Anaplastic thyroid cancer (ATC) is a rare and aggressive form of cancer affecting the thyroid. Doctors usually treat it with surgery as well as chemotherapy and radiation.

There are four types of thyroid cancer. Papillary thyroid cancer is the most common, and ATC is the rarest. ATC affects around 2% of those with thyroid cancer and is especially prevalent in those over 60 years.

It can be difficult for doctors to treat ATC as it is an aggressive form of cancer and spreads quickly. However, new treatment methods are developing, which improve the outlook for people with ATC.

This article discusses anaplastic thyroid cancer, its symptoms, diagnosis, and treatment. It also includes information on support for people living with this type of cancer.

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The thyroid is a butterfly-shaped gland at the base of the neck below the Adam’s apple. It secretes several hormones that help regulate the body’s processes. One of these hormones is thyroxine (T4) which influences metabolism, growth, and body temperature.

ATC is a fast-growing cancer of the thyroid. Doctors may refer to it as undifferentiated thyroid cancer. This is because the cancer cells do not resemble or behave like typical thyroid cells.

This form of cancer spreads rapidly and can be difficult to treat. Therefore the outlook is poorer than that of many other cancers.

The most common symptoms of anaplastic thyroid carcinoma include:

About one-third of individuals with ATC also experience vocal cord paralysis. This can make it difficult for people to eat, breathe, and speak as they usually do.

Doctors may find it difficult to treat ATC due to its aggressive nature, meaning it can spread rapidly to nearby and distant parts of the body.

Generally, doctors recommend surgery unless the individual has other medical conditions that would make the procedure too unsafe. Surgery involves removing the bulk of the tumor.

They may also recommend chemotherapy, radiation therapy, or both. These can kill or slow the cancer’s growth.

One option is external-beam irradiation, which focuses X-rays directly on the area requiring treatment. This could be the primary tumor or cancer that has spread to other areas.

Chemotherapy may enhance the effects of radiation. Some chemotherapy agents include:

  • taxanes — paclitaxel or docetaxel
  • anthracyclines — doxorubicin
  • platinum analogs — cisplatin or carboplatin

A doctor may recommend a single chemotherapy medication or a combination of two or more.

Diagnosing ATC may begin by taking a medical history and performing a physical examination. A doctor may gently palpate the throat area to feel for a mass.

Depending on their findings, they may then use the following tools to assist in their diagnosis:

  • Imaging: A doctor may use ultrasound, CT, or MRI scans to examine the tumor size and characteristics. For example, during an ultrasound, the typical signs of ATC include a solid mass with calcification and irregular borders. The tumor is normally wider than it is tall and may involve cervical lymph nodes.
  • Fine needle aspiration: This involves inserting a needle into the thyroid and removing cells for further laboratory analysis. A pathologist will examine the cells under the microscope to determine the type of tumor.

Doctors typically stage cancers on a scale of 1–4, with 1 being the least advanced and 4 being the most advanced.

ATC is typically stage 4 at the time of diagnosis. As it is so aggressive, by the time a person experiences symptoms and seeks medical attention, the cancer has usually progressed to stage 4.

Doctors may further subdivide stage 4 cancer into categories A, B, and C:

  • Stage 4A: Cancer has spread to nearby structures.
  • Stage 4B: Cancer has spread beyond nearby structures.
  • Stage 4C: Cancer has metastasized as secondary tumors.

ATC does not run in families. Some risk factors may include:

  • having a goiter, an abnormal enlargement of the thyroid gland
  • having type B blood
  • being older
  • being male

ATC is extremely aggressive and usually life threatening. It spreads quickly and is therefore challenging to treat.

The average survival is 6 months. However, around 1 in 5 people live 12 months or longer.

There are long-term survivors of ATC, and treatment options are advancing and improving continuously.

Receiving a diagnosis of ATC is life changing, and it is understandable for individuals to feel overwhelmed and frightened. People may want to talk with a doctor, medical professional, therapist, or counselor about their feelings and how best to cope.

Support groups are also available for people affected by cancer and their loved ones. These can provide emotional support and practical advice from people living a similar experience.

The following organizations provide information and support:

ATC is a rare and aggressive form of thyroid cancer. Doctors typically recommend surgery, radiation therapy, and chemotherapy.

Although the survival rates for ATC are low, there are long-term survivors, and researchers continually develop new treatments.