Chemotherapy for Thyroid Cancer
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Cancer chemotherapy is the use of drugs to kill cancer cells. Unlike radiation and surgery, which are localized treatments, chemotherapy is a systemic treatment, meaning the drugs travel throughout the whole body. This means chemotherapy can reach cancer cells that may have spread, or metastasized, to other areas.
Chemotherapy is rarely used to treat thyroid cancer. It is almost exclusively used when other treatments have failed and may be combined with external radiation therapy .
Chemotherapy Drugs Used for Thyroid Cancer
Chemotherapy drugs used to treat thyroid cancer include the following:
- Bleomycin (Blenoxane)
- Dacarbazine (DTIC-Dome)
- Docetaxel (Taxotere)
- Doxorubicin (Adriamycin, Rubex)
- Paclitaxel (Onxol, Taxol)
- Platinum agents
Effectiveness
Researchers are still trying to determine what the benefit of chemotherapy is for various stages of thyroid cancer and its metastases. In general, surgery is more important, as is radioablation therapy . When thyroid cancer is unresponsive to these types of treatment, however, chemotherapy with or without external radiation therapy may be attempted.
In anaplastic thyroid cancer, a highly aggressive form of thyroid cancer, chemotherapy may improve survival time. Doxorubicin is the most effective single agent in this type of cancer, often combined with radiation treatment.
Adverse Reactions
In general, the elderly and those with liver and kidney diseases are more prone to adverse side effects. Therefore, chemotherapy drugs should be used with caution in these populations.
Chemotherapy can cause a variety of adverse reactions including the following:
- Bone marrow suppression (with the exception of of bleomycin and vincristine)
- Infertility
- Pulmonary toxicity (in particular with bleomycin)
- Cardiac toxicity (in particular with anthracyclines)
- Nephrotoxicity (in particular with ciplatin, ifosfamide, and cyclophosphamide)
- Neurotoxicity (in particular with cisplatin, ifosfamide, and cyclophosphamide)
- Elevation of uric acid levels
- Nausea, vomiting
- Hair loss
- Diarrhea or bleeding from gut
- Altered taste or smell
- Mouth ulcers
References:
Baudin E, Schlumberger M. New therapeutic approaches for metastatic thyroid carcinoma. Lancet Oncol. 2007; 8:148-156
Conn’s Current Therapy. 54th ed. Philadelphia, PA: WB Saunders Company; 2002: 652-657.
Cooper DS, Doherty GM, Haugen BR, et al. The American Thyroid Association Guidelines Taskforce: management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006;16:1-33.
Cornett WR, Sharma AK, Day TA, et al: Anaplastic thyroid carcinoma: an overview. Curr Oncol Rep. 2007;9:152-158.
Fischer DS, Knobf MT, Durivage HJ, Knobf MKT, Durivae HJ. The Cancer Chemotherapy Handbook. Mosby-Year Book, Inc; 1997.
Rachmiel M, Charron M, Gupta A, et al. Evidence-based review of treatment and follow up of pediatric patients with differentiated thyroid carcinoma. J Pediatr Endocrinol Metab. 2006;19:1377-1393.
Thyroid carcinoma. In: Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000: 1247-1250.
What is thyroid cancer. American Cancer Society website. Available at http://www.cancer.org/docroot/CRI/CRI_2_3x.asp?dt=43 . Accessed December 10, 2002.
What you need to know about cancer of the thyroid. National Cancer Institute website. Available at http://cancer.gov/cancer_information/ . Accessed December 10, 2002.
Last reviewed November 2008 by Mohei Abouzied, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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