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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, within a few weeks other symptoms may develop, including:
- difficulty breathing – a thyroid tumour pressing on the windpipe (trachea) can cause this
- difficulty swallowing – a thyroid tumour pressing on the gullet (oesophagus) can cause this
- a hoarse voice, for no obvious reason, that doesn’t go away after a few weeks a feeling of pressure or discomfort in the neck.
If you have symptoms, you will usually start by seeing your GP, who will examine you. If they are unsure what the problem is, or think your symptoms could be caused by cancer, they will refer you to a hospital for specialist advice and treatment. You should be seen at the hospital within two weeks.
At the hospital, the doctor will ask you about your general health and any previous medical problems. They will examine you and 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 sometimes 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. You may have a local anaesthetic to numb the area. Sometimes the doctor uses an ultrasound scanner 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 whether there are any abnormal cells. If an FNA does not collect enough cells, sometimes it is done again.
You may need to have a core biopsy. You have a local anaesthetic to numb the area. Sometimes a general anaesthetic is used. 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 doesn’t collect enough cells
- the doctor who looks at the cells from the FNA under the microscope (pathologist) is not sure whether there are cancer cells present.
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 and will help you and your doctor decide on the best treatment for you. These tests may include the following:
CT scan (computerised tomography scan)
MRI scan (magnetic resonance imaging scan)
Vocal cord check
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 lead to an improvement in symptoms and a better quality of life.
Possible treatments include:
As well as treatment to try to slow the growth of the cancer, you will be offered supportive (palliative) care, with medicines to manage any symptoms.
We have more information about treating anaplastic thyroid cancer.
The aim of follow-up care is to make sure everything is going well and to find out if you have any concerns. The appointments are usually every few months in the first year.
At your appointments, your doctor will examine you and you will have blood tests. They will explain if you need any other tests.
We have more information on follow-up care after treatment.