EDUCATION

This information is a general guide about the medicine below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medicines only as recommended by your doctor, and included instructions. If you have further questions about medicine use or side effects, contact your doctor.

Hormonal Therapy

Hormones are chemical that help the body function. The thyroid makes and releases some important hormones. Cancer and its treatment can alter or stop these hormones. Hormone therapy can help to balance the hormones. Some hormones can also help cancer grow. In this case, thyroid-stimulating hormone (TSH) may help thyroid cancer grow. TSH is made by the pituitary gland in the brain. Medicine can help to lower TSH. Medicine may include:

  • Levothyroxine—Replaces the loss of thyroid hormones. Can also lower TSH levels to decrease chance of cancer coming back. May also stop remaining cancer from growing.
  • Liothyronine—Helps to replace thyroid hormones.
  • Thyrotropin—Mimics the actions of TSH.

Side Effects of Thyroid Hormone Therapy

It may take some time to find the right balance of medicine. The dose may be slowly changed until the right levels of hormones are found in your blood. The thyroid hormone levels will then be checked on a regular basis with blood tests. General side effects from medicine may include:

  • Skin rash
  • Increased hair loss
  • Nausea, muscle weakness, or headache (thyrotropin)

Too much thyroid hormone can lead to hyperthyroidism, which may cause:

  • Feel skipped, racing, or odd heartbeats
  • Chest pain
  • Sweating
  • Heat intolerance
  • Diarrhea
  • Abdominal cramps
  • Weight loss
  • Nervousness
  • Irritability

Too little thyroid hormone can lead to hypothyroidism, which may cause:

  • Cold intolerance
  • Dry skin
  • Dry hair
  • Fatigue and sluggishness
  • Weight gain
  • Muscle or joint pains

Targeted Therapy

Targeted therapy uses medicine to attack support system of cancer cells. For example, some medicine block the growth of new blood vessels for cancer. Without blood flow cancer cells cannot grow and spread. Other medicine can block receptors that promote cancer growth and spread. Targeted therapy may be used with other treatments for advanced thyroid cancer. They are often given as pills.

Targeted therapy drugs used to treat medullary thyroid cancer include:

  • Vandetanib
  • Cabozantinib
  • Motesanib
  • Sunitinib

Targeted therapy drugs used to treat papillary and follicular thyroid cancers include sorafenib and lenvatinib.

Common side effects include:

  • Skin rash, redness, or blistering on the palms of the hands and soles of the feet
  • Fatigue
  • Nausea
  • Diarrhea
  • Increased blood pressure

Vemurafenib is can treat cancer with the BRAF gene. Treatment with vemurafenib has shown promise in slowing metastatic papillary cancer growth. It may prolong life.

REFERENCES:

Anaplastic thyroid cancer. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/anaplastic-thyroid-cancer. Updated June 29, 2018. Accessed December 8, 2018.

General information about thyroid cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/thyroid/patient/thyroid-treatment-pdq. Updated August 18, 2017. Accessed December 8, 2018.

Follicular thyroid cancer. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/follicular-thyroid-cancer-21. Updated June 27, 2017. Accessed December 8, 2018.

Medullary thyroid cancer. EBSCO DynaMed website. Available at:hhttps://www.dynamed.com/condition/medullary-thyroid-cancer. Updated June 29, 2018. Accessed December 8, 2018.

Papillary thyroid cancer. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/papillary-thyroid-cancer. Updated August 15, 2018. Accessed December 8, 2018.

Targeted therapy for thyroid cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/thyroid-cancer/treating/targeted-therapy.html. Updated April 15, 2016. Accessed November 7, 2017.

Thyroid hormone therapy for thyroid cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/thyroid-cancer/treating/thyroid-hormone-therapy.html. Updated April 15, 2016. Accessed November 7, 2017.

Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/thyroid/patient/thyroid-treatment-pdq#section/_67. Updated August 18, 2017. Accessed November 7, 2017.

Last reviewed September 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP  Last Updated: 12/23/2020