Errors in the treatment of highly differentiated thyroid cancer as a multidisciplinary problem

Highly diﬀerentiated thyroid cancer is a common endocrine neoplasm with a favorable prognosis. However, errors in the treatment of this pathology can signiﬁcantly worsen the patient’s quality of life.Patient V., 65 years old, underwent an operation for papillary thyroid cancer with an injury to the recurrent laryngeal nerve in 2015. Only 6 months later, RAI therapy was performed with an insuﬃcient dose of RI, and levothyroxine was prescribed at a thyrotoxic dose, which led to the development of AF. Throughout the entire period after surgical treatment, biochemical remission could not be achieved, and in 2019, a control ultrasound scan revealed lymphadenopathy of the anterior cervical lymph nodes and metastases in the lungs.

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

Cancer Control ◽

10.1177/10732748211029726 ◽

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.

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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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SUN-416 Fatigue and Quality of Life Among Thyroid Cancer Survivors

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1830 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Maki Yukari

Keyword(s):

Quality Of Life ◽

Thyroid Cancer ◽

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Cancer Survivors ◽

Papillary Thyroid ◽

Explanatory Variables ◽

Initial Surgery ◽

Sf 36

Abstract BACKGROUND Fatigue among thyroid cancer survivors is an important issue that needs to be appreciated and managed appropriately. Although several studies have reported potential factors that might be related to postoperative fatigue, the associations have yet to be inconclusive. The purpose of the present study was to estimate the prevalence of clinical fatigue in patients with papillary thyroid carcinoma and to reveal predictive factors, including their quality of life. METHODS A cross-sectional survey was conducted on patients with papillary thyroid carcinoma. Patients who underwent non-curative surgery, or those with recurrent or metastatic PTC, or those with other malignancies were excluded. The primary outcome was fatigue measured by the Cancer Fatigue Scale (CFS), and the secondary outcome was quality of life (QoL) quantified using the SF-36 v2. The following explanatory variables were collected; gender, age, employment status, marital status, co-morbidities, time since initial surgery, types of surgery, replacement of thyroid hormone, use of radioactive iodine, and the level of thyrotropin. The prevalence of clinical fatigue was estimated with the cut-off value of 18/19 of the CFS score. Correlations between the CFS score and the explanatory variables were examined using uni-variable analyses as well as multi-variable analysis. RESULTS Three hundred twenty-one patients participated in the survey. Of them, 258 respondents (80%) were female. The median age was 58 years, and the median time from initial surgery was 6.4 years. The mean and the standard deviation of the CFS score were 17.9 and 9.3, respectively (range: 0-48). The prevalence of clinical fatigue was 42% [95%CI: 36-47%]. Among the variables explored, having a job and scores of the mental component summary, the physical component summary, and the role/social component summary of the SF-36 were inversely associated with the CFS score in both uni- and multivariable analyses. CONCLUSION Postoperative fatigue was common in thyroid cancer survivors. Patients with a job and better QoL, in particular, those with good mental health, maybe at low-risk of developing the burden.

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

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-015-3022-9 ◽

2015 ◽

Vol 42 (8) ◽

pp. 1179-1188 ◽

Cited By ~ 33

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

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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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