scholarly journals Short-term hypothyroidism after Levothyroxine-withdrawal in patients with differentiated thyroid cancer: clinical and quality of life consequences

2007 ◽  
Vol 156 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Leonidas H Duntas ◽  
Bernadette Biondi
Keyword(s):  
Quality Of Life ◽  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Cardiovascular Effects ◽  
The Elderly ◽  
Differentiated Thyroid Carcinoma ◽  
Thyroid Hormone Withdrawal ◽  
Multiple Organs ◽  
Acute Hypothyroidism

Acute hypothyroidism induced by thyroid hormone withdrawal in patients with differentiated thyroid cancer during monitoring for remnant or metastatic disease, seriously affects multiple organs and systems, and especially in severe cases can impair quality of life. Indeed, it may induce untoward cardiovascular effects and can be hazardous in patients with underlying cardiovascular disease, particularly in the elderly. Moreover, acute hypothyroidism deranges the lipid profile and exacerbates neuropsychiatric illness. The introduction of recombinant human TSH (rhTSH) as a diagnostic and therapeutic tool in the care of patients with thyroid cancer has widened the scope of disease management. The use of rhTSH prevents derangement of various systems at approximately equivalent societal costs to that of withdrawal and promotes compliance while preserving the patient’s normal daily functioning and productivity. Its reliability allied with its safety render this compound a valid alternative in the monitoring of patients with differentiated thyroid carcinoma as well as providing an alternative therapeutic procedure whenever LT4-withdrawal may be hazardous or in cases of patient non-compliance.

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 The Effect of Thyroid Hormone Withdrawal, Performed to Evaluate the Success of I-131 Ablation on Quality of Life and Psychological Symptoms 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 ◽  
Side Effects ◽  
Treatment Response ◽  
Differentiated Thyroid Cancer ◽  
Psychological Symptoms ◽  
Thyroid Hormone Withdrawal ◽  
Sf 36

Abstract Purpose: There is a need to evaluate the treatment response in patients who have undergone radioiodine treatment (RIT) for differentiated thyroid cancer. Our study aimed to show thyroid hormone withdrawal (THW) effects 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 have referred a median of 9 months (6-13 months) after RIT to perform a diagnostic whole-body scan (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). There was a statistically significant worsening in anxiety, psychosis, additional items, and general symptom index symptoms with the SCL-90-R questionnaire, 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. Thyrotropin alfa is an alternative to reduce side effects, but it can be costly and difficult to obtain in developing countries. In order to reduce the side effects of hypothyroidism and avoid the high cost, treatment response assessment can be done only in selected patient groups.

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

2015 ◽  
Vol 42 (8) ◽  
pp. 1179-1188 ◽  
Author(s):  
Eva-Maria Gamper ◽  
Lisa M. Wintner ◽  
Margarida Rodrigues ◽  
Sabine Buxbaum ◽  
Bernhard Nilica ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Cancer ◽  
Cancer Patients ◽  
Differentiated Thyroid Cancer ◽  
Monitoring Programme

scholarly journals Quality of Life and Anxiety in Adolescents with Differentiated Thyroid Cancer

2012 ◽  
Vol 97 (10) ◽  
pp. E1933-E1937 ◽  
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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