A vial containing a large amount of radioactive iodine containing a dose of a pill. Radioactive iodine is used to treat thyroid cancers and diseases. (University of Utah Health)

Estimated reading time: 6-7 minutes

SALT LAKE CITY – Shirley Krepe was a little hesitant when doctors suggested radioactive iodine to treat her thyroid cancer 12 years ago. She trusted her doctors at Huntsman Cancer Institute, but she was still scared and scared.

“Leaving a 12-year-old alone and my husband a widower, I drink poison whenever I encounter it,” she says.

Crepe, now 54, is a mother of four. Her youngest was 12 years old when she was diagnosed with cancer.

“We tried to make the cancer diagnosis as less of a big deal as we could,” she says.

Radioactive iodine therapy, however, was definitely an event.

She was given a small bottle to drink from, alone in a designated room, and was given multiple warnings over a speaker system not to spill or throw up. She said it tasted salty.

She was told to stay away from pregnant women and children for a week after drinking. She spent a week in her bedroom. “It’s heartbreaking,” Cripeauz said, but her husband has done what he can to help her connect with family, including video calls to the breakfast table and waves through the window.

“It was a week of my life in the grand scheme of things and then I came back to myself,” she said.

How it works

Thyroid cancer is one of the most common cancers, and one of the easiest to treat—in part because of radioactive iodine.

Dr. Dave Abraham at the Huntsman Cancer Institute first used radioactive iodine in the 1930s and 1940s at the same time chemotherapy was being developed and the treatment became popular in the 1960s. It treats thyroid cancers and disorders and Graves’ disease, which causes the thyroid to overproduce hormones.

“It has stood the test of time,” Abraham said.

It’s the dose that’s changed every time they’ve been used, Abraham said. Recently, there’s been a small but statistically significant increase because too much radioactive iodine is associated with a higher risk of other cancers, which has led to lower doses, he said. In the last five to 10 years.

Radioactive iodine is used to treat thyroid cancers and diseases.  Since it is a radioactive substance, many precautions are taken to minimize exposure.
Radioactive iodine is used to treat thyroid cancers and diseases. Since it is a radioactive substance, many precautions are taken to minimize exposure. (Photo: University of Utah Health)

Radioactive iodine is administered by capsule or drink, and Abraham said it is a highly targeted therapy. Thyroid tissue, including thyroid cancer tissue that has spread throughout the body, is destroyed by the treatment once it has entered the cell. Other cells that come into contact with the radioactive iodine in the blood are not harmed.

“This is a treatment that depends on the tissue’s ability to absorb or absorb or trap iodine. Therefore, tissues with iodine traps are more susceptible to being killed by this low level of radioactivity,” said Abraham.

Before administering a dose of radioactive iodine, doctors like Abraham starve a patient’s thyroid and thyroid cancer tissue of iodine by eliminating certain foods to help the cells starve and absorb more radioactive iodine.

Treatment is usually done after most of the cancer has been removed in surgery to treat thyroid tissue where cancer cells or cancer cells may have spread, which is more common in thyroid cancer than in other types of cancer.

In many cancers, spreading to other areas leads to a worse prognosis. But the spread of thyroid cancer with radioactive iodine does not necessarily mean a worse prognosis.

Long term effects

Although one death is too many, patients dying of thyroid cancer are not too many. Estimates of the American Cancer Society In the year By 2022, there will be approximately 43,800 new cases of thyroid cancer and 2,230 deaths.

He said the main goal of radioactive iodine is to reduce the frequency of thyroid cancer.

Cripeau continues to make annual appointments with Abraham, says he has cared for her over the years and that she continues to do well, and that the radioactive iodine treatment has been effective.

Crepeaux is one of the few thyroid cancer patients with residual disease, where a small amount of the cancer does not grow back. Abraham says these are probably thyroid cancer cells that are dying, and in most patients, cancer cells that remain but do not grow are as good as a cure.

Crepax is constantly associated with dry nose, throat and eyes due to radioactive iodine treatment. She said she always has her water bottle with her and uses products to help her stay hydrated.

Abraham said that one of the reasons why this treatment is suitable for the patient is the use of the smallest effective dose. Sometimes in severe cases two doses are used, but rarely three.

If the cancer comes back and Crepeaux decides to have a second dose of radioactive iodine, she said, it will keep her from having tears, saliva or saliva — more discomfort.

Optimism

Krepp has been a hairdresser for 30 years, but is now in school to become a medical assistant.

“This is what happened to me. I’m not who I am. I’m Shirley and I’ll always be Shirley. A little salty. A little rough… I’m not going to take it from anyone. And if I love you. I’m going to love you through everything… I’m not going to let cancer or anything else change or define me. I won’t let it,” she said.

She credits her primary care physician for her diagnosis of thyroid cancer. If not, she would have died within a few years. When it was discovered, it was between the third and fourth and had already spread to her lungs. Until then her symptoms had been shoulder pain and difficulty swallowing.

Now, Crepeaux encourages everyone to self-examine their thyroid gland for lumps, or ask their doctor for an annual physical exam.

Cripeau was told she would have a very hoarse and hoarse voice after her surgery, but therapy and her high pitched voice have helped save her voice – although she says it now takes a lot of effort to produce an audible voice.

“Luckily I was one of the loudest people before the surgery, so now I have a normal voice,” she said.

But her laugh is still the same loud laugh, a laugh that elicits laughter from many others in the room.

Overall, Crepeaux shared a message that there is hope and encouraged others in similar situations to be grateful and focus on the little things that bring them joy.

“Most people with cancer are living with it, not dying with it,” she said.

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Emily Ashcraft joined KSL.com as a reporter in 2021. She covers courts and legal issues as well as health, faith and religious news.

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