Patient Preparation and Radiation Protection Guidance for Adult Patients Undergoing Radioiodine Treatment for Thyroid Cancer in the UK

• Published in: Clinical oncology (Royal College of Radiologists (Great Britain)) 2023-01, Vol.35 (1), p.42-56
• Main Authors: Wadsley, J., Armstrong, N., Bassett-Smith, V., Beasley, M., Chandler, R., Cluny, L., Craig, A.J., Farnell, K., Garcez, K., Garnham, N., Graham, K., Hallam, A., Hill, S., Hobrough, H., McKiddie, F., Strachan, M.W.J.
• Format: Article
• Language: English
• Subjects: Adult; Humans; Iodine Radioisotopes - adverse effects; Radiation Protection; radioactive iodine treatment; thyroid cancer; Thyroid Neoplasms - drug therapy; Thyroid Neoplasms - radiotherapy; Thyrotropin; United Kingdom
• ISSN: 0936-6555; 1433-2981
• DOI: 10.1016/j.clon.2022.07.002

Radioactive iodine is a highly effective treatment for thyroid cancer and has now been used in clinical practice for more than 80 years. In general, the treatment is well tolerated. However, it can be logistically quite complex for patients due to the need to reduce iodine intake and achieve high levels of thyroid-stimulating hormone prior to treatment. Radiation protection precautions must also be taken to protect others from unnecessary radiation exposure following treatment. It has been well documented by thyroid cancer patient support groups that there is significant variation in practice across the UK. It is clear that some patients are being asked to observe unnecessarily burdensome restrictions that make it more difficult for them to tolerate the treatment. At the instigation of these support groups, a multidisciplinary group was assembled to examine the evidence and generate guidance on best practice for the preparation of patients for this treatment and the management of subsequent radiation protection precautions, with a focus on personalising the advice given to individual patients. The guidance includes advice about managing particularly challenging situations, for example treating patients who require haemodialysis. We have also worked together to produce a patient information leaflet covering these issues. We hope that the guidance document and patient information leaflet will assist centres in improving our patients' experience of receiving radioactive iodine. The patient information sheet is available as Supplementary Material to this article.