What is Anaplastic medullary Cancer(ATC)?
Anaplastic medullary cancer is the rarest type of thyroid cancer. ATC is the most fastest growing among all types of thyroid cancer. ATC is an undifferentiated thyroid cancer which means that the cells do not look or behave the way that thyroid cells usually do . About 1% of 60000 people having thyroid cancer has ATC. It is rare in younger people and mostly occurs in people above 60.
Survival rate of ATC patients are very low but there are also some long term survival. This Depends on patients age, whether the disease has spread outside at the time diagnosis and etc.
For more information in Thyroid cancer check
To know about Medullary thyroid cancer (MTC) check
Cause of Anaplastic cancer
The real cause of anaplastic cancer is not clear. ATC and is not related to other behavioral factors or lifestyle factor. In some people ATC is seen together with or arising from another form of thyroid cancer. Specially papillary and follicular type.
In about half of the patients at the time of diagnosis the cancer is seen to already spread to other organs, usually to lungs and bone.
ATC does not respond to Radioactive Iodine Therapy (RIT) or TSH(Thyroid Stimulating Hormone) suppression with levothyroxine used for some of the other types of thyroid cancer.
Symptoms of anaplastic Medullary Cancer
Symptoms of ATC are –
- Neck Mass enlarges, very often
- Hoarseness or changing voice
- Coughing up blood
- Difficulty swallowing
- Loud breathing
- “Stridor”(harsh-sounding breathing due to restricted airway)
Diagnosis of ATC
ATC Patients usually have previous records of goiter or some other nodules in their neck. It may be non cancerous for years but if it becomes anapastic cancer it grows very fast and rapidly. Thyroid functioning tests are usually normal when diagnosis of ATC is done.
Testing of a thyroid nodule that is not suspected of being ATC is usually done using a method named FNA. Fine needle aspiration(FNA) followed is by call analysis. If ATC is suspected, sometimes a core biopsy may require.
Open biopsy has to be done as a confirmation diagnosis when ATC is suspected because Diagnosis to detect ATC has to be certain. Sometimes a FNA ( Fine Needle Aspiration) and a core biopsy gives uncertain results.
Staging of ATC
ATC is different from other types of thyroid cancer, where stage 1 and stage 2 is considered mild risk stages and stage 3 and stage 4 is considered dangerous. Patients diagnosed with ATC are mainly diagnosed with stage 4 because of ts rapid growth and severe spread.
There are three sub stages of stage 4 of ATC-
Stage 4 A–
This stage means that ATC had not spread outside thyroid gland , it is present in thyroid gland yet.
Stage 4 B–
Here ATC is present in Thyroid gland and in other areas of the neck but not in any other parts.
Stage 4 C –
ATC is present in thyroid as well as other parts of the body, such as bone, liver, lungs etc
The first priority of treatment should be the ensure safety of your air way so that you can breadth easily because symptoms of thyroid cancer often include shortness of breathing and etc.Different doctors may have different opinions on what in the appropriate treatment of ATC. Treatment of anaplasic cancer varies highly. Depending on your circumstance and staging of your cancer .Treatments are usually more effective when it includes combination of methods.
Treatment of ATC includes:-
- Radiation therapy
- Clinical trials
- Palliative care
It is generally the first step of treatment and usually done in in case of localized ATC. Treatment includes surgery when it is completely safe to remove the tumor. Surgery usually consist of total or nearly total Thyroidectomy. This includes removal of lymph nodes in the central and lateral lymph node region on the neck.
Chemotherapy can be both alone or in combination with surgery and radiotherapy . Doctors use chemotherapy very often in ATC mostly if the ATC has not metastasized. Chemotherapy drugs includes Taxane such as paclitaxel or docetaxel, Anthacyclines such as doxorubicin and many more.
In this, radiation acts at ATC tumor cells for reducing and destroying it. Treatment may include radiotherapy both before surgery and after surgery depending on conditions. After surgery mostly it is done to clean up the remaining tumor cells. And sometimes it is done as a palliative care to ease the pain and also to improve breathing and swallowing.
Even After a combination of above mentioned treatments clinical testings and hospital visits has to continue. Every month or every three months in the first year which keeps on reducing with passage of time.
Post treatment palliative care is also important to aid quality of life. This may include physical support, mental support, social support and etc.