Safe Radiation Doses and Treatment Continuity in Oncology - Oncology

Dr. Chen Sirong reply Oncology

---

1.
Is a dose of 1.800 millicuries the safe total amount for treatment, or is this the safety value for the dose during scanning examinations?
Answer: Yes, but this refers specifically to I-131 and does not include other examinations.
2.
Is it necessary to stick with the original hospital and physician for treatment direction and dosage consistency, or can I switch specialties and doctors?
Answer: You can switch doctors and hospitals because you have your treatment records.
Even with annual check-ups, the dosage will not exceed the safe limits, so you don't need to worry.
3.
After a single high-dose treatment, is it true that one cannot have too many recurrences in the future, or else there will be risks related to hematopoietic function or blood disorders?
Answer: Multiple recurrences may ultimately lead to incurability and death, at which point concerns about hematopoietic function are no longer relevant.
4.
Is it possible that due to age, the cells are well-differentiated, which is why the current monitoring mainly involves blood tests for antibodies and ultrasounds?
Answer: Scientific advancements have led to the current follow-up checks for this condition primarily relying on these two methods.
5.
Given that more than half of the lymph nodes initially found were malignant, does that indicate a higher risk?
Answer: Yes, the presence of cancer cells in lymph nodes certainly increases the likelihood of recurrence compared to patients without cancer cells in their lymph nodes.
6.
Does aging lead to dedifferentiation of cells, making them more malignant, or does it affect iodine absorption or sensitivity related to one's constitution?
Answer: If recurrence occurs, there may be resistance to I-131, which could reduce its effectiveness.
However, taking I-131 after surgery generally has fewer side effects than chemotherapy, and it is usually recommended to use I-131 postoperatively.
7.
If everything has been completely removed and isotopic iodine is used, where does the truly recurrent tissue come from?
Answer: It could be from one or two residual cancer cells that are not visible to the naked eye.
If immune cells do not eliminate them, they may replicate and grow over time.
It's important to stay positive and envision yourself as one of the lucky ones who do not experience recurrence, rather than worrying about recurrence and radiation, which can negatively impact your immune response.
8.
After surgery and I-131 treatment, follow-ups were every three months for the first year, then ultrasounds every six months, and later became monthly or bi-monthly visits.

Answer: Please coordinate the follow-up frequency with your physician.
9.
However, small clinics can also provide medication and blood tests, and I feel that follow-ups at large hospitals are expensive.
I want to find a way to reduce frequent visits.

Answer: It's a dilemma between fearing recurrence and wanting to save money; I cannot provide a perfect solution.
10.
But what about those who have follow-ups every six months or a year and run out of medication? What do they do?
Answer: Each person's condition is different, so I cannot comment on that.
11.
Currently, without specific iodine treatment or scans, can I eat seaweed or broth made from kombu for hot pot?
Answer: Yes, you can, and you may also refer to other physicians' explanations.
12.
If the salivary glands secrete less due to iodine, making it easier to get cavities, does that mean that without specific treatment, I will be less likely to get cavities (as long as I maintain good oral hygiene)?
Answer: You have misunderstood; the salivary glands do not secrete less due to iodine.
After treatment, you should not have issues.
Wishing you good health.
- Chen Sih-Rong, Taoyuan Hospital.

---

Reply Date: 2020/12/16