any such cells that remain after surgery. This means that patients would now not have to go through several radiation treatments which increase other health risks.
Patients suffering from thyroid cancer are often given radioactive iodine treatment following surgery to kill cancer cells that may have been left behind. This radioactive treatment injects harmful radiation in the body that sometimes even kills healthy cells. Thus, doctors all over the world including India did research in the field and came up with a brand new set of guidelines which could save patients big bucks and ease their pain as well.
The association guidelines have suggested reducing the dosage of radioactive iodine by almost 70 per cent. low-dose radioactive iodine, about 30 millicurie, has received final approval for treatment of thyroid cancer after surgery in favour of high dose, around 100-150 millicurie, which is normally given. Additionally, patients will be treated as their per risk groups varying from low risk and intermediate risk to high risk basis in terms of recurrence of cancer and chances of death. One of the most important recommendations is the necessity of ultrasound and needle aspiration to be conducted on all patients before surgery. With some of these recommendations, doctors feel that there will be massive improvement in patient safety and standardisation of treatment.
“We try to give the lowest possible effective radiation dose so that we cure the current cancer but do not increase the risk of producing a second cancer resulting from the radiation itself. With a low dose, patients can safely go home without the risk of exposing their family members to radiation. This is a sea change from the present situation where Government rules mandate that a patient has to remain confined in a hospital’s isolation ward for days after administration of radioactive iodine. Almost 85 per cent cases fall in low to intermediate risk,” said Dr CS Bal from the Department of Nuclear Medicine in AIIMS.
An interesting finding in the guidelines is that, some of the low-risk patients may not need radioactive iodine treatment at all. Dr Pankaj Dougall, director nuclear medicine at Max Healthcare, said, “The advantage of the new guidelines could be that some of the patients could also be potentially treated on an outpatient basis, since, in our country, as per regulatory requirements, a maximum of 29.9 millicurie can be given on an outpatient basis, provided the patient can stay in a separate room at home for the initial three-four days.”
The Indian Thyroid Society claims that almost 4.2 crore Indians suffer from thyroid disorders, among which almost 90 per cent are undiagnosed.
