Avoiding Radioactive Iodine After Thyroid Cancer Surgery Can Improve Quality of Life for Low-Risk Patients

Recent findings from a large clinical trial have challenged the routine use of radioactive iodine treatment following surgery for low-risk thyroid cancer. Traditionally, patients who undergo thyroid removal are often given radioactive iodine to eliminate any remaining cancer cells, a process that can lead to side effects such as nausea, dry mouth, taste disturbances, and the need for isolation in hospital to prevent radiation exposure to others.

The IoN (Iodine or Not) trial, published in The Lancet, examined 504 patients aged 17 to 80 across 33 UK cancer centers, focusing on those with a low likelihood of cancer recurrence. Participants were randomly assigned to receive either the standard radioactive iodine therapy or just surgery without additional treatment. Patients were monitored for at least five years, revealing that 98% of those who did not receive radioactive iodine remained free of cancer, compared to 96% of those who did, a difference considered statistically insignificant.

Professor Allan Hackshaw from UCL highlighted that these results suggest radioactive iodine might be an unnecessary over-treatment in such cases, offering an improved quality of life for patients by avoiding side effects and hospital isolation. Many patients, particularly younger individuals with caregiving responsibilities, benefit from being able to resume normal activities more quickly.

Globally, this research indicates that approximately 2,500 patients in the UK and 400,000 worldwide could potentially avoid radioactive iodine treatment each year. Currently, this therapy involves hospital stays and strict safety precautions to limit radiation exposure, especially to children.

Dr. Ujjal Mallick, chief investigator at Newcastle’s Freeman Hospital, pointed out that skipping radioactive iodine minimizes the risk of side effects like taste and salivary problems as well as long-term risks such as second cancers. The study advocates for immediate updates to clinical guidelines, emphasizing cost savings and reduced pressure on healthcare systems.

Expert clinicians believe that this approach could significantly change thyroid cancer management worldwide, providing safer and more patient-centered care.