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The iodine quickly circulates to the thyroid gland, where is absorbed so it can kill both cancerous and healthy cells. The problem comes when patients have to answer the question, "Where can I go while I'm radioactive?"
For tens of thousands of people diagnosed with non-aggressive forms of thyroid cancer, at some point treatment will include the drinking of a "cocktail" of radioactive iodine.

In the United States, there are about 40,000 newly diagnosed cases of thyroid cancer every year. A very few of these cases will be anaplastic thyroid cancer. An anaplastic tumor is one that literally does not have boundaries. These kinds of tumors usually require removal of the thyroid gland and a great deal of surrounding tissue, and because it's impossible to determine whether the tumor is all gone, metastatic tumors in other parts of the body (especially the lungs) are common. Even this kind of thyroid cancer, however, is sometimes survivable.

Much more often, about 95 per cent of the time, the thyroid cancer is a papillary or follicular carcinoma. The important feature of these carcinomas is that their edges are well-defined. They can be located and removed surgically or targeted with radiation.

If the tumor is more than 1 cm (0.4 inches) in diameter, commonly accepted medical practice guidelines require its surgical removal. Smaller tumors may be irradiated. When the thyroid is destroyed, the patient will then have to take thyroid replacement hormone therapy for life. Even after treatment, however, it's possible for a few thyroid cancer cells to have been missed or to have escaped to other parts of the body.

The way doctors detect these cells is to administer a dose of radioactive iodine. If it is then concentrated somewhere in the body, the radiologist knows there are "loose" thyroid cancer cells. These are the cells that then get treated by the patient drinking a more potent solution of radioactive iodine.

The problem is that any kind of iodine taken by mouth can make the user sick to the stomach. It's not at all unusual for cancer patients to vomit up the radioactive solutions they take for their disease, and that puts caretakers, family members, and passers by at risk. And as hospitals and insurance companies continually cut costs, "drive through" radiation treatment has become the norm, with very few patients being kept in the hospital in quarantine.

If you have to take this kind of radiation therapy, and you don't want to put your loved ones or strangers at risk, what should you do?

1. Don't check into a hotel. It's not fair to the people who have to clean your room to expose them to your radiation.

2. Keep your family members literally at arm's length. While you have radioactive iodine in your body, usually for about a week, you should not sleep with anyone and no one should sit closer than about a meter (approximately 3 feet) away.

3. Don't hug children or pregnant women while you are radioactive.

4. If someone has to clean up after you while you are sick, make sure they wear gloves which they put into the garbage after just the one use.

5. Don't eat apples, fried chicken on the bone, or similar foods which may create contaminated trash.

Read More: Seven Cancer Treatment Practices That May Be Discontinued

Outside the United States, quarantine after radiation treatment is the standard of care. In the United States, you may be allowed to stay in quarantine, keeping your family safe, if you state your case very clearly. If you are subject to motion sickness, then keeping you in the hospital rather than sending you home in the car may be deemed medically necessary.

  • Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. Feb 2006,16(2):109-42
  • Handkiewcz-Junak D, Banasik T, Kolosza Z, Roskosz J, Kukulska A, Puch Z. Risk of malignant tumors in first-degree relatives of patients with differentiated thyroid cancer -- a hospital based study. Neoplasma. 2006, 53(1):67-72.