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To have RAI or not?

aidante
Posts: 1
Joined: Oct 2007

I had a Hemi-Thyroidectomy in September and a total thyroidectomy Nov. 21st for Papillary Thyroid Cancer with Follicular cells. The pathology report showed that my lymph nodes were not affected. The original tumor was 3.6 cent. The Oncologist told me it was my decision on whether to receive RAI or not because my tumor was under 4 cent. He basically said that doctors are split 50/50 on RAI with tumors under 4 cent. I'm waiting to get a referral and opinion from Endocrinologist. I'm leaning towards having RAI as a guarantee of sorts. I've read all the risks but really want to hear from people who have gone through this. I know it'll be rough but the fear of any cells lurking around scares me more. Does anyone have any insight to offer on this? Thanks so much

Rustifox's picture
Rustifox
Posts: 131
Joined: Mar 2005

I agree that RAI is a good idea for you. As a little background, it is only recently that this 'debate' has been going on about sizes nearing 4cm; it used to be that any one with cancer cells and a tumor above 1cm (yep - that's ONE centimeter) was recommended for radioactive iodine treatment.

In the long run, the thing we need to remember - and make sure that our doctors remember, too
!... is that it is MUCH, MUCH easier to treat thyroid cancer properly when it originally occurs. If cells are left behind, and allowed to mutate over time, those cells can become much more serious variants in some of us - it is known that anaplastic is a mutation of poorly treated or untreated follicular and papillary cancers, left to continue to mutate over many years... and as the years go by, the cancer often becomes less likely to 'suck up' the radioactive iodine, too.

I would definitely insist on radioactive iodine treatment with a 3.6cm malignancy. The best surgeons in the world cannot remove all the cells - there will always be a few tiny cells, at the very least, left behind. So unless there is a very concerning reason to avoid RAI treatment - I would want to have it done. Please also look at the prior post, from the lady who has rising thyroglobulin levels many years after her original diagnosis - there are links in there for guidelines for treatment/treatment protocols, etc, that may be helpful for you. All the best to you.

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