V. The Treatment of Thyroid Carcinoma by Radioiodine

Where a subject is still in an elementary stage of evolution it is all too easy prematurely to crystallise the state of affairs by setting them down in a paper. It is important therefore to keep in mind that this subject of radioiodine treatment of thyroid carcinoma is still very much in a state of flux. The ideas which I propose to outline now are merely a description of our present theories in Manchester of how this new method of treatment should be explored and no more than that.

The first point to be emphasised is that this use of radioiodine in thyroid cancer represents a completely new principle of therapy—the principle of systemic ingestion with, thereafter, selective absorption of a drug carrying a radioactive element in it and resulting in a zone of localised high radiation dosage in the selective absorption tissues.

Because it is based on new principles we have to start and think out our own basic principles of therapeutic use from scratch and to try and avoid assumption that those principles we have evolved for the more standardised methods of therapy necessarily still apply. For example the value of protracted radiation, the importance of normal tissue tolerance and the concept that a growth already widely disseminated is ipso facto too advanced for treatment may each no longer hold good.