Does Thyroid Cancer Need Chemotherapy?

Thyroid Cancer Treatment Methods

Thyroid surgery is known as the main treatment for thyroid cancer and is used in almost all types of thyroid cancer. In thyroid surgery, all or part of the thyroid gland, which includes cancerous tumors, is removed. In some cases, in addition to thyroid surgery, other treatment methods such as radioactive iodine, external radiation therapy, targeted drugs, and chemotherapy will also be used. The appropriate treatment method for thyroid cancer depends on the stage (grade) of the cancer, the type of cancer, the extent and speed of its spread, the patient’s general condition, and the diagnosis of the thyroid specialist.

Read more: When is thyroid cancer surgery performed?

Chemotherapy for thyroid cancer

Chemotherapy means the use of powerful anti-cancer drugs that are injected into a vein or taken orally. Chemotherapy is a type of systemic treatment; Because chemotherapy drugs enter the bloodstream and travel throughout the body to reach and kill cancer cells, chemotherapy is an effective treatment for many types of cancer, but fortunately, most types of thyroid cancer do not require chemotherapy.

When is chemotherapy recommended for thyroid cancer?

Doctors do not often use chemotherapy to treat thyroid cancer, but in some cases, chemotherapy is recommended as part of a thyroid cancer treatment plan.

• Chemotherapy may be used to treat a specific type of thyroid cancer called anaplastic thyroid cancer. This type of thyroid cancer is very aggressive and rare and usually does not respond to common cancer treatments. For anaplastic thyroid cancer, chemotherapy is often combined with external radiation therapy (external radiotherapy).
• Chemotherapy is also sometimes used to treat other types of thyroid cancer, when the cancer has spread and surgery and radiation are not suitable treatment options. However, targeted drugs are usually tried before chemotherapy because they are more likely to be effective.

Chemotherapy drugs for thyroid cancer

Chemotherapy drugs that are often used to treat thyroid cancer include:

• Dacarbazine
• Vincristine
• Cyclophosphamide
• Doxorubicin
• Streptozocin
• 5-fluorouracil
• Paclitaxel
• Docetaxel
• Cisplatin
• Carboplatin

Depending on the type of thyroid cancer and other factors, two chemotherapy drugs are sometimes combined. Doxorubicin (Adriamycin) and cisplatin are the most commonly used chemotherapy drugs on the list above. These drugs may be given together in combination, or you may take one of them with another chemotherapy drug.

Most of these drugs are given as an intravenous (IV) injection, although some are also available as pills.

Thyroid Chemotherapy Cycles

Thyroid chemotherapy is given in cycles, with a rest period after each treatment to allow the body to recover. Chemotherapy cycles usually last several weeks. For example, you might take a drug every day for one week and then not take it for two weeks (a rest cycle). This 3-week period is considered a treatment cycle.

Side Effects of Chemotherapy for Thyroid Cancer

Chemotherapy drugs can also affect and kill healthy cells in the body in addition to cancer cells. This can lead to side effects. The side effects of chemotherapy depend on the drugs prescribed, the dosage, the length of treatment, and how your body responds to the drugs. The most common side effects of chemotherapy for thyroid cancer include:

• Hair loss
• Mouth sores
• Loss of appetite
• Nausea and vomiting
• Diarrhea or constipation
• Increased risk of infection (due to a severe decrease in white blood cell count)
• Easy bruising or bleeding (due to a severe decrease in platelets)
• Fatigue (due to a severe decrease in red blood cells)

These side effects usually go away after treatment ends, and in most cases, there are ways to reduce them. For example, medications are usually prescribed to help prevent or reduce nausea and vomiting.

Some chemotherapy drugs may have other side effects, such as:

• Doxorubicin (one of the most common chemotherapy drugs for thyroid cancer) can affect how your heart works. If you receive doxorubicin, your doctor will monitor your heart function using tests such as an echocardiogram.
• Drugs such as cisplatin, carboplatin, and paclitaxel can damage nerves, causing symptoms such as pain, burning or tingling, sensitivity to cold or heat, or weakness (mostly in the hands and feet). This condition is known as peripheral neuropathy.

The bottom line

Most thyroid cancers are treatable and respond to standard treatments (such as thyroid surgery and radiation therapy). Chemotherapy is rarely used to treat thyroid cancer, but it can help control dangerous thyroid cancers that spread quickly (such as anaplastic thyroid cancer).

In some cases, chemotherapy may also be used for other types of thyroid cancer. Sometimes chemotherapy is combined with radiation therapy. The side effects of chemotherapy depend on the specific drugs you receive, as well as their doses.

Dr. Ahmad Fanaei is a thyroid and parathyroid surgeon and a member of the American Thyroid Association. He is known as the Golden Claw Thyroid Surgeon and performs thyroid surgeries with the most up-to-date equipment and technology in the world. Dr. Fanaei has over 20 years of experience in surgery and over 5,000 successful thyroid surgeries.