What is Therapeutic Nuclear Medicine?
What is Therapeutic Nuclear Medicine?
In therapeutic nuclear medicine (radionuclide therapy), the unique characteristics
of radioactive materials (radioisotopes) are used for therapeutic irradiation
of cells and/or organs. Typically, a small amount of a radiopharmaceutical*
is introduced into the body by injection or ingestion. The radiopharmaceutical
is attracted to particular organs or tissues. From their locations within
the body, the radioisotope releases small amounts of energy (radiation)
which will act on cells (target cells) and/or organs (target organs). This
irradiation can be for the purpose of a curative treatment (for instance
thyroid cancer), palliative treatment (for instance for bone pain) or to
reduce an organ’s function (for instance an over-active thyroid).
* Radiopharmaceuticals are molecules or chemicals that are attached to
a small amount of radioactive isotope that once administered to the patient
are able to specifically localize within organs and/or organ systems in
health and disease.
Some common procedures.
Radionuclide therapy is used by your doctor as part of your overall treatment.
Some common types of radionuclide therapy are:
- Treatment of over-active thyroid
- Treatment of thyroid cancer
- Palliative treatment of bone pain caused by metastatic cancers
- Treatment of blood disorders
- Chronic inflammatory rheumatism
- Treatment of Non-Hodgkins lymphoma
How should I prepare for the procedure?
For some treatments no special preparation is required. However for all treatment involving the thyroid you must follow special advice regarding medicine and diet.
You will always be given information about how you prepare for a certain procedure.
You may have to follow restrictions imposed on you after the procedure, for instance to limit close contact with other people especially children.
What is involved?
For radionuclide therapy a small amount of radioactive
tracer is injected into a vein, usually in your arm. The injection is no
more painful than a blood test. The injection is sometimes delivered with
the help of a syringe driver to help us give the injection over a longer
time if it is required, for instance over several minutes. After the injection
you may have to wait a short time before you can leave the department.
Treatment for thyroid disorders is always given by mouth as a drink or
a capsule.
If you are having treatment for thyroid cancer you will be admitted to
the hospital for a number of days, normally 3-4 days. You will also be
required to have a blood sample taken a few days before you are admitted.
While you are in the hospital you will be staying in a specially designed
room with en-suite facilities. You will be restricted to this room until
you are discharged.
For treatment of chronic inflammatory rheumatism you will be required to stay in the hospital for three days.
You will always be given detailed information about the procedure with the appointment letter.
What will I experience during the procedure?
Some discomfort during a procedure may arise from the intravenous injection, usually done with a small needle. Oral administration of the radiopharmaceutical normally does not cause any problems. But if you have problems swallowing a small capsule, please inform the department when you get the appointment letter.
Some treatment may give some minor swelling or tenderness or short time side effects, for instance lowering of blood counts. This will be monitored by your doctor.
What are the benefits versus risks?
Benefits:
- Radionuclide therapy is a non-invasive treatment and therefore less traumatic than surgery.
- It is a systemic treatment, which means that it targets sites which may not be known to exist by your doctor.
- The treatment normally consists of only one injection or oral dose. And you can normally leave the hospital directly after the procedure.
Risks:
- The total radiation received from radionuclide therapy is generally so low that there is an insignificant risk that it will cause cancer in the future. Some less common procedures, for instance treatment of blood disorders are associated with some risks. How big the risk is and whether it is associated with the radionuclide therapy is still under debate by experts.
- Effects on the blood forming organs are usually short lasting and should be controlled by your doctor.
- Radionuclide therapy is not carried out on pregnant women.
- Allergic reactions to the radiopharmaceutical can occur, but are extremely rare.
More advice
More advice is available on the internet. Good information is available
on:
Society on Nuclear Medicine
European Association of Nuclear Medicine
Radiology Info
References
This information has been produced by:
Head of Nuclear Medicine Lars Jansson
Senior Medical Physicist K. Dixon
Date Produced: February 2007
Review Date: February 2008
Responsible Clinician: Dr RP Crellin, Consultant Oncologist
