scholarly journals Quality of Life in Patients With Low and Very Low Risk Differentiated Thyroid Cancer Who Underwent Thyroidectomy in Quito-Ecuador 2020

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A869-A869
Author(s):  
Stefany A Baquero ◽  
Dana M Hill
Keyword(s):  
Quality Of Life ◽  
Thyroid Cancer ◽  
San Francisco ◽  
Differentiated Thyroid Cancer ◽  
Emotional Health ◽  
Demographic Data ◽  
Public Health Problem ◽  
Low Risk

Abstract Low-risk papillary thyroid cancer (less than one centimeter and entrusting the thyroid) is a common pathology, over-diagnosed and therefore mainly over-treated in young women. Considered a public health problem mainly by two premises: 1) psycho-emotional involvement in people who suffer from it and undergo treatments; 2) and because unnecessary interventions are sometimes carried out that represent a futile cost to the health budget, especially for emerging economies such as the Ecuadorian. Objective: Demonstrate the affectation of the quality of life (QoL) after total thyroidectomy in patients with differentiated thyroid cancer of low and very low risk, who underwent surgery with or without adjuvant radioactive iodine treatment. In addition, to identify if variables such as gender, age, and sequelae of surgery such as hypoparathyroidism and scar influence QoL. M&M: A mixed study (qualitative-quantitative) was carried out, where information was collected electronically (via the whats app) and video call from 25 patients who have been affected by low and very low-risk thyroid cancer, in follow-up in the General Hospital San Francisco de Quito. After approval of the study by the teaching department and the ethics committee, we contacted the patients and asked for demographic data (age, gender); clinical data (use of levothyroxine, calcium); and they were also asked to fill out a self-applicable survey of the quality of life of the University of Washington (UW-Qol v.4). Subsequently, an interview with semi-structured questions was carried out and the participants were asked to make a graph of their neck. Results: In the UW-QoL v.4, it was shown that the physical aspects of quality of life, (chewing, swallowing, shoulder, speech, taste, and saliva) scored 90 points on average, did not present as much impact as the emotional aspects (pain, mood, activity, appearance, recreation, and anxiety) with an average of 83 points. In the interview and in the drawing it is corroborated that the emotional aspect where the appearance with the scar and the decrease in activity is included determine a worse quality of life. Neither gender nor age, nor the appearance of hypoparathyroidism determines a worse QoL. Discussion: The QoL for the WHO has elements that influence the physical and emotional health of a subject, their state of independence, and their social and environmental relationship. The study showed that QoL is affected with low and very low risk thyroid cancer on an emotional level, but not physically. This leads us to raise the possibility that differentiated thyroid cancer due to its low risk of mortality and recurrence in patients could be kept on follow-up and benefit from surgery only in the case that in active follow-up, it increased and became intermediate risk (ATA). Studies with a larger patient population are required to determine if support networks are an important parameter that affects QoL.

scholarly journals The Effect of Thyroid Hormone Withdrawal, Performed to Evaluate the Success of I-131 Ablation, On Quality of Life in Female Patients With Low-Risk Differentiated Thyroid Cancer

2021 ◽  
Author(s):  
Osman Kupik ◽  
Bayram Şen ◽  
Medeni Arpa ◽  
Levent Akça ◽  
Uğur Avcı ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Differentiated Thyroid Cancer ◽  
Psychological Symptoms ◽  
Thyroid Stimulating Hormone ◽  
Low Risk ◽  
Thyroid Hormone Withdrawal ◽  
Sf 36

Abstract Objective: There is a need to evaluate the treatment response in patients who have undergone radioiodine treatment (RIT) for differentiated thyroid cancerDiagnostic tests that are used for this purpose include radioiodine whole body scan (sWBS) and serum thyroglobulin (Tg) measurement which are most accurate during thyroid-stimulating hormone (TSH) stimulation. However temporary discontinuation of thyroid hormone therapy to increase TSH (withdrawal) may be associated with the morbidity of hypothyroidism The aim of our study was to show the effects of thyroid hormone withdrawal (THW), on quality of life and psychological symptoms in female patients with low-risk, well-differentiated papillary thyroid cancer. Methods: We applied the short form-36 (SF-36) and Symptom Checklist-90-R (SCL-90-R) questionnaires to the patients in the euthyroid state who were referred a median of 9 months (6-13 months) after RIT, to perform a dWBS and to evaluate stimulated Tg. We applied the same questionnaire again when thyroid-stimulating hormone (TSH) was > 30 μIU/mL 4 weeks after THW (hypothyroid state). We evaluated the changes in questionnaire scores using the paired-samples t test or the Wilcoxon signed rank test. Results: Our study included 52 patients (median age 48 years, range 23-65 years) with differentiated cancer. Forthy –two (%) of these patients received 3700 MBq I-131 wheras 7 (%) patients received 1850 MBq. . Ablation success based on the dWBS only was 96.2%, based on Tg only was 98% and based on thyroglobulin antibodies (TgAb) only was 88.5%. There was statistically significant worsening in anxiety, psychosis, additional items and general symptom index symptoms with the SCL-90-R questionnaire, and physical functioning, role limitation due to physical health, energy/fatigue, emotional well-being, social function, general health and health change with the SF-36 questionnaire. Conclusions: THW worsened the patients’ psychological symptoms and quality of life. Our findings show that stimulated Tg and the dWBS may have side effects that outweigh benefits in patients with low-risk differentiated thyroid cancer without TgAb interference and access to ultrasonography.

scholarly journals Longitudinal analysis of quality of life in patients treated for differentiated thyroid cancer

2019 ◽  
Vol 181 (6) ◽  
pp. 671-679 ◽  
Author(s):  
Evert F S van Velsen ◽  
Elske T Massolt ◽  
Hélène Heersema ◽  
Boen L R Kam ◽  
Tessa M van Ginhoven ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Cancer ◽  
General Population ◽  
Differentiated Thyroid Cancer ◽  
University Hospital ◽  
Cross Sectional ◽  
Initial Surgery ◽  
Over Time

Objective Earlier cross-sectional studies showed that patients with differentiated thyroid cancer (DTC) have a significant reduction of quality of life (QoL) compared to controls. However, recent longitudinal studies showed mixed results and had relative short follow-up or lacked knowledge about QoL before initial surgery. Therefore, we initiated a longitudinal study to assess changes of QoL in patients undergoing treatment for DTC. Methods We prospectively included patients, aged 18–80 years, who were treated for DTC at a Dutch university hospital. Using questionnaires, QoL was assessed before surgery, just before radioiodine (RAI) therapy, and regularly during follow-up. Repeated measurement analysis was used to assess changes of QoL over time, and we explored the influence of different characteristics on QoL. Results Longitudinal QoL assessments were available in 185 patients (mean age 47 years; 71% women). All patients were treated according to the Dutch guidelines with total thyroidectomy followed by RAI (83% after thyroid hormone withdrawal). Median time between baseline and final questionnaire was 31 months, and patients completed a median of three questionnaires. QoL at baseline was lower than that in the general population, developed non-linear over time, was lowest around RAI therapy, and recovered over time. Females, younger patients, and patients with persistent hypoparathyroidism had lower QoL scores. Conclusions In a population of DTC patients, QoL before initial therapy is already lower than that in the general population. Thereafter, QoL develops non-linearly over time in general, with the lowest QoL around RAI therapy, while 2 to 3 years later, it approximates baseline values.

scholarly journals Evaluation of Quality of Life Related to I-131 Therapy in Patients with Well-Differentiated Thyroid Cancer and Emphasis in Salivary Morbidity: A Follow up Study after Treatment

2014 ◽  
Vol 05 (05) ◽  
pp. 409-417 ◽  
Author(s):  
Lucélia Garcia Corrêa ◽  
Sônia Marta Moriguchi ◽  
Érica Boldrini ◽  
André Lopes de Carvalho ◽  
José Humberto Tavares Guerreiro Fregnani ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Follow Up Study ◽  
Well Differentiated

scholarly journals Health-Related Quality of Life in Asian Differentiated Thyroid Cancer Survivors

2021 ◽  
Vol 28 ◽  
pp. 107327482110297
Author(s):  
Wing-Lok Chan ◽  
Horace Cheuk-Wai Choi ◽  
Brian Lang ◽  
Kai-Pun Wong ◽  
Kwok-Keung Yuen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Cancer ◽  
Cancer Survivors ◽  
Differentiated Thyroid Cancer ◽  
Summary Score ◽  
Health Related Quality ◽  
Factors Associated ◽  
Related Quality ◽  
Health Related

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.

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

Thyroid ◽  
2004 ◽  
Vol 14 (2) ◽  
pp. 133-140 ◽  
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

scholarly journals Quality of Life, Thyroid Function and Type of Surgery in Low Risk Thyroid Cancer

2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Cohen MV ◽  
◽  
de Fátima Teixeira P ◽  
Vaisman M ◽  
Vaisman F ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Cancer ◽  
Total Thyroidectomy ◽  
Thyroid Function ◽  
Low Risk ◽  
Significant Difference ◽  
Eortc Qlq C30 ◽  
Eortc Qlq ◽  
Type Of Surgery

Background: Low risk thyroid cancer can be treated with lobectomy or total thyroidectomy. Studies have shown that the risk of recurrence does not differ between the two surgeries, although there are higher rates of complications with total thyroidectomy. Our study aimed to find if there were differences in quality of life and thyroid function in the two treatments. Methods: Low risk DTC survivors answered three QoL questionnaires (EQ5D3L, SF36, and EORTC QLQ C30) and had their thyroid function evaluated. Results: Twenty-six lobectomy patients and 101 total thyroidectomy were included. Hypoparathyroidism occurred more in the total thyroidectomy, and TSH was more likely to be on target (0.5-2.0) in lobectomy. There was no difference between groups regarding QoL, but there was a significant difference regarding thyroid function. In SF36 form, TSH off target led to more physical limitations, pain, less vitality, and worse social aspects. Abnormal total T3 level was associated with pain, less vitality, and worse mental health. In the EORTC QLQ C30, off target TSH led to worse role functioning, fatigue, and nausea. EQ5D form showed that worse utility index was found when TT3 was not in normal range. Conclusion: This study showed there was a difference among thyroid function, specially TSH depending on type of surgery. When uncontrolled, TSH was associated with worse aspects of the quality of life. Therefore, lobectomy patients have a better thyroid function control and less surgical complications which might have an impact in some aspects of the quality of life when compared to total thyroidectomy.

OS09.7.A Quality of life outcomes in patients with incidental and operated meningiomas: the QUALMS study

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii12-ii13
Author(s):  
S M Keshwara ◽  
A I Islim ◽  
C P Millward ◽  
C S Gillespie ◽  
G E Richardson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Global Health ◽  
Cognitive Functioning ◽  
Emotional Health ◽  
Health Score ◽  
Sf 36 ◽  
Eortc Qlq

Abstract BACKGROUND Long-term Health-Related Quality of Life (HRQoL) is an important measure of patient wellbeing. There is a paucity of studies evaluating HRQoL in meningioma patients. MATERIAL AND METHODS Cross-sectional study of adult patients with an incidental or symptomatic intracranial meningioma. Patients with less than 5 years of follow-up, a history of craniospinal radiation or neurofibromatosis type 2 were excluded. HRQoL was evaluated with SF-36, EORTC QLQ-C30 and EORTC QLQ-BN20 questionnaires. Outcome determinants were evaluated using a multi-variable linear regression analysis, adjusted for patient, tumour and treatment characteristics, and duration of follow-up. RESULTS 699 patients were invited to participate and 246 responded: 118 (48%) had an incidental meningioma. Mean age at diagnosis was 56.8 years (SD=13) and 81% were female. Median time from diagnosis to completion of questionnaire was 8.5 years (IQR 6.8–11.5). During follow-up, 158 patients (64.2%) had at least one operation for their meningioma and 47 patients (19.1%) had radiotherapy. Of those operated, 126 (79.7%) had WHO grade 1 and 24 (15.2%) had grade 2 meningiomas. Compared to normative population values, meningioma patients reported a worse SF-36 general health score (mean 61.9 vs 56.5, P=0.003) but a similar QLQ-C30 global health score (mean 62.3 vs 65.8, P=0.039), worse SF-36 and QLQ-C30 physical functioning scores (mean 74.1 vs 64.6, P<0.001 and mean 81.8 vs 76.5, P=0.007) and similar SF-36 and QLQ-C30 emotional health scores (mean 72.2 vs 70.9, P=0.367 and mean 71.0 vs 71.9, P=0.960). QLQ-C30 cognitive functioning was worse (mean 80.5 vs 71.4, P<0.001). Compared to the meningioma literature, QLQ-BN20 seizure burden was similar (mean 2.0 vs 1.6, P=0.760). A worse performance status at diagnosis was associated with an inferior QLQ-C30 global health score (β-coefficient=-4.9 [95% CI -9.1-(-)0.6] P=0.024). Number of surgeries was significantly associated with a worse QLQ-C30 cognitive functioning score (β-coefficient=-7.0 [95% CI -13.2-(-)0.9], P=0.025). Anti-epileptic drug use was associated with a significantly worse QLQ-C30 emotional health score (β-coefficient=-10.9 [95% CI -21.7-(-)0.01], P=0.050). CONCLUSION Meningioma patients have long-term HRQoL impairments affecting their physical and cognitive functions. An understanding that multiple surgeries affects cognitive function, and the need for anti-epileptic drugs equate to poorer emotional health, could help target appropriate therapies and support in the future.

scholarly journals 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 ◽  
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.

scholarly journals Quality of life in thyroid cancer patients: a literature review

2017 ◽  
Vol 90 (2) ◽  
pp. 147-153 ◽  
Author(s):  
Elena Bãrbuş ◽  
Claudiu Peştean ◽  
Maria Iulia Larg ◽  
Doina Piciu
Keyword(s):  
Quality Of Life ◽  
Thyroid Cancer ◽  
Literature Review ◽  
Psychological Impact ◽  
Solid Base ◽  
Emotional Impact ◽  
Free Access ◽  
Patients With Cancer

Introduction. Quality of life (QoL) has received increasing interest in the last years, especially in patients with cancer. This article aims to analyze a selection of medical research papers regarding the quality of life in patients with thyroid carcinoma. We overviewed the main QoL aspects derived from several studies and highlighted those less researched issues, which could represent a solid base for future clinical studies.Method. We used an integrative selection method of medical literature, choosing mostly "free access" studies, as it was considered that they could be easily viewed, searched and researched including by patients.Results. After an integrative literature review, we selected 16 relevant studies. Patients with thyroid cancer have several factors influencing their QoL, with both physical and psychological impact. The decisive factors are the quality of the surgical act, radioiodine therapy, follow-up using rh-TSH vs. hormonal withdrawal, access to behavioral help and the relationship with their physician.Conclusion. We must understand the emotional impact of the cancer diagnosis on the patient and we must collaborate in order to help the patient restore the psychosomatic balance and to recover the quality of life.

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