[Ski]

#1066122

Hi Chuck,

It’s less likely that the thyroid has "grown back" and more likely that the RAI dose given to your daughter was simply not enough to destroy all thyroid tissue. Any thyroid tissue that remains active following RAI has the potential to react to the antibodies and ultimately bring the patient back to a hyperthyroid condition.

I had two RAI treatments for that very reason ~ my endocrinologist and I had communicated about a full ablation dose of RAI, but no one spoke with the doctor who chose my dose, and he believed there was a chance of killing "just enough" of the thyroid, so he gave me a lower dose than I required. A couple of years later, I was back for a second dose.

There should not be any issues with doing this a second time, except that I would have her touch base with her dosing doctor (usually a radiologist/oncologist) to ensure that they are AIMING to destroy the thyroid completely this time.

One thing to know ~ the dose is calculated based on a few factors. One of the main factors is the uptake percentage, derived from an uptake/scan. When we are first ill, typically that number is very high. It tells the doctors how much of the RAI dose will ultimately get INTO the thyroid. The way it figures in is this: if your doctor feels that your thyroid "needs" 8 millicuries in order to be destroyed, and (hypothetically) your uptake percentage is 80%, then you would need a dose of 10 millicuries in order that 8 millicuries (80% of the 10 millicuries) ultimately get to the thyroid. After you’ve had one RAI, your uptake percentage will be far lower, so the initial dose may be higher, but the amount ultimately taken to the thyroid may be very little. Let’s say they feel she needs 5 millicuries to do the job this time (much less thyroid to destroy), but her uptake is only 25%. That would mean an initial dose of 20 millicuries would be necessary in order that 5 millicuries ultimately get to the thyroid.

Remember, when you are looking at these numbers, that thyroid cancer patients routinely receive RAI doses in excess of 100, sometimes even 200 millicuries, and that is considered a safe, therapeutic dose for purposes of treatment. In other words, even at THOSE dosage levels, there is no anticipation of future issues related to the RAI.

Encourage your daughter to visit, we can help her with any questions she may have as well. Glad you found us!

[chuck]

#1018629

My daughter was 19 when she had her thyroid radiated. The thyroid has grown back and she is in for a second radiation treatment? Is this normal? What are the risks? Lonf term problems?

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