Anaplastic thyroid cancer is the least common and the most deadly type of thyroid cancers. Only 1% of thyroid cancer patients are diagnosed with anaplastic or undifferentiated thyroid cancer. The cure rate is very low even with the best of treatments, and the patient can barely survive for a year, from the date of diagnosis.

1. Incidence and cause
This type of thyroid cancer is more common in people over 60 years and is extremely rare in young patients. Though the exact cause of this malignancy cannot be pointed out, a long-standing goiter, which is an enlarged thyroid, or continuous exposure to radiation in the neck or chest can lead to anaplastic thyroid cancer.

2. Symptoms
As this is a fast-growing cancer, the symptoms begin to show and progress quickly within a few weeks. A lump in the neck or a nodule in the same area, shortness of breath, and difficulty in swallowing pills and food are some of the symptoms. As the cancer grows, the lump may become bigger, like a big hard mass in the neck, just in a few days. The voice can become hoarse and a persistent cough may occur. Breathing difficulties are common as the airway becomes restricted.

3. Stages
Anaplastic thyroid cancer is itself a stage 4 cancer. This is further divided into three stages based on the spread of the cancer:

• Stage 4A – the cancer is only in the thyroid
• Stage 4B – cancer has spread to the tissues around the thyroid and possibly the lymph nodes
• Stage 4C – cancer has metastasized to other organs like the lungs, brain, and bones.

4. Treatment for anaplastic thyroid cancer
The treatment is aggressive with either surgery, radiation, and chemotherapy or a combination of all three. The best treatment is complete surgical removal (resection) of the thyroid or nodules. Patients with resected anaplastic thyroid cancer will need to join a clinical trial of chemotherapy and/or radiation therapy to further treat their disease. However, as this cancer spreads quickly, patients are more likely to be diagnosed with unresectable anaplastic thyroid, which refers to cancer that cannot be completely removed surgically. For patients with unresectable disease, it is best to focus on improving the patient’s quality of life and making their days as comfortable as possible.

5. Palliative care is the best option

Patients may opt for palliative care or may opt to join a hospice where therapies are provided to make their days more comfortable. Palliative surgery may be done to improve the quality of life. Tracheostomy tube and a feeding tube may be inserted to make it easier for them to breathe and be fed. In more than 25% of the cases, anaplastic cancer would have grown into the trachea, blocking the patient’s airway. This is the reason why many patients with anaplastic thyroid cancer will have to opt for a tracheostomy. This procedure is mostly required as compared to patients with other types of cancer.