Radiation treatment following surgery can be safely omitted for patients with low-risk thyroid cancer, according to groundbreaking findings from the Iodine or Not study. The results could spare thousands of patients worldwide from unnecessary radioactive iodine therapy.
The trial, conducted across 33 UK cancer centres including Weston Park Cancer Centre, investigated whether patients with low-risk thyroid cancer could safely forego radioactive iodine treatment after surgery to remove the thyroid gland – a butterfly-shaped organ in the neck that regulates metabolism and energy.
Currently, most patients receive radioactive iodine after surgery to destroy any remaining thyroid or cancer cells. This treatment requires hospital isolation for up to three days and strict safety precautions for several days afterwards, including avoiding close contact with children.
The study followed 504 patients aged 17–80 for at least five years. Half received radioactive iodine treatment; the other half had surgery only. Results showed:
- Five-year cancer-free survival rates were similar: 98% for surgery-only patients vs. 96% for those receiving radioactive iodine.
- The small difference was attributed to chance rather than clinical significance.
Researchers concluded that omitting radioactive iodine for low-risk patients does not compromise outcomes, marking a major advance in thyroid cancer care.
The findings are expected to influence national and international treatment guidelines, reducing the physical, emotional, and social burden of radioactive iodine therapy – particularly for younger patients and parents of young children. Thyroid cancer is three times more common in women than men and often affects younger adults.
Professor Jonathan Wadsley, Clinical Oncologist at Weston Park Cancer Centre, commented:
“These study findings provide high-quality evidence that a significant group of thyroid cancer patients do not benefit from radiation treatment following thyroid cancer surgery, allowing patients to avoid unnecessary treatments, reducing side effects and treatment burden on patients.
“IoN is an exemplary study, demonstrating that research does not always need to focus on new shiny treatments. By improving the delivery of existing therapies, we can make real advancements in care, stop unnecessary treatments, and enhance patients’ quality of life by reducing treatment burden, side effects, and time away from family. In addition, these advances can lead to significant savings in costs for both healthcare services and patients, lowering expenses while also freeing up clinical staff and hospital beds.”
Globally, around 820,000 people are diagnosed with thyroid cancer annually. Researchers estimate that 2,500 UK patients and 400,000 worldwide could avoid radioactive iodine treatment each year.
Weston Park Cancer Centre, a leader in endocrine cancer care and home to a £4m nuclear medicine and molecular radiotherapy suite, was one of the highest recruiters for the trial and supported its management from the outset. The centre has already implemented the new treatment approach for low-risk patients.
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