Thyroid Cancer 101: Most Q of L Issues Come from Surgery Complications and Radioiodine Therapy
1. There are many reasons to get second opinions before your thyroid surgery of radioiodine therapy for thyroid cancer.
2. This paper show the drop off in quality of life for thyroid cancer patients from postoperative hypocalcemia
, dysphonia, dysphagia, scar appearance
, and complications from radioactive iodine.
3. More aggressive treatments ( total thyroidectomies, and radioiodine) and greater treatment-related adverse effects are associated with worse HRQOL scores in thyroid cancer survivors.
4.Thyroid cancer survivors (n = 1,743) reported a high incidence of complications related to surgery and radioactive iodine ablation.
5.Post surgery voice changes and trouble swallowing were associated with decreased Quality of Life.
Vocal cord paralysis
6.Short- or long-term complications of radioactive iodine, including gastrointestinal symptoms (51.9%), appetite changes (71.2%), sialadenitis (58.1%),
and xerophthalmia (45.1%)
were associated with worse quality of life.
7. A second opinion can find you dont have cancer even though the biopsy was positive. There is a benign tumor called papillary thyroid cancer the past that is now a benign thyroid tumor( NIFT-P ). A less aggressive surgery ( lobectomy) is only needed for diagnosis.
8. Some cancers are too small and show no signs of invasion and can be treated without surgery or radioiodine. This is called active surveillance.
9. Some of these small cancers if the patient does not want to have it in their neck for years can have alternative treatment with ethanol or radiofrequency.
10.Thyroid cancers have different mutations. Some mutations ( RAS ) suggest a type that can be treated with simple lobectomy.
11. Only the most aggressive thyroid cancers need total and radioiodine.
12. Save yourself from a lifetime of complications and poor quality of life by seeing a thyroid expert before the surgery.
2019 Mar 18. pii: S0039-6060(19)30066-2. doi: 10.1016/j.surg.2019.01.034. [Epub ahead of print]
Clinical factors associated with worse quality-of-life scores in United States thyroid cancer survivors.
Thyroid cancer survivors are a rapidly growing population in the United States. The factors that drive health-related quality of life (HRQOL) in this population have not been well characterized. We hypothesized that more aggressive treatments and greater treatment-related adverse effects would be associated with worse HRQOL scores in thyroid cancer survivors.
Thyroid cancer survivors (18-89 years of age) completed an online survey regarding their clinical history in addition to the Patient-Reported Outcomes Measurement Information System (PROMIS) 29 instrument. Univariable and multivariable modeling were performed to evaluate factors associated with worse HRQOL scores. We generated β-values and 95% confidence intervals to quantify the effect of each independent variable in the model.
Thyroid cancer survivors (n = 1,743) reported a high incidence of complications related to surgery and radioactive iodine ablation. Postoperative dysphonia (ß 1.83-3.07) and dysphagia (ß 2.05-3.65) predicted worse HRQOL scores across multiple PROMIS domains. Younger patient age (age <45 years) and short- or long-term complications of radioactive iodine, including gastrointestinal symptoms (51.9%), appetite changes (71.2%), sialadenitis (58.1%), xerostomia (73.3%), and xerophthalmia (45.1%) were associated with worse HRQOL scores (P < .01).
The factors associated with significantly worse HRQOL scores across multiple PROMIS domains for thyroid cancer survivors included patient age <45 years, postoperative hypocalcemia, dysphonia, dysphagia, scar appearance, and complications from radioactive iodine. Methods of evaluation, management, and prevention of these factors might positively impact HRQOL.