Condition Overview
Anaplastic thyroid carcinoma (ATC) is a rare and highly aggressive form of thyroid cancer. It accounts for less than 2% of all thyroid cancers but is responsible for a significant proportion of thyroid cancer-related deaths due to its rapid growth and tendency to spread to other parts of the body. ATC often presents in older adults and is typically diagnosed at an advanced stage.
Patients with ATC may experience a rapidly enlarging neck mass, difficulty swallowing (dysphagia), difficulty breathing (dyspnea), hoarseness, and pain. The rapid growth of the tumor can cause compression of surrounding structures in the neck, leading to additional symptoms such as stridor and vocal cord paralysis.
Diagnosis involves a combination of clinical evaluation, imaging studies (such as ultrasound, CT scan, or MRI), and biopsy. Fine-needle aspiration (FNA) or core needle biopsy can provide tissue samples for histopathological examination, which is essential for confirming the diagnosis of ATC. Fortunately, newer therapies have emerged that offer a much improved prognosis, especially for those with mutations in certain genes such as BRAF.
Treatment Options
- Surgery
- Description: Surgery aims to remove as much of the tumor as possible. However, complete surgical resection is often challenging due to the extensive local invasion typical of ATC. Surgery may be palliative in some cases to relieve symptoms caused by the tumor's compression of vital structures.
- Indications: Surgery can often follow the use of targeted therapy, in what is referred to as neo-adjuvant treatment.
- Radiation Therapy
- Description: External beam radiation therapy (EBRT) is used to target and kill cancer cells. It is often used in conjunction with surgery or as a primary treatment when surgery is not feasible. Radiation therapy can help control local disease and relieve symptoms. An experienced Radiation Oncology team is critical.
- Indications: Postoperative adjuvant therapy, unresectable tumors, palliation of symptoms, part of a multimodal treatment approach.
- Chemotherapy
- Description: Chemotherapy involves the use of drugs to kill cancer cells or slow their growth. It is often combined with radiation therapy (chemoradiation) for a synergistic effect. Commonly used chemotherapeutic agents include doxorubicin and cisplatin.
- Indications: Advanced or metastatic disease, part of a multimodal treatment approach, palliation of symptoms.
- Targeted Therapy
- Description: Targeted therapy uses drugs that specifically target molecular pathways involved in cancer cell growth and survival. Recent advances in understanding the genetic mutations and molecular drivers of ATC have led to the development of targeted therapies, such as kinase inhibitors.
- Indications: Tumors with specific genetic mutations, part of a multimodal treatment approach, advanced or metastatic disease.
- Supportive Care
- Description: Supportive care focuses on relieving symptoms and improving the quality of life for patients with advanced ATC. This may include pain management, nutritional support, respiratory support, and psychological counseling.
- Indications: All stages of ATC, especially advanced or metastatic disease, palliative care.
Having an experienced team such as that at the Russell Center ensures that you will have access to the widest range of options for your anaplastic thyroid carcinoma, while also ensuring that some very hard decisions are made in the manner that prioritizes your goals of care.
