Anaplastic Thyroid Cancer

Anaplastic thyroid cancer is a rare and aggressive form of thyroid cancer.  The cells in anaplastic thyroid cancer divide very rapidly, leading to an extremely aggressive growth rate. Patients usually experience rapid enlargement of their thyroid gland that may cause symptoms such as neck pain, tenderness, voice changes, trouble breathing,  and/or difficulty swallowing. Early detection of this disease and its symptoms is crucial to prompt treatment. In general, the first step in the treatment of a patient with anaplastic thyroid cancer is to determine whether or not the patient is a candidate for surgery. The goal of surgery is to remove the disease, thereby preventing the cancer from impacting the patient’s ability to breathe and swallow. External beam radiation therapy and chemotherapy are commonly used after surgery, or instead of surgery, if the disease is deemed inoperable. 

Currently, genetic and molecular testing is one of the most important steps in the management of anaplastic thyroid cancer. This testing can determine whether a patient’s cancer expresses a specific genetic mutation, known as BRAF v600E. For cancers that express this mutation, certain targeted therapies can be used to attack the cancer both at the primary site and at other possible sites of metastatic spread. If the targeted therapy is successful in reducing the volume of the disease, it is usually followed by surgery and then a course of external beam radiation and chemotherapy. After several months of targeted therapy, cancers that were initially deemed to be inoperable may shrink in size such that they become operable. 

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