Anaplastic Thyroid Cancer
- Anaplastic thyroid carcinoma is the least common type of Thyroid Cancer of the
begin in the gland itself. This is a very aggressive cancer,
and often spreads quickly to surrounding tissues, as
well as to distant sites. It is often seen in those over
age 60, and the only risk factor may be previous surgery for
cancer of the thyroid, in which only part of the gland was
removed (i.e., partial thyroidectomy). This arises out a
multinodular goiter -- usually, a quickly enlarging mass
that compresses the surrounding tissues.
- Anaplastic thyroid carcinoma does
not pick up iodine, making scanning with radioiodine of
little use. Treatment involves surgical removal of the
(entire) thyroid gland. As with scanning, because the cancer
does not take up iodine, radioactive destruction of the
cancer is not an option either.
- Most people with Thyroid Cancer
usually have painless swelling of the thyroid gland.
- The thyroid gland may be swollen
all over, but most often only one area of the gland is
affected. Often, there is a nodule (or lump) present, which
is firm, painless, and does not move freely.
- Most Thyroid Cancers do
not produce any thyroid hormone. Therefore, most people with Thyroid Cancer do not
have symptoms of hyperthyroidism.
- Lymph nodes in the front part of the
neck may be enlarged, but are usually not tender to touch.
- Growing very rapidly, this type of
cancer can put pressure on some of the other structures in
the neck and lead to trouble swallowing, difficulty
breathing, or hoarse voice. It depends on its size, rate of
growth, and location.
- It is not known what causes Thyroid Cancer.
- Anaplastic Thyroid Cancer
spreads very early to the surrounding tissues, as well as to
- The history, symptoms, and
examination can help point the doctor in the right
- However, the most effective method
of diagnosis involves removing a piece of the thyroid and
examining it under the microscope to see if cancer is
present. This is usually done via a process known as FNA
(fine needle aspiration), in which a needle is used to
remove a sample of the lump.
- As stated above, in most cases of Thyroid Cancer, the tumor does not produce any thyroid hormone. Therefore, most people with Thyroid Cancer have
normal thyroid tests.
- An Ultrasound of the
neck is also helpful in determining the size of the cancer
and to see if it has spread to other areas within the neck.
- Radioiodine scanning is not helpful
(for reasons given above).
- Chest X-Ray, CT scan, MRI, or PET
scan can also be helpful in detecting any metastatic
- Laryngoscopy may be done if
paralysis of vocal cords is suspected.
- Treatment for almost all Thyroid Cancers
begins with surgical removal of the thyroid -- usually the
entire gland. In a few cases, only part is removed. The best
surgical option should be discussed with your doctors.
- Surgery, if done by a skilled
physician, is usually safe. There are potential
complications and you should discuss these with your
- However, one of the most common
complications is accidental removal of the parathyroid gland
because it is located very close to the thyroid. If this
happens, it is generally not life threatening if detected
- Immediately after surgical removal
of the thyroid gland, thyroid hormone replacement will be
initiated, and will continue for the rest of the patient's
- Radioiodine scans and treatment with radioactive iodine are not options for those with anaplastic Thyroid Cancer
because these cancers do not take up iodine.
- If Thyroid Cancer has
spread to the bone, then radiation therapy may be needed.
- If the cancer has spread to the
brain, then gamma knife radiation (a special type of
radiation treatment) will be needed.
- After one has been treated for this condition, he will need to be followed very closely with periodic physicals, neck exams, and chest X-Rays. Monitoring for the
correct amount of thyroid hormone replacement is requisite.
- The long-term outlook (or
prognosis) is guarded for this type of cancer. The one-year
survival is about 10% and the 5-year survival is only about
- Iodine is used by the thyroid
gland to make thyroid hormone. Doctors can use this fact
to their advantage by ordering a nuclear medicine scan
using radioiodine when a problem with the thyroid is
suspected. The patient is given radioiodine and if the
gland is active, it will take up the radioiodine and use
it to make thyroid hormone. A scan is performed to see
what areas of the body are taking up the radioiodine.
Radioactive iodine (131I) can then be used to destroy the
cancer. Therefore, whether or not the cancer takes up
iodine is very important in both the diagnosis and
treatment of thyroid diseases.
- Radioactive iodine is generally
safe. However, depending on the dose and individual
response to the medicine, it can cause side effects,
including stomach inflammation, temporary low sperm count,
low blood count, and, very rarely, leukemia.
- To summarize -- if a lump is detected in the thyroid gland, first determine whether or not it is cancer. If cancer is present, then blood tests and X-Rays will be needed, followed by surgery to remove the cancer. In certain types of Thyroid Cancers, an
iodine scan is administered to determine if the cancer has spread -- and radioactive iodine is used to destroy any Metastatic Cancer. (Anaplastic Thyroid Cancer,
however, does not take up iodine, making this approach
inapplicable in such cases). After surgery, in
addition to receiving thyroid hormone replacement,
survivors of this virulent cancer will have to be closely
followed to make sure that the cancer does not come
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