Anaplastic thyroid cancer
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Anaplastic thyroid cancer is the rarest type of thyroid gland cancer. It is more common in women and mostly affects people over the age of 60. It usually grows more quickly than other types of thyroid cancer.
About 1 to 2 out of 100 (1 to 2%) of thyroid cancers are anaplastic.
The most common symptom of anaplastic thyroid cancer is a mass or lump in the neck that grows quickly. Often, other symptoms often develop within a few weeks, including:
- difficulty breathing – caused by the thyroid tumour pressing on the windpipe (trachea)
- difficulty swallowing – caused by the thyroid tumour pressing on the gullet (oesophagus)
- a hoarse voice that has no obvious cause and does not go away after a few weeks
- a cough
- a feeling of pressure or discomfort in the neck.
You usually start by seeing your GP, who will examine you. They will refer you to a hospital for specialist advice and treatment if they:
- are unsure what the problem is
- think your symptoms could be caused by cancer.
If they think it could be cancer, you should be seen at the hospital within 2 weeks.
At the hospital, the doctor will ask you about your general health and any previous medical problems. They will also examine you. You may have some of the following tests:
An ultrasound scan uses sound waves to build up a picture of the inside of the neck and the thyroid gland. Your doctor will also check the lymph nodes in your neck to see if any of them are abnormal. This is because thyroid cancer can spread to the lymph nodes.
Fine needle aspiration (FNA)
A doctor gently passes a small needle into the lump or swelling in your neck. Sometimes the doctor uses an ultrasound scan to help guide the needle to the right area. Then they take a small sample of cells and examine it under a microscope to check for any abnormal cells.
If an FNA does not collect enough cells, it may need to be done again.
You may need to have a core biopsy. You have a local anaesthetic to numb the area. Your doctor uses a needle to take a sample of tissue. The needle is slightly bigger than the one they use for the FNA. They may use an ultrasound scan to guide the needle to the right area. You may have a core biopsy if:
- the FNA does not collect enough cells
- the results from the FNA are not clear enough to make a diagnosis.
Further tests for anaplastic thyroid cancer
If the tests show that you have thyroid cancer, your doctor may want to do some further tests. These are to find out the size and position of the cancer and whether it has spread to other parts of the body. This is called staging. Knowing the stage of the cancer helps you and your doctor decide on the best treatment for you. These tests may include the following:
Vocal cord check
Only a few people with anaplastic thyroid cancer can have surgery to remove the thyroid gland. If you do have surgery, you may need to have your vocal cords checked before and after your operation This is because the nerves that control your vocal cords are close to the thyroid gland, and can be damaged during surgery..
The treatment you have will depend on the stage of the cancer and your general health.
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).
For many people, anaplastic thyroid cancer has already spread when it is diagnosed. In this case, treatment aims to try and slow the growth of the cancer. This may improve your symptoms and give you a better quality of life.
Treatments may include:
As well as treatment to try to slow the growth of the cancer, you will be offered supportive (palliative) care, with medicines and support to manage any symptoms.
We have more information about treating anaplastic thyroid cancer.
Your doctor and nurse will arrange follow up appointments with you to check how you are. They will examine you, and may arrange some tests, including blood tests.
They will give you advice about controlling any symptoms you may have and what to expect. They can also give you emotional support and refer you to any other types of support you may need.
You may have lots of different emotions after being diagnosed with cancer. You may get anxious between appointments. This is natural. It may help to get support from family, friends or a support organisation.
Macmillan is also here to support you. If you would like to talk, you can:
Below is a sample of the sources used in our thyroid cancer information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
British Medical Journal. Best Practice Guidelines, Thyroid cancer. 2020.
European Society Medical Oncology (ESMO): Thyroid cancer, Clinical Practice Guidelines for Diagnosis, Treatment and Follow-up. 2019.
National Institute for Health and Care Excellence (NICE). TA535: Lenvatinib and Sorafenib for treating differentiated thyroid cancer after radioactive iodine. 2018. www.nice.org.uk/guidance/ta535 [accessed May 2021].
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Nick Reed, Consultant Clinical Oncologist.
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