Treatments for anaplastic carcinoma
The following are treatment options for anaplastic carcinoma of the thyroid. Your healthcare team will suggest treatments based on your needs and preferences. They will work with you to develop a treatment plan.
Anaplastic carcinoma is often advanced when it is diagnosed. This means that it might not be possible to completely remove or destroy of all the cancer.
Radiation therapy is a common treatment for anaplastic carcinoma. External beam radiation therapy is given to the thyroid and neck to help slow down and control the growth of the cancer. It is sometimes given during the same time period as chemotherapy (called chemoradiation).
A standard radiation schedule gives radiation once a day. Smaller doses of radiation therapy may be given 2 times a day. This is called hyperfractionation. A standard radiation schedule may be used if there are too many side effects with hyperfractionation.
Chemotherapy is usually offered for anaplastic carcinoma. It may be given alone or with radiation therapy as a part of chemoradiation. The chemotherapy combination used most often is doxorubicin (Adriamycin) and cisplatin (Platinol AQ). Sometimes doxorubicin is used alone. Paclitaxel (Taxol) or docetaxel (Taxotere) may also be used for some cases.
Surgery is rarely offered for anaplastic carcinoma. This cancer is often advanced when it is diagnosed, and it usually can’t be removed with surgery (it is unresectable). But surgery may be offered before or after other treatments in certain cases. The type of surgery done depends on the stage of the cancer, the size of the tumour and what structures and organs the cancer has grown into or spread to.
Lobectomy or total thyroidectomy may be done if the tumour is only in the thyroid. A lobectomy removes one side, or lobe, of the thyroid. A total thyroidectomy completely removes the thyroid. Hormonal therapy with levothyroxine (Synthroid, Eltroxin) will need to be taken for the rest of your life if you have a total thyroidectomy.
Neck dissection is often done at the same time as the lobectomy or thyroidectomy. It is surgery to remove lymph nodes from the neck. Other tissues around the thyroid may also be removed.
En bloc resection may be done for anaplastic carcinoma when the cancer has spread outside the thyroid to tissues and structures in the neck. It removes the tumour and surrounding tissues, lymph nodes and structures in the neck as one piece (en bloc).
Palliative surgery may be done to remove a large tumour or debulk cancer that is causing symptoms. For example, the surgeon may remove cancer that is blocking an airway or the esophagus or pressing on the spinal cord.
Tracheostomy is often needed when a tumour presses on or blocks the trachea. It is a surgical procedure to create an opening (called a stoma) in the trachea (windpipe) through the neck so air can reach the lungs.
Surgery for metastasis may be used in rare cases to remove anaplastic carcinoma that has spread to other organs and is causing symptoms. Find out more about metastatic cancer.
If you can’t have or don’t want cancer treatment
You may want to consider a type of care to make you feel better rather than treat the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.
Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.
You may be asked if you want to join a clinical trial for anaplastic carcinoma. Find out more about clinical trials.
The removal of as much of a tumour as possible.
Debulking can be done by surgery, radiation, laser or chemotherapy.