Thursday, December 17, 2009

Misunderstanding in thyroid cancer patients

2008 radionuclide therapy in the Fifth National Conference, Dalian, 210 Hospital Dr. Zhao Zhigang address the General Assembly, he proposed the theory of radionuclide treatment of diseases has been recognized country. After many years of clinical experience in patients with thyroid cancer, there is summarized the following five errors.

Misunderstanding 1, surgical resection has been clean, and no longer need to iodine 131 therapy

   
131 iodine therapy including "A clear" (clear thyroid tissue) and "treatment", "Ching A" means the use of iodine 131 after the destruction of residual normal thyroid tissue, the international community has a well-known theory: different from other cancers, thyroid cancer is the number of centers, namely, by CT, B-chao, surgery to detect thyroid nodules within a cancer, but in other parts of the thyroid gland may also have cancer, but because the cancer cells without the formation of less obvious nodules. Some people think that a good surgical total removal of thyroid experts will clean, no residual normal thyroid tissue or cancer. This is a misunderstanding, and then brilliant surgical specialists, can do the naked eye or the removal of thyroid cancer, and can not be removed under a microscope, that there is still more after thyroid cells or residual cancer cells, these residual thyroid cells or cancer cells must serve to eliminate iodine 131.

    
The use of thyroid papillary carcinoma, follicular carcinoma with a high degree of iodine uptake and uptake ability of the patient's oral administration of 131 Iodine, 131 I will be cancer-specific absorbed, 131 iodine release of β-rays will be hidden in any part of the body elimination of thyroid cancer cells, so 131 iodine treatment of thyroid cancer is truly targeted therapy, is the first one can be completely cured of human malignant tumors, after 131 I treatment of thyroid cancer will live like normal people. Therefore, after Operation 131 patients with thyroid cancer iodine treatment would bring great benefits to patients will significantly prolong the survival period of patients, reduce recurrence of cancer. Misunderstanding 2, some thyroid cancer patients are not served nor recurrence of iodine 131, iodine no longer need to serve 131

    
Thyroid cancer is a malignant growth slower than that of other tumors, in 3-5 years, if we did not do ECT examination or blood thyroglobulin testing and color Doppler ultrasound or CT alone is difficult to determine whether the recurrence of cancer, but patients is likely to already have a smaller cancer lesions. We often found in clinical, no service

    
Iodine 131 thyroid cancer patients 3-5 years after surgery, oral administration of small doses of 131 iodine Across ECT scan, found in cervical lymph nodes or thyroid bed in patients with site metastasis or recurrence occurred stove, while the body thyroglobulin levels in patients with rise, after serving 131 iodine therapy, patients cured, many patients got regret was not aware of thyroid cancer, iodine 131 therapy should be served. Misunderstanding 3 and serve as side effects of iodine 131

    
International studies have proven that serving 131 I do not have any impact on fertility will not lead to leukemia and other cancers in patients with increased incidence, unlike chemotherapy, radiation therapy, as side effects, serving a 131 iodine, only the equivalent of the patient is shot accepted by a chest X-ray radiation. Serving 131 iodine process was very easy, just pick up the patients, as penicillin bottle size, with 2 ml colorless, odorless liquid glass bottles, drink and water rinse to complete the treatment, many patients after iodine 131 in the service did not Any discomfort, easy to get just feel like drinking a mineral water. Mistakes 4, after ECT do first check, and then decide whether to serve 131 Iodine

    
China's 2007 "Chinese Journal of Surgery," published on the treatment of thyroid cancer expert consensus, the consensus was clearly that: As long as thyroid papillary carcinoma, follicular thyroid carcinoma patients after surgery, are required to serve 131 iodine therapy. Do check the results of ECT in patients with thyroid bed area certainly has a radionuclide concentration, delays in patient treatment opportunity. Also do check before ECT, the need for 131 patients with oral administration of small doses of iodine, will affect the patient service of the efficacy of high-dose 131 iodine, academics call this phenomenon as "stunning."

    
Misunderstanding 5, serving 131 patients with thyroid cancer iodine, surgery to the hospital do not need to review

    
Because the existence of thyroid cancer recurrence or metastasis may be, in the service of iodine 131 scan confirmed the recovery after the ECT patients, it should be an annual review, review no problem, 2-year review, review no problem, reviewed every 5 years. Review Project: Thyroid color Doppler ultrasound, ECT whole body scan, blood thyroglobulin levels, thyroid functions.

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