Cancer after RAI

When we think about the newly diagnosed we are motivated to keep up with our work here. Sometimes it's hard for us to share some of this information. On one hand we are "part of the story", we have to digest it. On the other hand, we think how scary can it be for those who have already had RAI.

However, this subject will be developed soon in more detail. Here is an an overview of the subject in a post from one Atomic Woman at a Thyroid Board.

A member wrote:

"I have been diagnosed with Graves and I would like to get some information. Has anyone had RAI teatment for graves disease?. If so, what were the results like? Have you had any adverse reactions to the treatment? I have heard that there is a risk of cancer much later on in life. Is this true? where can I get the information? what studies have there been? I hope someone can help. D."

Hi D.,

I had RAI, to my eternal regret.

It contributed to trigger infiltrative eye disease, and had I to suffer decompression surgery in both eyes.

By having RAI, the thyroid gland is destroyed or seriously damaged with radiation, when the thyroid itself is not the problem, is the victim. Graves' is a disease of immunity, not of the thyroid.

This destruction causes an acute condition, which is curable, into a chronic disease: hypOthyroidism, with no way back once the gland has been destroyed.

You can find some information at the AtomicWomen's site. Also at the AtomicWomen's yahoo club and Atomic Women's mailing list:

It is true that there is an increased risk of cancer. We have not yet touched this subject at our -evolving- site, but will do soon.

The biggest study was published in 1974 and showed 19 thyroid cancers one year after radioiodine treatment.

The Swedish group in a paper published on 1991, with a 10 year follow up after RAI, found significant increase in 3 cancers, stomach, bladder and brain.

An important prospective study was published on March 1998 by the Birmingham group, UK, (N Engl J Med 1998 Mar 12;338(11):712-8). The cohort was very big 7209 persons, and so it was follow up period, nearly 40 years. Results showed that mortality from all causes was increased, especially mortality from thyroid disease, cerebro-vascular disease, cardio-vascular disease, and fractures of the femur, leading to death.

This study was criticized in the USA, by AMA, ATA, and some other thyroid organizations and in July l998 E. Ron et al (The Cooperative Thyrotoxicosis follow up Study Group) published a follow up of that big study dated 1974 quoted above, and summed up stating that "RAI appears to be safe" and "no significant increase in death rates was found". They add: "While there was an elevated risk of thyroid cancer mortality following I-131 treatment, in absolute terms the excess number of deaths was small, and the underlying thyroid disease appeared to play a role".

(Note that this risk for thyroid cancer was increased by 4 fold after RAI. They do not explain how the "underlying thyroid disease" can cause it... )

However, one year later, the British group publishes another paper showing that deaths from small bowel cancer increased by 5 fold, deaths from cancer of the thyroid increased by 3.3 fold.

My best advice to you is: read and learn as much as possible in order to take informed decisions.

Many of us did not have information on RAI, thus we blindly followed our doctor's instructions. And now regret it.

Good luck!