radioiodine ablation therapy for thyroid cancer
TRANSCRIPT
A4 Blue Apr 2019Visit www.leicestershospitals.nhs.uk for maps and
information about visiting Leicester’s Hospitals
To give feedback about this information sheet, contact [email protected]
Re-use of this leaflet is restricted by Creative Commons license 1
Health information and support is available at www.nhs.uk
or call 111 for non-emergency medical advice
Produced: November 2020
Review: May 2023
Leaflet number: 962 Version: 3.1
What is radioiodine ablation treatment?
This is a treatment for thyroid cancer and has two parts:
Inpatient treatment
You will be given a capsule to swallow, which contains a radioactive form of iodine (called
radioiodine). The radioiodine will kill off remnant thyroid cells and thyroid cancer cells. This
is an effective treatment, with few side effects.
The radioactivity will remain in your body for several weeks. During the first few days, when
you are most radioactive, you will stay in hospital in an isolation room on a hospital ward.
The length of your stay will vary based on the amount of radioiodine you are given and how
quickly it leaves your body.
The room has a TV and an en-suite toilet and shower. You are welcome to visit this room
before your appointment date and discuss your stay with the ward staff. Please telephone
0116 258 6309 to arrange this.
Outpatient scan
You will then return to hospital 1 week after the capsule is given to you for a whole body
iodine scan. This will be performed in the Nuclear Medicine Department.
At the department you will need to lie still on a couch for about 30 to 40 minutes. A camera,
which is sensitive to the radioiodine, will take images of you. This shows where the
radioiodine from the capsule has gone in your body.
If you have any questions about your outpatient scan, you can ask the member of Nuclear
Medicine staff you see when you are given the capsule, or contact the Nuclear Medicine
Department (telephone number will be on your appointment letter).
Department of Nuclear Medicine
A large group of staff are involved in your treatment:
The day to day care during your stay in the isolation room is given by the normal ward staff.
This includes doctors, nurses and healthcare assistants.
Your capsule will be given by a member of the Nuclear Medicine Department who will return
each day to take a measurement. This is used to determine when you can go home.
Your outpatient scan will be performed by a Nuclear Medicine Technologist.
On occasions a trainee may also be present. If you wish, you can request that the trainee is
not present during your procedure.
How do I prepare for this treatment?
Children and babies are particularly sensitive to radiation. We need to be sure you are not
pregnant. If you are pregnant or there is any possibility that you may be pregnant, please
inform your consultant.
If you are breastfeeding, you should stop 8 weeks before treatment and then not breastfeed
that child again. Please discuss this with your consultant.
If you have incontinence problems or you need caring support, please inform your consultant
or the Nuclear Medicine Department. This will not prevent you having the treatment but
additional considerations must be made.
For 3 weeks before the treatment:
Do not take any cough medicines, multivitamins or cod liver oil.
For 2 weeks before the treatment, eat a low iodine diet:
Do not eat fish, seaweed (such as kelp), seafood or iodised (sea) salt.
Do not eat glacé or maraschino cherries or products containing the colouring material E127
(this is a red food colouring).
Try to cut down on dairy produce such as eggs, cheese, milk and milk products, as these all
contain some iodine.
The following are examples of foods that are low in iodine and so are suitable to eat as part
of a low iodine diet: fresh meat; vegetables; fresh fruit; pasta; rice.
Please note that the iodine content of food varies around the world. For this reason low
iodine diets from other countries should not be followed. Low iodine diets found on the
internet are often from outside of the UK and can result in conflicting information.
Please see the leaflet “The low iodine diet” for further guidance and meal suggestions.
www.leicestershospitals.nhs.uk 3
For the 2 days before your treatment:
You will be given Thyrogen injections 24 and 48 hours before your treatment, usually by your
district nurse. This ensures your Thyroid will absorb the radioiodine without you having to
stop your thyroid medication. This will be arranged with you in advance.
Please make sure you keep the Thyrogen vials in your fridge and you are at home until after
the district nurses have given you your injections each day.
Some patients may not be able to have Thyrogen injections. These patients will have to
come off their normal thyroid medication for a number of weeks before the treatment and
then restart as instructed by their consultant. If you are unable to have Thyrogen this will be
discussed with you before your treatment.
What to bring for your hospital stay:
You will need to bring some old clothes to wear during your stay including footwear such as
slippers and socks. Please also bring an extra set of clothes to change into when you go
home.
Please bring with you any current medication to last your stay in hospital. We recommend 4
days supply for most patients.
Please only bring the minimum number of items you think you will need. Any items you bring
with you into the room are likely to become contaminated with radiation and will be disposed
of after you have been discharged.
You will be able to use your mobile phone/ tablet/ laptop in the room, but you will be unable
to keep your charger in the room as it might become contaminated. We can cover your
phone/ tablet with plastic film so that it doesn’t become contaminated and you can take it
with you when you leave hospital. We will leave the charger in a locked cupboard so that the
ward staff can charge the device for you and you can take with you when you leave the
hospital.
There is hospital Wi-Fi available for patients, however the signal can be low in this room.
On the day of your treatment:
You will be given a radioiodine capsule (similar in size to a paracetamol capsule) to swallow
with a drink of water. It is important that you let us know in advance if you have difficulty
swallowing capsules.
Please do not eat or drink from 9am on the day of treatment, and for 2 hours after
taking the capsule.
During your hospital stay:
Each day the Nuclear Medicine staff will measure the radioiodine remaining in your body, to
work out when you can go home.
www.leicestershospitals.nhs.uk 4
After your radioiodine treatment, your body will contain some radioactivity which will decrease
every day. Most of the radioiodine leaves your body in your urine, sweat and saliva during the first
few days after your treatment. For this reason, there are a number of instructions we would like
you to follow during your stay to help reduce the spread of contamination:
Drink plenty of fluids and empty your bladder often. This will help clear the radioiodine more
quickly. Do not hesitate to call the ward staff when you need a top up of water.
When using the toilet, take care to make sure there are no splashes of urine. Flush the toilet
twice and wash hands well. Male patients should sit down when going for a pee.
The shower is a wet room style. Please point the showerhead towards the wall when
possible.
When using the sink for brushing teeth and washing, please try to avoid splashing, and rinse
the basin after use.
Please do not use the sink in the bedroom area.
Please use slippers when walking around the room.
The bedroom floor and any items you are likely to touch when in the room (table, door and
window handles, remote control etc.) will be covered in a plastic, non-slippy see-through film
called Packexe.
Visitors
Visitors are not allowed during your stay due to regulations that we have to follow.
Going home after your hospital stay
You can travel home on the day of discharge by public or private transport, providing the journey
takes no more than 1 hour. If sharing a car you should be sat diagonally opposite (and not directly
next to) any other passengers.
If your journey home is likely to take longer than 1 hour, please contact us in advance to discuss
this.
Advice to follow after discharge
If you have discomfort in the throat or neck in the days after treatment, take aspirin or paracetamol
to relieve the symptoms.
In the first week after discharge:
Flush the toilet twice after use and make sure you wash your hands well.
Make sure you wash your hands well before preparing food and wash your cutlery well.
Make sure you drink plenty of fluids.
You will visit the Nuclear Medicine Department for an imaging procedure (see “Outpatient
scan” on page 1).
Restrictions on your contact with other people:
You will still have some radioactivity left inside you when you leave hospital. So you need to
restrict your contact with other people you see regularly, such as people you live and work with.
Full written details of the restrictions will be given to you before you leave hospital on the
‘Radionuclide instruction sheet’ - please carry this sheet with you at all times whilst the
contact restrictions still apply. Show this sheet to healthcare workers if you go to the doctor or into
hospital as a patient, so they are aware that you have recently had the treatment. Restrictions will
be made on an individual basis, however typical restrictions are:
for the first 2 weeks after discharge, make sure that you stay at least 1 metre away from
children over 5 years of age and adults with whom you have regular contact. This may delay
your return to work (see below).
typically, you will need to sleep separately from a partner for about 2 weeks. The beds
should be at least 1 metre apart. This distance still applies if the beds are in different rooms
next to each other.
there will be restrictions lasting up to 4 weeks on the amount of contact you have with
children under 5 years of age and pregnant women with whom you normally have regular
contact. During this period you should stay at least 1 metre away from them.
Going back to work:
There may also be a delay before you can return to work; typically you can expect to take up to 2
weeks off. This period will vary according to your job and may be longer if you work with children.
A member of staff will discuss this with you on the day you come into hospital.
Starting a family:
Female patients must not become pregnant in 6 months following treatment.
Male patients must not father a child in the 4 months following treatment.
www.leicestershospitals.nhs.uk 6
Travelling abroad:
If you plan to travel abroad in the 6 months following your treatment, please be aware that the
security gates at ports and airports may use very sensitive radiation detectors. These may be
able to detect the very low levels of radiation coming from you. We will provide you with a letter
detailing your treatment which you can show to security officers, if needed.
Are there any side effects with radioiodine treatment?
Thyrogen - you may feel sick (nausea) or have headaches after your injection but these are
not severe and do not last long.
Feeling sick (nausea) - nausea occurs in 1 in 10 patients within the first 12 hours following
administration of radioiodine. You should ask a nurse for anti-sickness drugs if you feel
nauseous.
Taste disturbance - you may find that your sense of taste changes the day following
radioiodine administration. You might get a metallic taste or you might lose your sense of
taste. This usually returns to normal over the next few weeks. Drinking plenty of fluid helps
to reduce this.
Neck oedema - slight swelling of the neck tissue occurs in about 1 out of 10 patients, a
couple of days after treatment. The swelling usually goes away within a week of treatment.
Paracetamol or aspirin can be taken to relieve these symptoms.
Tiredness (lethargy) - if you have to stop your thyroid medication, you may feel lethargic
and weak before treatment. These symptoms will disappear when you resume your thyroid
medication, following instructions from your consultant. Patients who have Thyrogen
injections and remain on their medication should not experience this side effect.
Frequently asked questions
Will treatment increase the chance of getting other cancers?
There is no strong evidence to suggest that treatment with radioiodine increases the chances of
getting another cancer. If you have been referred for this treatment your consultant believes the
benefits of treating your thyroid cancer outweigh any risks involved.
Why are the restrictions on contact with pregnant women and children greater than
for adults?
Unborn babies and children are more sensitive to the effects of radiation than adults. So a longer
restriction period is needed. It is important to stay at least 1 metre away from them during the
restriction period.
Leicester’s Hospitals is a research active trust so you may find research happening on your ward or in your clinic. To find out about the benefits of research and become involved yourself, speak to your clinician or nurse, call 0116 258 8351 or visit www.leicestersresearch.nhs.uk/
patient-and-public-involvement 7
If you would like this information in another language or format such as EasyRead
or Braille, please telephone 0116 250 2959 or email [email protected]
,
, ‘
Aby uzyska informacje w innym jzyku, prosz zadzwoni pod podany niej numer telefonu
P re
vi o
u s
re fe
re n
ce : P
A T0
4 6
-0 7
1 5
A T0
1 2
-0 5
0 8
Do I need to stay away from public places until the restriction periods end?
No. You can go to public places. Passing people in the street or in a shop is not a problem. The
restrictions will apply to people you see regularly and repeatedly, such as people you live or
work with.
Do I need to restrict contact with my pets?
We offer no specific guidance on this but feel free to discuss this with us, before or on the day of
your treatment.
Contact details
If you have any further concerns or questions about the restrictions due to radiation, or your
whole body iodine scan, please phone 0116 258 5627 during normal working hours (Monday to
Friday, 9am to 5pm) and ask to speak to a physicist.
If you have any medical questions or concerns, you can contact the consultant’s secretary
during normal working hours on 0116 258 7882. For concerns out of hours please contact your
GP.
https://www.british-thyroid-association.org/information-for-professionals-and-
The British Thyroid Foundation website: http://www.btf-thyroid.org/
You can obtain a copy of the British Thyroid Foundation booklet from the patient
information stand in the main entrance to the Oncology Service, Osborne Building at
Leicester Royal Infirmary.
To give feedback about this information sheet, contact [email protected]
Re-use of this leaflet is restricted by Creative Commons license 1
Health information and support is available at www.nhs.uk
or call 111 for non-emergency medical advice
Produced: November 2020
Review: May 2023
Leaflet number: 962 Version: 3.1
What is radioiodine ablation treatment?
This is a treatment for thyroid cancer and has two parts:
Inpatient treatment
You will be given a capsule to swallow, which contains a radioactive form of iodine (called
radioiodine). The radioiodine will kill off remnant thyroid cells and thyroid cancer cells. This
is an effective treatment, with few side effects.
The radioactivity will remain in your body for several weeks. During the first few days, when
you are most radioactive, you will stay in hospital in an isolation room on a hospital ward.
The length of your stay will vary based on the amount of radioiodine you are given and how
quickly it leaves your body.
The room has a TV and an en-suite toilet and shower. You are welcome to visit this room
before your appointment date and discuss your stay with the ward staff. Please telephone
0116 258 6309 to arrange this.
Outpatient scan
You will then return to hospital 1 week after the capsule is given to you for a whole body
iodine scan. This will be performed in the Nuclear Medicine Department.
At the department you will need to lie still on a couch for about 30 to 40 minutes. A camera,
which is sensitive to the radioiodine, will take images of you. This shows where the
radioiodine from the capsule has gone in your body.
If you have any questions about your outpatient scan, you can ask the member of Nuclear
Medicine staff you see when you are given the capsule, or contact the Nuclear Medicine
Department (telephone number will be on your appointment letter).
Department of Nuclear Medicine
A large group of staff are involved in your treatment:
The day to day care during your stay in the isolation room is given by the normal ward staff.
This includes doctors, nurses and healthcare assistants.
Your capsule will be given by a member of the Nuclear Medicine Department who will return
each day to take a measurement. This is used to determine when you can go home.
Your outpatient scan will be performed by a Nuclear Medicine Technologist.
On occasions a trainee may also be present. If you wish, you can request that the trainee is
not present during your procedure.
How do I prepare for this treatment?
Children and babies are particularly sensitive to radiation. We need to be sure you are not
pregnant. If you are pregnant or there is any possibility that you may be pregnant, please
inform your consultant.
If you are breastfeeding, you should stop 8 weeks before treatment and then not breastfeed
that child again. Please discuss this with your consultant.
If you have incontinence problems or you need caring support, please inform your consultant
or the Nuclear Medicine Department. This will not prevent you having the treatment but
additional considerations must be made.
For 3 weeks before the treatment:
Do not take any cough medicines, multivitamins or cod liver oil.
For 2 weeks before the treatment, eat a low iodine diet:
Do not eat fish, seaweed (such as kelp), seafood or iodised (sea) salt.
Do not eat glacé or maraschino cherries or products containing the colouring material E127
(this is a red food colouring).
Try to cut down on dairy produce such as eggs, cheese, milk and milk products, as these all
contain some iodine.
The following are examples of foods that are low in iodine and so are suitable to eat as part
of a low iodine diet: fresh meat; vegetables; fresh fruit; pasta; rice.
Please note that the iodine content of food varies around the world. For this reason low
iodine diets from other countries should not be followed. Low iodine diets found on the
internet are often from outside of the UK and can result in conflicting information.
Please see the leaflet “The low iodine diet” for further guidance and meal suggestions.
www.leicestershospitals.nhs.uk 3
For the 2 days before your treatment:
You will be given Thyrogen injections 24 and 48 hours before your treatment, usually by your
district nurse. This ensures your Thyroid will absorb the radioiodine without you having to
stop your thyroid medication. This will be arranged with you in advance.
Please make sure you keep the Thyrogen vials in your fridge and you are at home until after
the district nurses have given you your injections each day.
Some patients may not be able to have Thyrogen injections. These patients will have to
come off their normal thyroid medication for a number of weeks before the treatment and
then restart as instructed by their consultant. If you are unable to have Thyrogen this will be
discussed with you before your treatment.
What to bring for your hospital stay:
You will need to bring some old clothes to wear during your stay including footwear such as
slippers and socks. Please also bring an extra set of clothes to change into when you go
home.
Please bring with you any current medication to last your stay in hospital. We recommend 4
days supply for most patients.
Please only bring the minimum number of items you think you will need. Any items you bring
with you into the room are likely to become contaminated with radiation and will be disposed
of after you have been discharged.
You will be able to use your mobile phone/ tablet/ laptop in the room, but you will be unable
to keep your charger in the room as it might become contaminated. We can cover your
phone/ tablet with plastic film so that it doesn’t become contaminated and you can take it
with you when you leave hospital. We will leave the charger in a locked cupboard so that the
ward staff can charge the device for you and you can take with you when you leave the
hospital.
There is hospital Wi-Fi available for patients, however the signal can be low in this room.
On the day of your treatment:
You will be given a radioiodine capsule (similar in size to a paracetamol capsule) to swallow
with a drink of water. It is important that you let us know in advance if you have difficulty
swallowing capsules.
Please do not eat or drink from 9am on the day of treatment, and for 2 hours after
taking the capsule.
During your hospital stay:
Each day the Nuclear Medicine staff will measure the radioiodine remaining in your body, to
work out when you can go home.
www.leicestershospitals.nhs.uk 4
After your radioiodine treatment, your body will contain some radioactivity which will decrease
every day. Most of the radioiodine leaves your body in your urine, sweat and saliva during the first
few days after your treatment. For this reason, there are a number of instructions we would like
you to follow during your stay to help reduce the spread of contamination:
Drink plenty of fluids and empty your bladder often. This will help clear the radioiodine more
quickly. Do not hesitate to call the ward staff when you need a top up of water.
When using the toilet, take care to make sure there are no splashes of urine. Flush the toilet
twice and wash hands well. Male patients should sit down when going for a pee.
The shower is a wet room style. Please point the showerhead towards the wall when
possible.
When using the sink for brushing teeth and washing, please try to avoid splashing, and rinse
the basin after use.
Please do not use the sink in the bedroom area.
Please use slippers when walking around the room.
The bedroom floor and any items you are likely to touch when in the room (table, door and
window handles, remote control etc.) will be covered in a plastic, non-slippy see-through film
called Packexe.
Visitors
Visitors are not allowed during your stay due to regulations that we have to follow.
Going home after your hospital stay
You can travel home on the day of discharge by public or private transport, providing the journey
takes no more than 1 hour. If sharing a car you should be sat diagonally opposite (and not directly
next to) any other passengers.
If your journey home is likely to take longer than 1 hour, please contact us in advance to discuss
this.
Advice to follow after discharge
If you have discomfort in the throat or neck in the days after treatment, take aspirin or paracetamol
to relieve the symptoms.
In the first week after discharge:
Flush the toilet twice after use and make sure you wash your hands well.
Make sure you wash your hands well before preparing food and wash your cutlery well.
Make sure you drink plenty of fluids.
You will visit the Nuclear Medicine Department for an imaging procedure (see “Outpatient
scan” on page 1).
Restrictions on your contact with other people:
You will still have some radioactivity left inside you when you leave hospital. So you need to
restrict your contact with other people you see regularly, such as people you live and work with.
Full written details of the restrictions will be given to you before you leave hospital on the
‘Radionuclide instruction sheet’ - please carry this sheet with you at all times whilst the
contact restrictions still apply. Show this sheet to healthcare workers if you go to the doctor or into
hospital as a patient, so they are aware that you have recently had the treatment. Restrictions will
be made on an individual basis, however typical restrictions are:
for the first 2 weeks after discharge, make sure that you stay at least 1 metre away from
children over 5 years of age and adults with whom you have regular contact. This may delay
your return to work (see below).
typically, you will need to sleep separately from a partner for about 2 weeks. The beds
should be at least 1 metre apart. This distance still applies if the beds are in different rooms
next to each other.
there will be restrictions lasting up to 4 weeks on the amount of contact you have with
children under 5 years of age and pregnant women with whom you normally have regular
contact. During this period you should stay at least 1 metre away from them.
Going back to work:
There may also be a delay before you can return to work; typically you can expect to take up to 2
weeks off. This period will vary according to your job and may be longer if you work with children.
A member of staff will discuss this with you on the day you come into hospital.
Starting a family:
Female patients must not become pregnant in 6 months following treatment.
Male patients must not father a child in the 4 months following treatment.
www.leicestershospitals.nhs.uk 6
Travelling abroad:
If you plan to travel abroad in the 6 months following your treatment, please be aware that the
security gates at ports and airports may use very sensitive radiation detectors. These may be
able to detect the very low levels of radiation coming from you. We will provide you with a letter
detailing your treatment which you can show to security officers, if needed.
Are there any side effects with radioiodine treatment?
Thyrogen - you may feel sick (nausea) or have headaches after your injection but these are
not severe and do not last long.
Feeling sick (nausea) - nausea occurs in 1 in 10 patients within the first 12 hours following
administration of radioiodine. You should ask a nurse for anti-sickness drugs if you feel
nauseous.
Taste disturbance - you may find that your sense of taste changes the day following
radioiodine administration. You might get a metallic taste or you might lose your sense of
taste. This usually returns to normal over the next few weeks. Drinking plenty of fluid helps
to reduce this.
Neck oedema - slight swelling of the neck tissue occurs in about 1 out of 10 patients, a
couple of days after treatment. The swelling usually goes away within a week of treatment.
Paracetamol or aspirin can be taken to relieve these symptoms.
Tiredness (lethargy) - if you have to stop your thyroid medication, you may feel lethargic
and weak before treatment. These symptoms will disappear when you resume your thyroid
medication, following instructions from your consultant. Patients who have Thyrogen
injections and remain on their medication should not experience this side effect.
Frequently asked questions
Will treatment increase the chance of getting other cancers?
There is no strong evidence to suggest that treatment with radioiodine increases the chances of
getting another cancer. If you have been referred for this treatment your consultant believes the
benefits of treating your thyroid cancer outweigh any risks involved.
Why are the restrictions on contact with pregnant women and children greater than
for adults?
Unborn babies and children are more sensitive to the effects of radiation than adults. So a longer
restriction period is needed. It is important to stay at least 1 metre away from them during the
restriction period.
Leicester’s Hospitals is a research active trust so you may find research happening on your ward or in your clinic. To find out about the benefits of research and become involved yourself, speak to your clinician or nurse, call 0116 258 8351 or visit www.leicestersresearch.nhs.uk/
patient-and-public-involvement 7
If you would like this information in another language or format such as EasyRead
or Braille, please telephone 0116 250 2959 or email [email protected]
,
, ‘
Aby uzyska informacje w innym jzyku, prosz zadzwoni pod podany niej numer telefonu
P re
vi o
u s
re fe
re n
ce : P
A T0
4 6
-0 7
1 5
A T0
1 2
-0 5
0 8
Do I need to stay away from public places until the restriction periods end?
No. You can go to public places. Passing people in the street or in a shop is not a problem. The
restrictions will apply to people you see regularly and repeatedly, such as people you live or
work with.
Do I need to restrict contact with my pets?
We offer no specific guidance on this but feel free to discuss this with us, before or on the day of
your treatment.
Contact details
If you have any further concerns or questions about the restrictions due to radiation, or your
whole body iodine scan, please phone 0116 258 5627 during normal working hours (Monday to
Friday, 9am to 5pm) and ask to speak to a physicist.
If you have any medical questions or concerns, you can contact the consultant’s secretary
during normal working hours on 0116 258 7882. For concerns out of hours please contact your
GP.
https://www.british-thyroid-association.org/information-for-professionals-and-
The British Thyroid Foundation website: http://www.btf-thyroid.org/
You can obtain a copy of the British Thyroid Foundation booklet from the patient
information stand in the main entrance to the Oncology Service, Osborne Building at
Leicester Royal Infirmary.