• Journal of East-West Nursing Research
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• v.22 no.2
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• pp.148-157
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• 2016

Purpose: The purpose of this study was to explore the meaning of the experience of receiving radioactive iodine therapy among patients with thyroid cancer. Methods: A qualitative research design was adopted. The participants were ten women diagnosed with thyroid cancer who had received radioactive iodine therapy within one year. Data were collected through in-depth interviews from October of 2015 to April of 2016. Individual interviews were recorded, and transcribed data were analyzed using Colaizzi's method. Results: The six categories of the experience of receiving radioactive iodine therapy were "Finally realizing having cancer," "The lonely fight that feels like prison life," "Narrower scope of life," "Lack of understanding by others," "Enduring a short, yet difficult journey," and "A turning point for a new life." Conclusion: This study provides deep insight into the experience of thyroid cancer patients who had received radioactive iodine therapy. Nurses should concern their distress during radioactive iodine treatment and manage psychological difficulties as well as physical symptoms. Support from family and health care providers may help them to overcome the hard journey.

• Asian Oncology Nursing
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• v.12 no.4
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• pp.297-304
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• 2012

Purpose: This study was to identify the symptom severity, interference and their psychological predictors in thyroid cancer patients hospitalized for radioactive iodine administration. Methods: One hundred seventy-seven thyroid cancer patients admitted to the isolation room for Iodine ($I^{131}$) therapy were recruited. Subjects were asked to complete the questionnaire on core symptoms, thyroid cancer symptoms, interference, depression and state anxiety in the evening after receiving radioactive iodine therapy. Data was analyzed using frequency, percentage, mean, Pearson's correlation, and multiple regression with SPSS vs. 19. Results: Lack of appetite, drowsiness, sleep disturbance, fatigue, and nausea were the 5 most core symptoms. More than 20% of patients experienced moderate to severe thyroid cancer symptoms including feeling cold, hoarseness, swallowing difficulty, and feeling hot. More than 30% of subjects experienced moderate to severe interferences in mood, general activity, and 22% in walking. Depression and state anxiety were identified as predictors of core symptoms, thyroid symptom severity and interference. Conclusion: Nursing interventions to reduce the symptom severity and interference need to be developed by considering thyroid cancer patients' depression and anxiety when hospitalized in the isolation room for radioactive iodine administration.

• The Korean Journal of Nuclear Medicine
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• v.32 no.5
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• pp.436-442
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• 1998

Radioactive iodine treatment has been widely used for nearly 50 years in the treatment of thyroid cancer to ablate residual thyroid tissue after thyroidectomy and to treat metastatic disease. Leukemia is a rare complication associated with the radioactive iodine therapy. The occurrence of leukemia is known to be related to the cumulative dosage of I-131 more than 37 GBq (1 Ci) and also associated with the intervals of less than 12 months between the repeated doses. We report a case of a 52 year-old female patient with papillary cancer of thyroid who developed acute myelogenous leukemia after the total 20.4 GBq (550 mCi) of I-131 therapy over 3.2 years and palliative radiation therapy (3000 cGy) due to multiple bone metastasis of papillary cancer.

• Korean Journal of Head & Neck Oncology
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• v.18 no.2
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• pp.173-178
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• 2002

Background and Objective: Factors that are associated with the recurrence after radioactive iodine ablation therapy have not been identified yet. The aim of this study is to elucidate the factors that are related to the recurrence after thyroid surgery of the thyroid papillary cancer followed by radioactive iodine ablation therapy. Patients and Methods: Fifty four cases who had underwent thyroid cancer surgery and postoperative radioactive iodine ablation therapy were included in this study. Mean followup duration was 7 years. There were 41 women and 13 men. Data analysis was done retrospectively with medical record review. Chi-square test and Fisher's exact test was used for the statistical analysis. Results: Age over 40, capsular invasion, and loca invasion were the factors that were associated with the high rate of recurrence. But sex, size of the tumor, multiplicity and extent of the surgery were not related to the recurrence. Conclusion: Without the curative resection of the tumor, radioactive iodine ablation therapy cannot lower the recurrence rate. So aggressive resection of the thyroid papillary cancer is important.The more data accumulated and the longer the followup, the easier we can reveal the recurrence-related factors of postoperative radioactive ablation therapy.

• Journal of Nutrition and Health
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• v.55 no.2
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• pp.250-262
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• 2022

Purpose: Elevated iodine intake is related to a higher prevalence of subclinical hypothyroidism (SCH). We investigated the short-term effect of dietary iodine restriction on thyroid function in patients with SCH with high iodine intakes. Methods: The iodine levels in 64 SCH patients with serum TSH levels from 4.0 to 10.0 mIU/L and normal serum fT4 levels (n = 64) were assessed using 24-hour urine iodine test results and iodine intake levels calculated using a semi-quantitative food frequency questionnaire. Dietary iodine restriction was not recommended for patients with an iodine intake in the normal range (group A, n = 13), but seaweed restriction was recommended for patients with high iodine intakes (group B, n = 33). Thyroid functions and iodine levels were rechecked after three months. Another eighteen patients were prescribed thyroid hormone replacement therapy according to clinical criteria. Results: Median baseline iodine intake for the 64 patients was 290.61 ㎍/day, and median 24-hour urine iodine was 33.65 µmol/g of creatinine. The major source of dietary iodine was seaweed, which accounted for 72.2% of median baseline intake. Urine iodine and calculated iodine intake levels were positively correlated with serum TSH levels (p < 0.001 and p = 0.027, respectively), and calculated iodine intakes were significantly correlated with urine iodine levels (p = 0.001). In group B, iodine restriction significantly decreased urine iodine (p = 0.042) and TSH levels (p = 0.004), and conversion to euthyroid status was achieved in 16 of the 33 patients (48.5%). Conclusion: Iodine intake and urine iodine levels are correlated with thyroid function in SCH patients, and dietary iodine restriction can aid functional thyroid recovery in patients with elevated iodine intakes.

• Nutrition Research and Practice
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• v.10 no.2
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• pp.167-174
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• 2016

BACKGROUND/OBJECTIVES: Despite the importance of a low-iodine diet (LID) for thyroid cancer patients preparing for radioactive iodine (RAI) therapy, few studies have evaluated dietary intake during LID. This study evaluated the amount of dietary iodine intake and its major food sources during a typical diet and during LID periods for thyroid cancer patients preparing for RAI therapy, and examined how the type of nutrition education of LID affects iodine intake. SUBJECTS/METHODS: A total of 92 differentiated thyroid cancer patients with total thyroidectomy were enrolled from Seoul National University Hospital. All subjects completed three days of dietary records during usual and low-iodine diets before $^{131}I$ administration. RESULTS: The median iodine intake was $290{\mu}g/day$ on the usual diet and $63.2{\mu}g/day$ on the LID. The major food groups during the usual diet were seaweed, salted vegetables, fish, milk, and dairy products and the consumption of these foods decreased significantly during LID. The mean energy intake on the LID was 1,325 kcal, which was 446 kcal lower than on the usual diet (1,771 kcal). By avoiding iodine, the intake of most other nutrients, including sodium, was significantly reduced during LID (P < 0.005). Regarding nutritional education, intensive education was more effective than a simple education at reducing iodine intake. CONCLUSION: Iodine intake for thyroid cancer patients was significantly reduced during LID and was within the recommended amount. However, the intake of most other nutrients and calories was also reduced. Future studies are needed to develop a practical dietary protocol for a LID in Korean patients.

• Journal of Chest Surgery
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• v.28 no.12
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• pp.1155-1159
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• 1995

Differentiated thyroid carcinoma is a slow growing tumor with relative good prognosis. But locally advanced thyroid cancer with T4 or N1b is difficult to manage. Between June 1988 and April 1995, we resected 8 advanced thyroid cancers trans-sternally. All patients had direct mediastinal extension [T4 or mediastinal lymph node metastasis [N1b with airway obstruction or dysphagia. We operated all the patients by partial or total sternotomy for mediastinal dissection along with thyroidectomy and radical neck dissection. There were some acceptable morbidities but no operative mortality. Postoperative radioactive iodine therapy was followed without side effects. Follow-up survival period was between 11 months to 81 months with 2 late mortalities [17 month, 30 month . Although definite benefit for routine mediastinal dissection in thyroid cancer has not been established, in locally advanced cases impending airway obstruction or dysphagia who have questionable effect by radioactive iodine therapy alone, aggressive mediastinal mass dissection including lymph node metastasis has the significant role to prevent the patients from suffocation & dysphagia, and to enhance the effect of followed radioactive iodine tharapy.

• Journal of The Korean Ophthalmological Society
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• v.55 no.1
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• pp.1-6
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• 2014

Purpose: To investigate the clinical manifestation of nasolacrimal duct obstruction after radioactive iodine therapy for thyroid cancer. Methods: The authors examined 622 patients who were treated with radioactive iodine therapy after the operation for thyroid cancer from January 2009 to December 2011. Fourteen patients (18 eyes) were diagnosed nasolacrimal duct obstruction based on the lacrimal irrigation test, lacrimal probing test and dacryocystography in our oculoplastic clinic. We analyzed the dose of radioactive iodine therapy, number of treatments, clinical manifestation and treatment type by retrospectively reviewing the patients' medical records. Results: The mean radioactive iodine dose ($215.7{\pm}23.1mCi$, p = 0.01) and the mean number of treatments ($1.36{\pm}0.50$, p < 0.001) were significantly greater in 14 patients who had nasolacrimal duct obstruction than in patients who did not. The average onset of tearing symptoms occurred 10.2 months after radioactive iodine therapy. The mean time between correct diagnosis and therapy was 18.4 months. Three patients (3 eyes) had occlusion at the common cannaliculus and 11 patients (15 eyes) had occlusion at the nasolacrimal duct. Ten patients (13 eyes) underwent endonasal dacryocystorhinostomy for complete obstruction and 4 patients (5 eyes) underwent silicone tube intubation for partial obstruction. Conclusions: Nasolacrimal duct obstruction is a rare complication associated with radioactive iodine therapy for thyroid cancer, thus, clinicians should be aware of this complication and refer patients with symptoms of epiphora to the oculoplastic department for specialized evaluation and treatment.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.61-69
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• 1998

Objectives: The response rate of the radioactive iodine(RI) therapy with low dose was variable. Only a few studies reported the response and complication rate with high dose. The goal of this study was to access the ablation and complication rate after high dose of RI therapy (more than 100mCi) and to evaluate the factors affect the results. Material and Methods: During a period of 12 years, 225 patients received high dose of RI from 100 to 200mCi depending on the RI uptake in the whole body after total thyroidectomy. 100mCi of RI was given to 123 patients for ablation who showed the uptake only in the thyroid bed. 150mCi was given to another 84 patients for ablation who had uptake confined to the neck. The other 21 patients took more than 200mCi of RI because the whole body scan showed distant metastasis. Among these patients, the ablation and the complication rate was investigated. Results: Elevated level of the serum thyroglobulin(Tg) decreased less than 5ng/ml after RI therapy in all patients except two in the first group. The second group showed reduction of the serum Tg in 93%. Eighteen of the 21 patients in the third group are still alive after RI therapy. There were no fatal complications after high dose RI therapy and most of the complications were minimal and transient. The complication rate was not related with the dose of RI, age, sex, DNA flowcytometry, serum thyroglobulin level and the extent of node dissection. Conclusion: We concluded that RI therapy with high dose was very effective for thyroid ablation after operation and it also showed excellent results with minimal complications for treatment of metastatic lesions.

• Korean Journal of Head & Neck Oncology
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• v.37 no.2
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• pp.1-9
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• 2021

Thyroid cancer refers to various cancers arising from thyroid gland. Differentiated thyroid cancers (DTCs) include papillary, follicular, and Hurthle cell carcinomas and represent cancers retain normal thyroid functions such as iodine uptake. Radioactive iodine (RAI) is generally used for upfront treatment of metastatic DTCs, but RAI refractory DTCs remain to be clinical challenges. Sorafenib and lenvatinib were approved for the treatment of RAI refractory DTCs and more recently, genomics-based targeted therapies have been developed for NTRK and RET gene fusion-positive DTCs. Poorly differentiated and anaplastic thyroid cancers (ATCs) are extremely challenging diseases with aggressive courses. BRAF/MEK inhibition has been proven to be highly effective in BRAF V600E mutation-positive ATCs and immune checkpoint inhibitors have shown promising activities. Medullary thyroid cancers, which arise from parafollicular cells of thyroid, represent a unique subset of thyroid cancer and mainly driven by RET mutation. In addition to vandetanib and cabozantinib, highly specific RET inhibitors such as selpercatinib and pralsetinib have demonstrated impressive activity and are in clinical use.