Anaplastic thyroid cancer: diagnosis and urgent care

It can enlarge quickly in the neck and press on the windpipe or swallowing passage. Treatment is tailored to whether the tumour can be removed and whether testing finds a change that a targeted medicine can address.

This cancer arises from thyroid tissue but behaves differently from more differentiated thyroid cancers. Common presentations include a rapidly growing neck mass, hoarse voice, trouble swallowing, cough or breathing difficulty. A biopsy confirms the cell type, imaging maps its relationship to the airway and nearby structures, and molecular testing looks for tumour changes that may guide drug treatment. Radioactive iodine generally does not work when the cancer cells no longer take up iodine.

Assessment should be coordinated promptly by specialists in thyroid surgery, medical oncology, radiation oncology, radiology and airway care. Surgery may be considered when the tumour can be removed without unacceptable harm. Targeted therapy may be suitable when the tumour carries a matching molecular change; radiotherapy and systemic medicines may also be combined or sequenced. Symptom control, nutrition, communication support and personal care goals belong in the plan from the outset.

Seek emergency help for new or worsening difficulty breathing, noisy breathing, inability to swallow saliva, blue or grey lips, or rapidly increasing neck swelling. Do not wait for a routine appointment when these symptoms occur. Contact the specialist team promptly for a new hoarse voice, increasing trouble swallowing, coughing up blood, worsening pain or reduced food and fluid intake.

Ask how secure the airway is, whether surgery is feasible, what molecular testing found and how quickly treatment should begin. Request a clear contact plan for breathing or swallowing changes. You may also want to discuss the intended benefit and burdens of each option, support for eating and speech, and how your priorities will shape care.