Anaplastic thyroid cancer

Introduction of anaplastic thyroid cancer
This type is the least common (about 0.5% to 1.5% of people with thyroid cancer have this type) and most deadly of all thyroid cancers. This cancer has a very low cure rate with the very best treatments. Only 10% of patients are alive 3 years after it is diagnosed. Most patients with anaplastic thyroid cancer do not live one year from the day they are diagnosed.

Treatment of anaplastic thyroid cancer
Most cancers are inoperable at diagnosis and treatment should begin with oncologic treatment. Early diagnosis and a fast-track treatment plan is deployed. Treatment consists of hyperfractionated external beam radiation to 46 Gy/29 fractions (1,6 Gy twice daily 5 days a week) with concomitant doxorubicin and bevacizumab on day 1. Following this a resectability investigation is performed by CT of the neck and thorax. If distant metastases are present and local tumor growth is not a present problem surgery is not advocated. However, if the tumor is judged as locally resectable and in the absence of distant metastases, surgery is performed. Advanced procedures to resect locally advanced disease (over growth into surrounding and nearby structures such as the trachea and larynx) are not advocated. Surgery should be performed 2-3 weeks after radiation therapy. The next step is to start doxorubicin 2 weeks post-operatively. There are ongoing studies on post-operative treatment regimens combining doxorubicin and bevacizumab.