Q: My younger brother who is just 26 year old (well built and very active) developed a node (painless) on left side of lower neck which was visible prominantly only as recently as 15 days back. It was first checked by an ENT Specialist and later refered to a Endocrine Surgeon (Apollo Chennai) both of whom recommended an immediate surgery. So immediately surgery was conducted last week where complete thyroidectomy was done and tumor was found to be cancerous and it had slightly spread to paratracheal node (lymph nodes). Everything was surgically excised and sample send for biopsy. The biopsy report suggested it as papilliary carcinoma and metastatic papilliary carcinoma on nodes and earlier FNAC report also suspected papilliary fronds. Now the concerned surgeon has requested for Radioiodine therapy after 3 weeks and he is not being given any thyroxine tablets now. Now my queries are:
Is this radioiodine therapy safe? What precautions henceforth we have to take so that he doesnt have any problem in future? What may be the possible cause for this disease to come? Is it completely curable and what is the normal life span after having this disease treated. What all tests have to be done regularly to check him? Patient details are: 6 feet tall, well built, 75 kgs, software professional, teetotaller and non smoker.
A:This patient has a favourable long-term prognosis as Papillary Thyroid cancer presenting at a young age generally carries an excellent prognosis. Assuming that adequate surgery has been performed, the patient needs a high dose Iodine scan first to determine the need for radioiodine therapy. If needed, it is a safe treatment. The only long-term treatment needed is Eltroxin.