Persistent quality of life impairments in differentiated thyroid cancer patients: results from a monitoring programme

Background: Health-related quality of life (HRQoL) is important for differentiated thyroid cancer survivors, but data for Asian survivors is lacking. This study aimed to have an overview of, and identify any disease-or treatment-related factors associated with, HRQoL in Asian differentiated thyroid cancer survivors. Patients and Methods: Thyroid cancer survivors were recruited from the thyroid clinics at Queen Mary Hospital, Hong Kong from February 2016 to December 2016. All adult differentiated thyroid cancer patients with stable disease more than or equal to 1 year received a survey on HRQoL using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and Thyroid cancer specific quality of life (THYCA-QoL) questionnaire. Clinical information was collected retrospectively from the computerized clinical management system. To identify factors associated with poor HRQoL, univariable and stepwise multivariable regression analysis were performed. Results: A total of 613 survivors completed the questionnaires (response rate: 82.1%; female: 80.1%; median survivorship: 7.4 years (range: 1.0-48.2 years)). The QLQ-C30 summary score mean was 84.4 (standard deviation (SD): 12.7) while the THYCA-QoL summary score mean was 39.9 (SD: 9.7). The 2 highest symptom subscales were fatigue (mean: 26.4, SD: 20.6) and insomnia (mean: 26.2, SD: 27.6). Factors associated with worse HRQoL included serum thyrotropin (TSH) greater than 1.0 mIU/L, unemployment, and concomitant psychiatric disorders. Concomitant psychiatric illness (n = 40/613, 6.5%) also showed significant association with most of the symptom and functional subscales. Conclusions: Fatigue and insomnia were the 2 most common symptoms experienced by our differentiated thyroid cancer survivors. Long-term survivorship care with monitoring serum TSH level, supporting return-to-work and screening for concomitant psychiatric disorders should be offered.

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Risk Factors of Deterioration in Quality of Life Scores in Thyroid Cancer Patients After Thyroidectomy

Cancer Management and Research ◽

10.2147/cmar.s235323 ◽

2019 ◽

Vol Volume 11 ◽

pp. 10593-10598 ◽

Cited By ~ 1

Author(s):

Jie Li ◽

Ling Bo Xue ◽

Xiao Yi Gong ◽

Yan Fang Yang ◽

Bu Yong Zhang ◽

...

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Thyroid Cancer ◽

Cancer Patients

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Quality of Life with Well-Differentiated Thyroid Cancer: Treatment Toxicities and Their Reduction

Thyroid ◽

10.1089/105072504322880373 ◽

2004 ◽

Vol 14 (2) ◽

pp. 133-140 ◽

Cited By ~ 39

Author(s):

April Mendoza ◽

Brian Shaffer ◽

Daniel Karakla ◽

M. Elizabeth Mason ◽

David Elkins ◽

...

Keyword(s):

Quality Of Life ◽

Thyroid Cancer ◽

Cancer Treatment ◽

Differentiated Thyroid Cancer ◽

Well Differentiated

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Prophylactic prednisolone for the prevention of early and intermediate adverse effects of radioactive iodine therapy in patients with thyroid cancer: study protocol for a single-centre, phase II/III, randomized, double-blinded, placebo-controlled clinical trial

Trials ◽

10.1186/s13063-020-04744-x ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Umesh Jayarajah ◽

Mahilal Wijekoon ◽

Sanjeewa A. Seneviratne

Keyword(s):

Quality Of Life ◽

Clinical Trial ◽

Thyroid Cancer ◽

Adverse Effects ◽

Differentiated Thyroid Cancer ◽

Radioactive Iodine ◽

Oral Prednisolone ◽

Single Centre ◽

Double Blinded

Abstract Background Radioactive iodine (RAI) therapy is the standard adjuvant treatment for differentiated thyroid cancer (i.e. papillary and follicular). RAI is associated with troublesome early, intermediate and late adverse effects. Although glucocorticoids are used for the management of these adverse effects, there is little evidence regarding the effectiveness of prophylactic glucocorticoids to prevent these complications. This trial will evaluate the efficacy of a short course of prophylactic glucocorticoids in the prevention of adverse effects of RAI treatment in patients with differentiated thyroid cancer. Methods A phase II/III, single-centre, randomized, double-blinded, placebo-controlled, parallel-arm clinical trial will be conducted. Patients with differentiated thyroid cancer who are referred to RAI therapy at the National Cancer Institute, Sri Lanka, will be randomized into two arms consisting of 200 patients each. The experimental group will receive prophylactic oral prednisolone 0.5 mg/kg and omeprazole 20 mg single dose 6 h before RAI therapy followed by oral prednisolone 0.5 mg/kg and omeprazole 20 mg daily for 3 days. The control group will receive oral placebo and omeprazole 20 mg single dose 6 h before RAI therapy followed by oral placebo and omeprazole 20 mg daily for 3 days. Clinically significant adverse effects assessed as related to RAI as well as prednisolone therapy and the quality of life parameters will be compared between the two groups. Discussion If proven beneficial, this intervention can be incorporated into the standard practice to reduce early and intermediate adverse effects of RAI for thyroid cancer with a potential improvement of quality of life. Trial registration Sri Lanka Clinical Trials Registry SLCTR/2020/009. Registered prospectively on 23 February 2020. Items of the WHO Trial Registration Data Set are provided in the supplementary file.

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Comparison of four strategies of follow-up in thyroid cancer patients: A cost-utility analysis

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.6606 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 6606-6606

Author(s):

G. de Pouvourville ◽

I. Borget ◽

M. Allyn ◽

M. Schlumberger

Keyword(s):

Quality Of Life ◽

Thyroid Cancer ◽

Diagnostic Accuracy ◽

Cancer Patients ◽

Cost Utility ◽

Cost Utility Analysis ◽

Whole Body ◽

Utility Analysis

6606 Background: In thyroid cancer patients, follow-up is designed to detect recurrent disease and consists of neck- ultrasonography (US), thyroglobulin measurement (Tg) and radioiodine whole body scan (WBS). Recent guidelines have restricted the use of WBS to suspicious cases. To insure diagnostic accuracy, follow-up control requires TSH stimulation, either with thyroid hormone withdrawal (THW) or rhTSH, which have demonstrated similar diagnostic accuracy. THW induces significant morbidity associated with hypothyroidism, leading to a decrease in patient quality of life and ability to work, whereas rhTSH is an innovative costly drug that avoids such patient burden. A societal cost-utility analysis was conducted to compare 4 follow-up strategies, combining a method of stimulation (rhTSH or THW) and a testing protocol (US+Tg+WBS or US+Tg alone). Methods: A Markov model was built to describe the follow-up of thyroid cancer patients first treated by thyroidectomy and radioiodine ablation, over 5 years. Estimates for diagnostic accuracy values and recurrence rate were extracted from a French multicenter randomized trial. Costs were computed from the perspective of the society, including medical resources consumed (hospitalisation, rhTSH, tests, treatment of recurrence). The model also incorporated the benefits of rhTSH in terms of quality of life (utility scores derived from SF36) and the reduction in duration and overall cost of sick leave. Results: Among the 753 patients included, 13 patients presented recurrence. rhTSH stimulation resulted in a higher utility score (0.802 vs. 0.637) over the period of stimulation and a reduction of 1083 € of absenteeism costs in active patients. As compared to the THW+Tg+US+WBS strategy, the incremental cost-utility ratios (ICER) showed economic dominance for the rhTSH strategies with ratios of −16,876 and −19,297 €/QALY with and without WBS respectively. The ICER for the strategy THW+US+Tg reached 29,333 €/QALY, as compared to THW+Tg+US+WBS strategy. Conclusions: the recommended strategy combining Tg determination and US after rhTSH stimulation appears the most cost-effective in the follow-up of thyroid cancer patients, as it is the strategy the less costly and associated with improved patient quality of life. No significant financial relationships to disclose.

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Peer review report 2 on "Quality of Life in Patients with Differentiated Thyroid Cancer. Qualitative Study."

International Journal of Surgery ◽

10.1016/j.ijsu.2018.03.020 ◽

2018 ◽

Vol 49 ◽

pp. 42

Author(s):

Paolo Aiello

Keyword(s):

Quality Of Life ◽

Thyroid Cancer ◽

Qualitative Study ◽

Peer Review ◽

Differentiated Thyroid Cancer

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Quality of Life and Anxiety in Adolescents with Differentiated Thyroid Cancer

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2012-1823 ◽

2012 ◽

Vol 97 (10) ◽

pp. E1933-E1937 ◽

Cited By ~ 10

Author(s):

Asaf Oren ◽

Melissa Anne Benoit ◽

Anne Murphy ◽

Fiona Schulte ◽

Jill Hamilton

Keyword(s):

Quality Of Life ◽

Thyroid Cancer ◽

Lymph Node ◽

Differentiated Thyroid Cancer ◽

Lymph Node Involvement ◽

Autoimmune Hypothyroidism ◽

Control Subjects ◽

Node Involvement ◽

Anxiety Levels

Abstract Context: Adolescents with differentiated thyroid cancer (DTC) require lifelong monitoring with a high possibility of reoperation or radioactive iodine. Although adult DTC survivors have similar or slightly worse quality of life (QOL), this has not been evaluated in the pediatric population. Objective: Our objective was to compare QOL and anxiety in adolescents with DTC to patients with acquired autoimmune hypothyroidism. Design, Setting, and Patients: In this cross-sectional pilot study, three validated questionnaires were administered to 16 adolescents with DTC and 16 controls for assessment of QOL and anxiety levels. These included teen and parent PedsQL, Multidimensional Anxiety Scale for Children, and Coddington Life Events Scales for Adolescents. The contribution of age, time since diagnosis, and biochemical variables were compared with the outcome measures. Results: There were 16 DTC patients (seven males); 13 had papillary carcinoma, one had follicular carcinoma, and two had mixed type. At diagnosis, five DTC patients had lymph node involvement and two had lung metastases, although at time of assessment, only one DTC patient had lymph node involvement. DTC patients were older than control subjects (P = 0.004) and had lower TSH levels than control subjects at time of assessment (P = 0.013). QOL and anxiety levels did not differ between DTC patients compared with control subjects and with previously reported scores in a healthy cohort. QOL and anxiety level parameters were not influenced by age, time since diagnosis, or free T4 levels measured at the time of assessment. Conclusions: Adolescents with DTC have similar QOL and anxiety levels compared with autoimmune hypothyroidism patients and with a healthy normative population.

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