- Re: - Re: RAI effectiveness

[Guest guest]

Hi ,

I read through the article and see that they stated a TSH level of less than or

equal to 0.05 as the dose for suppression.

I'm wondering what to keep my TSH level at now - .05 or .1?

Help!

Thanks,

Mabel

- Re: RAI effectiveness

jordan07282000 wrote:

> So my endo casually mentioned in passing that RAI only works 65% of

> the time, which justifiably scared the sh** out of me. I actually

> read a similar figure on some website somewhere in my hours of

> research (specifically, " between 30% and 40% of thyroid cancers are

> either resistant or become resistant to radioactive iodine " ). Is

> this accurate, b/c it sure doesn't seem to be reflected in the

> messages I'm reading here?

Hi, -

I think there are two ways of looking at RAI success; is the first follow up

scan clean, and then, is there a later recurrence?

I've read all sorts of figures on total success of initial RAI ablation.

The most recent is included in a lengthy article by Dr. Mazzaferri, et al ...

" ...About 80% of patients appear to be rendered disease-free by initial

treatment,.... " , meaning, obviously, that 20% require a second - or, far less

frequently, a third - ablation before having a negative

scan. While none of us wants to have additional treatments, this doesn't

effect our long-term survival rate.

" In our cohort, 40-yr recurrence rates are about 35%, two

thirds of which occurred within the first decade after initial

therapy (Fig. 1A). These rates, including those for distant

recurrence, are higher under age 20 and over 60 yr2 (Fig. 1B).

" .....long-term relapse rates remain high, in the order of 20-40%,

depending upon the patient's age and tumor stage at the time

of initial treatment. "

You can download the full text from

http://jcem.endojournals.org/cgi/reprint/86/4/1447.pdf

Even though I've read figures similar to these many times, I must admit that

it always comes as a surprise to me, too. One would think that one

characteristic of The Good Cancer would be a high percentage

of single - and final - treatments, but it doesn't seem to work that way.

> It also doesn't make sense to me: if it is only 60-70%,

> then why would our survival rates be so statistically high?

Because the fact that it may require more than one treatment doesn't mean it

doesn't ultimately get treated efficiently. If you pour a glass of water on a

small fire, it may or may not be extinguished;

the fact that you may need to pour a second glass of water on it doesn't alter

the fact that it does ultimately become extinguished. And the fact that the

fire is extinguished doesn't meant that you

should still keep an eye on it, to be sure it doesn't flare up again.

> One more question: the maximal dimension of my tumor was 2.5

> cm. Is this large, average, humongous?? I know from reading staging

> info that a tumor size of 1.5 cm or less demonstrates the best

> prognosis...

That's what the statistics say. My impression is that 2.5 cm is on the large

size of average, or perhaps the small side of large. Around here, 1 or 1.5 cm

seems to be an average size at diagnosis, but

we've also had members with tumors twice the size of yours. Sometimes size

doesn't matter, it's what you do with it that counts ;-)

> As an aside to : I do indeed get up very early in the a.m., so I

> am feeling a [friendly, of course] challenge to " stump " you with a

> question:)

LOL!

Well, it's early morning, and I'm ready and waiting :-)

I think you're getting closer with each letter :-)

(not a statistician)

NYC