Radioiodine shortage for 6 months, thyroid cancer patients in distress

Infograph: TBS

Aminur Rahman, 45, a supermarket employee from Lohagora, Munshiganj, underwent surgery for thyroid cancer three and a half months ago. His doctors advised him to receive radioiodine therapy within four to six weeks of the surgery. 

Since then, despite contacting the National Institute of Nuclear Medicine & Allied Science (NINMAS) at Bangladesh Medical University (BMU) two to three times each month, he has received no assurance about when radioiodine  will be available. He now lives in constant fear that his cancer might return.

Aminur Rahman told The Business Standard, "The surgery at Labaid Hospital cost me more than Tk2 lakh. Now I constantly worry that the cancer might return. I'm not the only one. Every day, many patients leave disappointed after looking for radioiodine. No one can say when the medicine will be available."

Like Aminur, Ahmed Ali, a Bangladeshi expatriate in Dubai originally from Habiganj in Sylhet, also fears the return of cancer due to the shortage of radioiodine. He underwent thyroid cancer surgery at a private hospital in Dhaka about one and a half months ago.

Ahmed Ali told TBS, "After the surgery, my doctor told me I must undergo radioiodine therapy. Since then, I've been following up with the Atomic Energy Commission in Sylhet and the BMU. They all say they'll let me know in another month or two when the medicine arrives. I'm worried the cancer might come back if I don't get the therapy."

Like Aminur and Ahmed, at least 2,500 thyroid cancer patients are currently awaiting radioiodine therapy and are at risk of cancer recurrence, according to doctors. 

The Bangladesh Atomic Energy Commission is responsible for importing this medicine and supplying it to nuclear medicine centres across the country. Bangladesh currently has 24 such centres, through which radioiodine therapy is provided. 

Dr Abdul Karim, thyroid surgeon and assistant professor at the National Institute of ENT in Tejgaon, Dhaka, told TBS, "Cancer treatment is a coordinated process. Even if we perform the surgery well, we cannot ensure full recovery without radioiodine therapy. This shortage is putting patients' lives at risk.

"Radioiodine therapy is extremely important after thyroid cancer surgery. Without it, the treatment is incomplete and the cancer could return. International research shows that 30-40% of patients face recurrence if they don't receive radioiodine. The standard protocol is to administer it within four to six weeks of surgery." 

Regarding the shortage the surgeon said, "This shortage has been ongoing for about six months. We advise patients to try other nearby nuclear medicine centres, but they return saying the medicine isn't available anywhere."

Doctors emphasised that, unlike other types of cancer, thyroid cancer does not usually require radiotherapy or chemotherapy — instead, radioiodine is administered orally. Delaying this therapy can cause the cancer to spread from the thyroid gland to other organs.

Professor Dr Abu Hanif, former director of the National Institute of ENT, told TBS, "Patients have been reporting a shortage of radioiodine for nearly six months. Patients regularly ask us when the medicine will be available. I've spoken with the secretary and special assistant at the health ministry and contacted the Atomic Energy Commission to ensure this issue is resolved quickly."

Farzana Hafiz, admin of the Facebook-based patient support community Thyroid Support Group, said, "Every day, many patients are posting with concerns, asking for alternative treatments. Some are being forced to seek treatment abroad. This crisis is not just medical — it's creating mental stress, financial strain, and uncertainty."

Although there is no population-based national data, doctors estimate that 6,000 to 8,000 new thyroid cancer cases are diagnosed in Bangladesh each year.

What the authorities say

Professor Dr Md Sayedur Rahman, special assistant to the chief adviser for the health and family welfare ministry, told TBS, "We are aware of the radioiodine isotope shortage. Although the import of the medicine is not under the direct control of the health ministry, the impact is within the health sector. So we will contact the Atomic Energy Commission for a quick resolution."

Md Mokabbir Hossain, senior secretary at the science and technology ministry, told TBS, "I've inquired at the Atomic Energy Commission. The chairman told me that treatment is continuing through alternative means and no disruption has occurred. A certain group is creating complications in the import process — possibly for business reasons. They tried to buy and sell the medicine outside of the approved procedure. There's a problem with the tender process, but it will be resolved soon."