Saturday, May 5, 2012

New treatment standards

I am always torn when new treatment standards are announced which promise the same or better results with fewer side effects. My first thought is always "why didn't they have that when I was treated". I actually find it worse when they decide that the previous standard of treatment didn't really work, but that's another story.

In thyroid cancer treatment, the first step is a thyroidectomy. Because of where your thyroid is, it is virtually impossible to remove it all - its kind of squished in between some essential body parts - spinal cord, esophagus, wind pipe, arteries, vocal cords - that are pretty darn important. So after removing as much of your thyroid as they can, they treat patients with radioactive iodine to dissolve the rest of your thyroid. Thyroids absorb iodine - which is why we have iodized salt. Now that sums of my medical knowledge on the subject of thyroids. I haven't had one for so long I haven't really spent much time learning about it.

The problem with radioactive iodine is that it is radioactive. And patients treated with it tend to be radioactive as a result. And while they are 'glowing' going out in public isn't a good idea, nor is exposure to small children, pregnant women, etc. So often, after treatment, patients are stuck in isolation for a few days - which just sucks. Pretend you are the boy in the plastic bubble for a few days and you'll get the point.

Also before the radioactive iodine treatment, patients would have to go off their synthetic thyroid hormone for two to four weeks and live on a low iodine diet - no shrimp, no salt, and nothing made with either to start with and then a few (thousand) more restrictions on top of that. And since you are off your meds for so long, you feel like hibernating.

Now they want to change all that. They have found that they can reduce the radioactive iodine dose to 1/3 of its current dose, orally as an outpatient. And they do not have to reduce their synthetic thyroid dose either. So for the patient, its easier, quicker, and less disruptive. (For the health insurers, it costs a lot less so even they are happy.)

The only burning question is - when will it appear at a hospital near us patients?

No comments: