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 Recombinant Human Thyroid Stimulating Hormone versus Thyroid Hormone Withdrawal for Radioactive Iodine Treatment of Differentiated Thyroid Cancer with Nodal Metastatic Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Robert M. Wolfson ◽  
Irina Rachinsky ◽  
Deric Morrison ◽  
Al Driedger ◽  
Tamara Spaic ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Metastatic Disease ◽  
Differentiated Thyroid Cancer ◽  
Radioactive Iodine ◽  
Thyroid Stimulating Hormone ◽  
Human Thyroid ◽  
Thyroid Hormone Withdrawal ◽  
Significant Difference ◽  
Stimulating Hormone

Introduction.Recombinant human thyroid stimulating hormone (rhTSH) is approved for preparation of thyroid remnant ablation with radioactive iodine (RAI) in low risk patients with well differentiated thyroid cancer (DTC). We studied the safety and efficacy of rhTSH preparation for RAI treatment of thyroid cancer patients with nodal metastatic disease.Methods.A retrospective analysis was performed on 108 patients with histopathologically confirmed nodal metastatic DTC, treated with initial RAI between January 1, 2000, and December 31, 2007. Within this selected group, 31 and 42 patients were prepared for initial and all subsequent RAI treatments by either thyroid hormone withdrawal (THW) or rhTSH protocols and were followed up for at least 3 years.Results.The response to initial treatment, classified as excellent, acceptable, or incomplete, was not different between the rhTSH group (57%, 21%, and 21%, resp.) and the THW group (39%, 13%, and 48%, resp.;P=0.052). There was no significant difference in the final clinical outcome between the groups. The rhTSH group received significantly fewer additional doses of RAI than the THW group (P=0.03).Conclusion.In patients with nodal-positive DTC, preparation for RAI with rhTSH is a safe and efficacious alternative to THW protocol.

scholarly journals Thyroid hormone and its metabolites in relation to quality of life in patients treated for differentiated thyroid cancer

2016 ◽  
Vol 85 (5) ◽  
pp. 781-788 ◽  
Author(s):  
E.T. Massolt ◽  
M. van der Windt ◽  
T.I.M. Korevaar ◽  
B.L.R. Kam ◽  
J.W. Burger ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Differentiated Thyroid Cancer

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.

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