8.04.2009

Guinea Pig

I was reading about advances in thyroid cancer treatments and really, there have been few to no changes since the 1950's! Apparently, the scientific community found something that worked pretty well so they figured why fix it. Well, with the emergence of more aggressive thyroid cancers and RAI resistant strains, there are more and more research projects out there. Most of them deal with advanced (with distant mets) or non-RAI avid (doesn't uptake the radioactive iodine) types but there is currently ONE clinical trial out there for stage 1&2 papillary thyroid cancer. There are 2 locations running this trial - Bethesda, MD and Washington DC and both are currently accepting participants.

So why am I thinking about this? After all, its basically like being a human guinea pig or donating your body to science before you are gone, right?

Well, let me tell you some small details of this trial. They are doing RAI therapy in small doses (30mCi instead of standard 100-200 mCi) given with small doses of Lithium. I know that the RAI is "safe" and I know that the Lithium is "safe" and of course the placebo pill is safe. So this isn't involving some new, crazy drug. Apparently, the docs believe that the Lithium increases the uptake time and sensitivity of the RAI so the body isn't exposed to so much radiation. The lower dose of radiation has less risk of side effects...and if the small dose doesn't kill off the cancer, you can get another dose.

So it seems there are a lot of good points to this one and I could be helping future thyroid cancer patients. Anyone have thoughts to ponder on this?

6 comments:

  1. What if you get the placebo? That is what scares me about those studies! But I am also a chicken shit. :-)

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  2. That's a good point. The only placebo possible in this study is the Lithium which isn't necessary for the cancer treatment, they are just hoping to prove it enhances it. The RAI I would get would still kill off the cancer cells just maybe not as effective as a super high dose, but I can get a second dose if needed.

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  3. It seems to me that this is one of the times where a clinical trial makes sense. You get the medicine you already need, a dose that will likely lessen the side effects, and something else that may make it even more effective. If you get the placebo, at least there's a perfectly viable backup plan.

    The only real issue is time. You have to assume in these things that you're going to get the placebo, which means you need to count on getting that second dose of RAI, which of course means a longer time in treatment and a longer time for the cancer to spread. If your cancer is slow-growing enough, then the time issue may not be a big deal. If you think you can handle the potential double-shot of RAI, then there really isn't a downside here.

    Oh wait, thought of a potential other issue. Does your insurance cover experimental treatments?

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  4. Thyroid cancer is typically slow growing and my surgeon thinks it has been contained to the thyroid gland... of course with the TT coming up we will know more and they may do some sentinel lymph node biopsies too to confirm. So that wouldn't be a huge issue with the 2 RAI doses - not super fun though.

    Insurance - Michigan is one of a few states that mandates insurances pay for clinical trials in phase 2 & 3 at certain medical centers. This trial is phase 2 and the MD location is the NIH which is on the approved list :) Not sure the DC location is though so we would have to push for the Bethesda one.

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  5. Oh and a note about side effects - the high dose RAI can possibly cause nausea/vomiting, salivary gland problems (if it concentrates there), headaches, loss of taste, radiation sickness issues like peeling of the skin in your mouth, and even sterilization... at 30yrs, not married, hoping to have kids yet, knowing unfertilized eggs don't freeze well... its the last one that has me very interested in the smaller dose.

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  6. I think this is a win-win situation, Christina. I'd say go for it -- you've done the research and it really sounds like you are talking yourself into it!!!

    Go, girl!

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