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33

NCCN Guidelines for Patients

®

:

Thyroid Cancer, Version 1.2017

4

Cancer treatment

Radiation therapy

If you have a CT scan with contrast, it can delay the

start of treatment with RAI therapy. Your doctor will

consider this when planning your care. A CT may be

necessary to see more of the neck or chest area to

check for disease.

The radiation itself will exit your body through urine

and other body fluids. Thus, your body will give off

small amounts of radiation after treatment. For a

short period, you may need to take special safety

measures around other people, especially children

or pregnant women. Ask your doctor to share a

complete list of instructions on your care before,

during, and after RAI therapy.

Radiation therapy

Radiation therapy uses high-energy rays to treat

cancer. The rays damage a cell’s instructions for

making and controlling cells. This either kills the

cancer cells or stops new cancer cells from being

made. Radiation can also harm normal cells and

cause side effects.

External beam radiation is sometimes given to treat

medullary and almost always given to treat anaplastic

thyroid cancer. Radiation may also be given when

the cancer does not respond to RAI therapy, if it

cannot be completely surgically removed.

Two ways radiation is given for thyroid cancer

include:

†

†

EBRT (

e

xternal

b

eam

r

adiation

t

herapy) is

given using a machine outside the body.

†

†

IMRT (

i

ntensity-

m

odulated

r

adiation

t

herapy)

involves giving smaller doses of radiation for

a few weeks with x-ray beams of different

strengths based on the thickness of the tumor.

Radiation therapy plan and schedule

Before beginning radiation therapy, pictures of the

cancer in your body will be taken with a CT scan

using contrast. This process is called simulation.

Your radiation oncologist will use the pictures to

decide the radiation dose and to shape the radiation

beams. Beams are shaped with computer software

and hardware added to the radiation machine. PET

scans may also be used for radiation treatment

planning (simulation).

Your treatment team will decide the best time to

have radiation therapy after surgery. During radiation

treatment, you will lie on a table in the same position

as done during simulation. Devices may be used to

keep you from moving so that the radiation targets

the tumor. Likewise, methods may be applied to

control breathing.

You will be alone while the technician operates the

radiation machine from a nearby room. He or she

will be able to see, hear, and speak with you at all

times. As treatment is given, you may hear noises.

One treatment session can take between 30 to 60

minutes. You will likely have 5 sessions a week.

Radiation may also relieve symptoms caused by

cancer. For thyroid cancer that has spread, this could

include difficulty or pain swallowing, loss of your

voice, or pain or stiffness in your neck. It is helpful to

ask your radiation treatment team for a complete list

of side effects and care instructions.

Common side effects of radiation to the neck area

may include:

†

†

Skin rash or redness

†

†

Problems swallowing

†

†

Dry mouth

†

†

Extreme tiredness (fatigue)