Trial makes thyroid cancer treatment safer and shorter

May 4, 2012

A new gold standard for thyroid cancer treatment has been set, reducing radiation doses to just one third of the current level, according to research from the CRUK-UCL Cancer Trials Centre. The results are published in New England Journal of Medicine.

Patients currently have surgery to remove the entire gland. A few weeks later they take a capsule containing radioactive iodine which destroys any remaining healthy thyroid gland tissue and any potential . Improvements in surgery mean more of the thyroid gland is removed during the operation, leaving fewer remaining cells to be ‘mopped up’ - so lower radiation doses are adequate and equally effective.

The HiLo trial of 438 patients at hospitals across the UK, led by researchers at UCL’s Cancer Institute, showed that giving selected patients a much lower dose of radioactive iodine* in a single oral capsule delivers similar treatment success to the current higher dose - destroying all thyroid gland cells remaining after surgery, with fewer side effects

The higher doses of radioactive iodine previously thought necessary meant that patients had to stay in a hospital isolation unit for at least two days while the radiation left their bodies, without physical contact from family and friends. These high doses could have several side effects – the more serious of which occur later in life, such as a permanent dry mouth, and a small chance that a new cancer will develop.

However, patients taking the lower dose capsule can be treated as an outpatient. The process is easier, quicker (hours, rather than days), and patients experience fewer side effects.

The makes and releases hormones. After it is removed patients require thyroid hormone tablets for the rest of their lives. Radioactive iodine works best when patients stop taking thyroid hormone tablets two to four weeks beforehand, but this leads to side effects such as lethargy, fatigue and weight gain, reducing patients’ quality of life and their ability to function at home and at work.

A secondary finding of the HiLo study is that patients can avoid these symptoms if they continue to take thyroid hormone tablets and are also given an injection of Thyroid Stimulating Hormone (Thyrogen) just before they take the low dose radioactive iodine.

"HiLo is a seminal trial that will affect how most thyroid cancer patients will be treated,” says Professor Allan Hackshaw, a senior author of the paper and leader of the HiLo trial at the CRUK-UCL Cancer Trials Centre. “Health professionals have waited several decades for reliable research to show that a lower dose of can be used instead of the standard high dose. Future patients will thus have a shorter and safer treatment"

Lead study author, Dr Ujjal Mallick, at the Freeman Hospital in Newcastle, says: “We’re delighted that this study of thyroid cancer will change international approaches to treat the disease more safely, by reducing the chance of another cancer developing later in life and other side effects.

“Patients will have a much better quality of life. They’ll be treated much more quickly, which will keep the disruption to their lives to a minimum, as well as saving the NHS money.”

Kate Law, director of clinical research at Cancer Research UK, says: “This pivotal study – which is the first for thyroid cancer in the UK – heralds a vastly improved treatment for the disease.

“Being treated as an outpatient means that patients should be able to be in their home surroundings on the same day as the treatment. The lower dose of radiation and thyrogen will help them carry on with their lives as usual at work or at home without requiring several days to recover.

"More than 2,100 people are diagnosed with in the UK every year** - and it has the fastest rising incidence rate of the most common cancers in the UK***. We're continuously striving to improve common treatments and reduce side-effects for this type of cancer."

Explore further: Thyroid cancer treatment varies by hospital, study finds

Related Stories

Thyroid cancer treatment varies by hospital, study finds

August 16, 2011
Where thyroid cancer patients go for care plays a large role in whether they receive radioactive iodine treatment, a new study from the University of Michigan Comprehensive Cancer Center finds.

BRAF addiction of thyroid cancers makes them therapeutically vulnerable

November 21, 2011
Papillary carcinoma is the most common form of thyroid cancer. Approximately one quarter of these carcinomas have mutations in the BRAF gene. The prevalence of such mutations is even greater in high-grade carcinomas, particularly ...

African-Americans with thyroid cancer fare worse than whites

June 21, 2011
African-Americans have fewer incidences of thyroid cancer but have a more advanced form of the disease once they receive a diagnosis -- and are more likely to die from it, according to a new study.

Antineoplastic agents associated with thyroid dysfunction

October 18, 2011
Antineoplastic agents such as immunotherapies and targeted therapies that specifically target signaling pathways in cancer cells are associated with thyroid dysfunction in 20%-50% of cancer patients taking them, which can ...

Recommended for you

Major study of genetics of breast cancer provides clues to mechanisms behind the disease

October 23, 2017
Seventy-two new genetic variants that contribute to the risk of developing breast cancer have been identified by a major international collaboration involving hundreds of researchers worldwide.

Microbiologists contribute to possible new anti-TB treatment path

October 23, 2017
As part of the long effort to improve treatment of tuberculosis (TB), microbiologists led by Yasu Morita at the University of Massachusetts Amherst report that they have for the first time characterized a protein involved ...

New study shows how cells can be led down non-cancer path

October 23, 2017
As cells with a propensity for cancer break down food for energy, they reach a fork in the road: They can either continue energy production as healthy cells, or shift to the energy production profile of cancer cells. In a ...

Proton therapy lowers treatment side effects in pediatric head and neck cancer patients

October 23, 2017
Pediatric patients with head and neck cancer can be treated with proton beam therapy (PBT) instead of traditional photon radiation, and it will result in similar outcomes with less impact on quality of life. Researchers from ...

Big Data shows how cancer interacts with its surroundings

October 23, 2017
By combining data from sources that at first seemed to be incompatible, UC San Francisco researchers have identified a molecular signature in tissue adjacent to tumors in eight of the most common cancers that suggests they ...

Symptom burden may increase hospital length of stay, readmission risk in advanced cancer

October 23, 2017
Hospitalized patients with advanced cancer who report more intense and numerous physical and psychological symptoms appear to be at risk for longer hospital stays and unplanned hospital readmissions. The report from a Massachusetts ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.