How can radiation therapy treat endocrine system diseases?

Dr. Jack Merendino, MD
Endocrinology Diabetes & Metabolism
There are two common situations in which radiation therapy is used in endocrine system disease. The first is in the treatment of Graves’ disease, which is the most common cause of an overactive thyroid. Graves’ disease can be treated with medication, with surgery or with radiation therapy. The medicines that are used (methimazole and propylthiouracil in the U.S. and often carbimazole in Europe) reduce the amount of thyroid hormone that the thyroid gland makes. Surgery reduces thyroid hormone levels by simply removing a portion of the thyroid gland and thereby lessening the amount of hormone that can be made.

Radiation therapy for Graves’ disease involves giving radioactive iodine as either a pill or a liquid. Iodine is concentrated in the thyroid gland. When the iodine is radioactive it damages the thyroid cells and many of them die over the space of a few months after taking the radioactive iodine. As the cells die, the amount of thyroid hormone that can be produced falls and the hyperthyroidism improves. The treatment has very few side effects in most cases because the radioactive iodine only concentrates in thyroid cells and the surrounding tissues are not exposed to much radiation.

Radiation therapy is also used to treat endocrine tumors and cancers, just as it is used to treat cancers in other systems. There is one difference, however. In most cases radiation therapy is used only to treat malignant tumors -- i.e., cancers. However, endocrine tumors treated with radiation therapy are often benign and need to be destroyed because they are over-producing hormones rather than because they may spread to other organs. This is often the case with pituitary tumors, for example. Especially with growth-hormone secreting tumors that cause acromegaly, radiation therapy is usually necessary even if surgery has been done. Certain endocrine tumors may also be malignant and these are sometimes treated with radiation therapy as well.

Radiation therapy can be used to treat endocrine system diseases caused by tumors. Sometimes, tumors can be too difficult to remove surgically. Radiation therapy can help to reduce the size of inoperable tumors or even eliminate them altogether.

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