Chemotherapy for Thyroid Cancer

Chemotherapy (chemo) uses anti-cancer drugs that are injected into a vein or are taken by mouth. Chemotherapy is systemic therapy, which means that the drug enters the bloodstream and travels throughout the body to reach and destroy cancer cells.

Chemotherapy is seldom helpful for most types of thyroid cancer, but fortunately it is not needed in most cases. It is often combined with external beam radiation therapy for anaplastic thyroid cancer and is sometimes used for other advanced cancers that no longer respond to other treatments.

The chemotherapy drugs most commonly used to treat mainly medullary thyroid cancer and anaplastic thyroid cancer include:

  • Dacarbazine
  • Vincristine
  • Cyclophosphamide
  • Doxorubicin
  • Streptozocin
  • Fluorouracil
  • Paclitaxel
  • Docetaxel
  • Carboplatin

Possible side effects

Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body, such as those in the bone marrow, the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells are also likely to be affected by chemotherapy, which can lead to side effects.

The side effects of chemotherapy depend on the type and dose of drugs given and the length of time they are taken. Common side effects of chemo include:

  • Hair loss
  • Mouth sores
  • Loss of appetite
  • Nausea and vomiting
  • Diarrhea
  • Increased chance of infections (from too few white blood cells)
  • Easy bruising or bleeding (from too few blood platelets)
  • Fatigue (from too few red blood cells)

These side effects are usually short-term and go away after treatment is finished. There are often ways to lessen these side effects. For example, drugs can be given to help prevent or reduce nausea and vomiting.

Some chemotherapy drugs may have other specific side effects that require monitoring. For example, doxorubicin (one of the most common chemo drugs used in thyroid cancer) can affect heart function. If you are taking doxorubicin, your doctor will check your heart regularly using tests such as echocardiograms.

More information about chemotherapy

For more general information about how chemotherapy is used to treat cancer, see Chemotherapy.

To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

American Thyroid Association Guidelines Task Force, Kloos RT, Eng C, Evans DB, et al. Medullary thyroid cancer: Management guidelines of the American Thyroid Association. Thyroid. 2015 25;19:567-610.

American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2016; 26:1-133.

Davidge-Pitts CJ and Thompson GB. Chapter 82: Thyroid Tumors. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Thyroid Carcinoma. V.3.2018. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf on February 20, 2019.

Schneider DF, Mazeh H, Lubner SJ, Jaume JC, and Chen H. Chapter 71: Cancer of the Endocrine System. In: Niederhuber JE, Armitage JO, Dorshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa. Elsevier: 2014.

Sherman SI. Differentiated thyroid cancer refractory to standard treatment: Chemotherapy. https://www.uptodate.com/contents/differentiated-thyroid-cancer-refractory-to-standard-treatment-chemotherapy. UpToDate website. Updated Nov 8, 2018. Accessed February 19, 2019. 

Last Medical Review: March 14, 2019 Last Revised: March 14, 2019

American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.