Radionuclide therapy ward helps thyroid cancer patients

Source: Shuang Ho Hospital

Published on 2019-02-12

Waits for thyroid cancer treatment beds have decreased since Shuang Ho Hospital opened its radionuclide therapy ward in June 2018.


TMU Vice President Fei-Peng Lee (3rd right), Shuang Ho Superintendent Mai-Szu Wu (4th right), Academia Sinica Academician Jacqueline Whang-Peng (3rd left), Wanfang Hospital Directors Che-Ming Yang (1st left), Director Chung-Huei Hsu (2nd left), Tay-Jiunn Lee (1st right), and Pin-Zhir Chao (2nd right) at the unveiling.

Shuang Ho Superintendent Mai-Szu Wu said that 2015 statistics for New Taipei City showed thyroid cancer alone accounted for 700 new cancer cases. Due to the lack of isolated radiation ward beds in the greater Taipei area, these patients have to wait an average of at least 1-2 months for a bed. The radionuclide therapy ward at Shuang Ho Hospital provides comprehensive care, so patients requiring isotopic treatments can use this facility without weeks of waiting.

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According to the 2015 cancer statistics from the Health Promotion Administration, thyroid cancer has become one of the top ten cancers in Taiwan, with incidences around 3 times higher in women than in men, and most patients aged 20-40 years. Director of metabolic medicine Dr. An-Tsz Hsieh says radiation exposure can contribute to thyroid cancer, and serious air and water pollution may also increase cancer risk.

Dr. Hsin-An Chen, Director of General Surgery, notes that the main thyroid cancer types are mastoid and follicular carcinoma, and the primary treatment is surgical excision. If the patient is of a medium- or high-risk group, or if there are metastases in tissues around the thyroid gland, in the lymph nodes or in other tissues, oral radioiodine therapy can be considered to eliminate the remaining cancer cells and tissues.

As the patient’s body will produce radiation after taking in high dosages of radioactive iodine, to avoid affecting others around them, regulations require patients who are undergoing high-dosage radioiodine therapy – over 30 mCi – to stay in a radionuclide therapy ward until radiation from the body is below a safe dosage threshold determined by the radiation protection committee.

Dr. Che-Ming Yang, Director of Nuclear Medicine, says the new radionuclide therapy ward can isolate a maximum dosage treatment of 300 mCi, and is accepting referrals from other hospitals for patients needing this treatment.

With regards to the benchmark of radioiodine therapy for differentiated thyroid cancer, Otorhinolaryngology Director Dr. Mei-Chien Chen says American Thyroid Association treatment guidelines mandate the use of Iodine 131 in terms of necessity and dosage risks after surgery is based on the low, medium and high relapse risk benchmarks. High risks include obvious brain tumor beyond the thyroid, incomplete excision of tumors, or tumors metastasized to lymph node and larger than 3 cm: these cases would require radioiodine therapy. Director Yang says 90% of thyroid cancers differentiate into mastoid or follicular carcinoma; after lesions are surgically removed, radioiodine therapy and follow-up treatments are given to patients with residual cancer cells or concerns over metastasis. The average 5-year survival rate for this group of patients can be as high as 98%.

Shuang Ho Hospital’s Radionuclide Therapy Ward provides comprehensive clinical services for a variety of departments by integrating nuclear medicine with general surgery, metabolic medicine, otorhinolaryngology, radiotherapy, hematology and oncology as well as nutrition and social worker consultations. The ward has special irradiated liquid waste tanks, macerating toilets, and video phones with smart cloud functions allowing easy communication between patients and medical staff. The radiation dose detectors can detect patients’ levels as they leave the hospital, as well as monitoring radiation from the lead trolleys carrying radiation medication and other areas. This treatment environment is optimal for both patient comfort and radiation safety, and enables Shuang Ho to provide the most comprehensive cancer care.

Radionuclide therapy area