Thyroid Cancer (cont.)
What are side effects of cancer treatment?
Because cancer treatment may damage healthy cells and tissues, unwanted side
effects sometimes occur. These side effects depend on many factors, including
the type and extent of the treatment. Side effects may not be the same for each
person, and they may even change from one treatment session to the next. Before
treatment starts, the health care team will explain possible side effects and
suggest ways to help the patient manage them.
The NCI provides helpful booklets about cancer treatments and coping with
side effects, such as Radiation Therapy and You, Chemotherapy and You, and
Eating Hints for Cancer Patients. See the sections "National Cancer Institute
Information Resources" and "National Cancer Institute Booklets" for other
sources of information about side effects.
Surgery
Patients are often uncomfortable for the first few days after surgery.
However, medicine can usually control their pain. Patients should feel free to
discuss pain relief with the doctor or nurse. It is also common for patients to
feel tired or weak. The length of time it takes to recover from an operation
varies for each patient.
After surgery to remove the thyroid and nearby tissues or organs, such as the
parathyroid glands, patients may need to take medicine (thyroid hormone) or
vitamin and mineral supplements (vitamin D and calcium) to replace the lost
functions of these organs. In a few cases, certain nerves or muscles may be
damaged or removed during surgery. If this happens, the patient may have voice
problems or one shoulder may be lower than the other.
Radioactive iodine (I-131) therapy
Some patients have nausea and vomiting on the first day of I-131 therapy.
Thyroid tissue remaining in the neck after surgery may become swollen and
painful. If the thyroid cancer has spread to other parts of the body, the I-131
that collects there may cause pain and swelling.
Patients also may have a dry mouth or lose their sense of taste or smell for
a short time after I-131 therapy. Chewing sugar-free gum or sucking on
sugar-free hard candy may help.
During treatment, patients are encouraged to drink lots of water and other
fluids. Because fluids help I-131 pass out of the body more quickly, the
bladder's exposure to I-131 is reduced.
Because radioactive iodine therapy destroys the cells that make thyroid
hormone, patients may need to take thyroid hormone pills to replace the natural
hormone.
A rare side effect in men who received large doses of I-131 is loss of
fertility. In women, I-131 may not cause loss of fertility, but some doctors
suggest that women avoid pregnancy for one year after I-131 therapy.
Researchers have reported that a very small number of patients may develop
leukemia years after treatment with high doses of I-131.
Hormone treatment
Thyroid hormone pills seldom cause side effects. However, a few patients may
get a rash or lose some of their hair during the first months of treatment.
The doctor will closely monitor the level of thyroid hormone in the blood
during followup visits. Too much thyroid hormone may cause patients to lose
weight and to feel hot and sweaty. It also may cause chest pain, cramps, and
diarrhea. (The doctor may call this condition "hyperthyroidism.") If the thyroid
hormone level is too low, the patient may gain weight, feel cold, and have dry
skin and hair. (The doctor may call this condition "hypothyroidism.") If
necessary, the doctor will adjust the dose so that the patient takes the right
amount.
External radiation therapy
External radiation therapy may cause patients to become very tired as
treatment continues. Resting is important, but doctors usually advise patients
to try to stay as active as they can. In addition, when patients receive
external radiation therapy, it is common for their skin to become red, dry, and
tender in the treated area. When the neck is treated with external radiation
therapy, patients may feel hoarse or have trouble swallowing. Other side effects
depend on the area of the body that is treated. If chemotherapy is given at the
same time, the side effects may worsen. The doctor can suggest ways to ease
these problems.
Chemotherapy
The side effects of chemotherapy depend mainly on the specific drugs that are
used. The most common side effects include nausea and vomiting, mouth sores,
loss of appetite, and hair loss. Some side effects may be relieved with
medicine.
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