RAI treatment is the only useful treatment of papillary and follicular thyroid cancers once they have spread beyond the thyroid gland. It is the only known effective systemic thyroid cancer treatment; that is, it can kill thyroid cancer cells in the entire body system, wherever they may be hiding. This is necessary because many thyroid cancers have spread to multiple sites in the neck, or distantly to the lungs or bones, long before they are discovered in your thyroid gland. Also, the smallest tumor deposit that can be seen by a human eye contains more than a million cancer cells. While the surgeon may be able to see and remove some of these during your surgery, the surgeon is incapable of finding and removing tumor deposits of one hundred thousand cells, ten thousand cells, one thousand cells, or even smaller numbers. In theory, it can take only a single cancer cell to start the process of cell division and reproduction that brings back much larger tumor deposits. This means that a surgeon is incapable of reliably providing a cure by surgery alone, making the surgery only the first step of your treatment. I-131 therapy becomes the second step of your treatment because it is an effective systemic treatment for iodine-avid thyroid cancers. In addition, by using nuclear medicine scanning equipment, the same I-131 that is used for treatment provides a way of detecting the sites of these thyroid cancer deposits.
RAI is given in the same way that it is administered for Graves' disease as described in the preceding section, either as a liquid that's sipped through a straw or in capsules that are swallowed. The major difference is in the higher amount of I-131 that's used. Because there are concerns about exposing other people who come in contact with you after your treatment to unnecessary radiation, there are regulations that often require you to spend a day or two in a special hospital room for what is called radioactive isolation.
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