Patients of all ages are actively recruited to this natural history protocol in which methods for follow-up of patients using radiopharmaceutical tracers such as I-131, I-123, 201Tl chloride, 99mTc-Sestamibi, 111In-pentetreotide, 18-FDG PET and other PET ligands are evaluated. The limitations and significance of serum thyroglobulin (Tg) measurement for diagnosing tumor recurrence are assessed as is the risk/benefit ratio of already established methods of administering I-131 therapy including the impact of pre-treatment dosimetric calculations and administration of adjuvants such as recombinant human TSH and lithium. The use of radioactive iodine in the treatment of patients with stage I or II thyroid cancer who are at low risk for mortality is controversial. In a randomized, controlled clinical trial, the effects of lithium carbonate or placebo on the rate of successful ablation of thyroid remnant are asssessed. By increasing the biological half-time of I-131 through its effects on thyroid hormone release, it is hypothesized that adjuvant lithium administration will improve the efficacy of low dose radiodine (30 mCi). The goal is to obtain satisfactory ablation of thyroid with minimum radiation exposure. Recruitment to this study in now complete. Samples of benign nodules and cancer tissue specimens for research studies will be collected to assess new immunohistochemical markers, and other techniques to characterize tumors for correlation with response to therapy and prognosis. Blood specimens are collected for future clinical and research studies in both the hypothyroid and euthyroid state. Coded clinical data are entered in the National Thyroid Cancer Registry in selected patients. This study also serves to screen patients for participation in other protocols.
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