Anaplastic Thyroid Cancer

Definition

Definition of Anaplastic Thyroid Cancer
Anaplastic Thyroid Cancer (ATC) is a form of thyroid cancer which has a very poor prognosis (14% ten-year survival rate) due to its aggressive behavior and resistance to cancer treatments.

Symptoms

Symptoms of Anaplastic Thyroid Cancer

1. Cough
2. Coughing up blood
3. Difficulty swallowing
4. Hoarseness or changing voice
5. Loud breathing
6. Lower neck mass, often noted to be rapidly enlarging

Causes

Causes of Anaplastic Thyroid Cancer
Anaplastic thyroid cancer grows very rapidly and is an invasive type of thyroid cancer. It occurs most often in people over age 60. The cause is unknown.

Diagnosis

Diagnosis of Anaplastic Thyroid Cancer
A physical examination almost always show a neck mass.

1. A CT scan or MRI of the neck may show a tumor growing from the thyroid gland.
2. A thyroid biopsy shows anaplastic cancer.
3. An examination of the airway with a fiberoptic scope (laryngoscopy) may show a paralyzed vocal cord.
4. A thyroid scan shows this mass to be "cold," meaning it does not absorb a radioactive isotope.

Treatment

Treatment of Anaplastic Thyroid Cancer
Unlike its differentiated counterparts, anaplastic thyroid cancer is highly unlikely to be curable either by surgery or by any other treatment modality, and is in fact usually unresectable due to its high propensity for invading surrounding tissues.

Palliative treatment consists of radiation therapy usually combined with chemotherapy.

However, with today's technology, new drugs, such as fosbretabulin (a type combretastatin), bortezomib and TNF-Related Apoptosis Induced Ligand (TRAIL), are being introduced and trialed in clinical labs and human clinical studies. Based on encouraging Phase I and II clinical trial results, with fosbretabulin, a type of drug that selectively destroys tumor blood vessels, a large, multi-national clinical trial is being undertaken to determine whether the drug can extend the survival of patients with ATC. Recent studies in Italy have shown positive results against ATC, but more tests outside the lab are needed to confirm this before it can be used in chemotherapy. There have been some case studies where patients with aggressive thyroid cancer have survived outside the mean expected survival time.

Prognosis

Prognosis of Anaplastic Thyroid Cancer
The overall 5-year survival rate of anaplastic thyroid cancer has been given as 7% or 14%, although the latter has been criticized as being overestimated.

Treatment of anaplastic-type carcinoma is generally palliative in its intent for a disease that is rarely cured and almost always fatal, with worse prognosis associated with large tumours, distant metastases, acute obstructive symptoms, and leukocytosis. Death is attributable to upper airway obstruction and suffocation in half of patients, and to a combination of complications of local and distant disease, or therapy, or both in the remainder.

Prevention

Prevention of Anaplastic Thyroid Cancer
Consult with your doctor.