1
|
Thiagarajan S, Menon A, Panmand H, Bamane P, Pawar A. A prospective study to assess cervical scar satisfaction following conventional open thyroidectomy for thyroid cancer. Eur Arch Otorhinolaryngol 2024; 281:4363-4372. [PMID: 38676715 DOI: 10.1007/s00405-024-08668-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/08/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Conventional open thyroidectomy (COT) remains a common method of thyroidectomy in many parts of the world for various reasons. METHODS In this prospective (cross-sectional) study, we evaluated the scar satisfaction among patients and surgeons following COT using the Patient and Observer Scar Assessment Scale (POSAS) and the Patient Scar Assessment Questionnaire (PSAQ). RESULTS A total of 116 patients were included. The median age of the patients was 44 years and the majority were women. The median scar length overall was 12.2 cm. On POSAS, the median score for surgeon 1 was 1 (range 1-5), for surgeon 2, it was 2 (range 1-6), and for the patient, it was 1 (range 1-6) suggesting good scar satisfaction. The patient's response in the PSAQ was also echoing similar outcomes with scar satisfaction. CONCLUSIONS Overall, both the patients and the surgeons seem to be satisfied with the overall scar appearance following COT despite the scar length.
Collapse
Affiliation(s)
- Shivakumar Thiagarajan
- Division of Head & Neck, Department of Surgical Oncology, Homi Bhabha National Institute (HBNI), Tata Memorial Centre, Mumbai, India.
| | - Abhishek Menon
- Division of Head & Neck, Department of Surgical Oncology, Homi Bhabha National Institute (HBNI), Tata Memorial Centre, Mumbai, India
| | - Hrutika Panmand
- Department of Clinical Research, Homi Bhabha National Institute (HBNI), Tata Memorial Centre, Mumbai, India
| | - Pooja Bamane
- Department of Clinical Research, Homi Bhabha National Institute (HBNI), Tata Memorial Centre, Mumbai, India
| | - Akash Pawar
- Clinical Research Secretariate, Homi Bhabha National Institute (HBNI), Tata Memorial Centre, Mumbai, India
| |
Collapse
|
2
|
Banerjee S, Sharma S, Thakur A, Sachdeva R, Sharma R, Nepali K, Liou JP. N-Heterocycle based Degraders (PROTACs) Manifesting Anticancer Efficacy: Recent Advances. Curr Drug Targets 2023; 24:1184-1208. [PMID: 37946353 DOI: 10.2174/0113894501273969231102095615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/06/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023]
Abstract
Proteolysis Targeting Chimeras (PROTACs) technology has emerged as a promising strategy for the treatment of undruggable therapeutic targets. Researchers have invested a great effort in developing druggable PROTACs; however, the problems associated with PROTACs, including poor solubility, metabolic stability, cell permeability, and pharmacokinetic profile, restrict their clinical utility. Thus, there is a pressing need to expand the size of the armory of PROTACs which will escalate the chances of pinpointing new PROTACs with optimum pharmacokinetic and pharmacodynamics properties. N- heterocycle is a class of organic frameworks that have been widely explored to construct new and novel PROTACs. This review provides an overview of recent efforts of medicinal chemists to develop N-heterocycle-based PROTACs as effective cancer therapeutics. Specifically, the recent endeavors centred on the discovery of PROTACs have been delved into various classes based on the E3 ligase they target (MDM2, IAP, CRBN, and other E3 ligases). Mechanistic insights revealed during the biological assessment of recently furnished Nheterocyclic- based PROTACs constructed via the utilization of ligands for various E3 ligases have been discussed.
Collapse
Affiliation(s)
- Suddhasatwa Banerjee
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, 110031, Taiwan
| | - Sachin Sharma
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, 110031, Taiwan
| | - Amandeep Thakur
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, 110031, Taiwan
| | - Ritika Sachdeva
- College of Medicine, Taipei Medical University, Taipei, 110031, Taiwan
| | - Ram Sharma
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, 110031, Taiwan
| | - Kunal Nepali
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, 110031, Taiwan
- Ph.D. Program in Drug Discovery and Development Industry, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Jing Ping Liou
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, 110031, Taiwan
- Ph.D. Program in Drug Discovery and Development Industry, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
3
|
Lee J, Lee YJ, Lim DJ, Lee JM, Chang SA, Kim MH. Quality of Life of Survivors of Thyroid Cancer Is Not Inferior to That in Subjects without Cancer: Long-Term after Over 5 Years. Endocrinol Metab (Seoul) 2022; 37:664-673. [PMID: 36065647 PMCID: PMC9449106 DOI: 10.3803/enm.2022.1499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/04/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGRUOUND Patients with thyroid cancer undergo less extensive surgery and additional therapies compared to those with other cancers. We aimed to compare the quality of life (QoL) between patients with thyroid cancer and healthy subjects using representative data from Korea. Differences in QoL of thyroid cancer survivors according to the duration after cancer diagnosis was also evaluated. METHODS This population-based cohort study included 50,278 subjects who participated in the Korea National Health and Nutrition Examination Survey between 2007 and 2017. QoL was compared between patients with thyroid cancer and healthy subjects using self-reported data from the EuroQoL (EQ)-5 dimension (5D) and EQ-visual analog scale (VAS). Propensity score matching was used to match thyroid cancer survivors to healthy subjects (1:5 matching). RESULTS Linear regression with univariate analysis showed that the presence of thyroid cancer was positively correlated with better EQ-5D index scores (β-coefficient=0.010, p=0.046). After adjusting for multiple covariables, statistical significance was maintained. EQ-VAS fails to demonstrate any significant correlation. Among the EQ-5D categories, patients with thyroid cancer showed better self-care than healthy subjects. Thyroid cancer duration did not correlate with the EQ-5D index score. In subgroup analyses, compared to patients with thyroid cancer duration of <5 years, no significant difference was observed in the correlation between the EQ-5D index score and survival duration in those with thyroid cancer duration of 5 to 9 years and ≥10 years. CONCLUSION Using a large-scale nationwide population-based database, our study demonstrated better QoL, especially in terms of self-care, among thyroid cancer survivors than among healthy subjects without cancer.
Collapse
Affiliation(s)
- Jeongmin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Youn-Ju Lee
- Division of Biostatistics, Medical Excellence Inc., Seoul, Korea
| | - Dong-Jun Lim
- Division of Endocrinology and Metabolism, Seoul St. Mary’s hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung-Min Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang-Ah Chang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Corresponding author: Min-Hee Kim. Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 1021 Tongil-ro, Eunpyeong-gu, Seoul 03312, Korea Tel: +82-2-2030-4348, Fax: +82-2-2030-4641, E-mail:
| |
Collapse
|
4
|
Bach K, Prince S, Pitt SC, Robbins S, Connor NP, Macdonald C, Sippel RS, Long KL. Time Heals Most Wounds - Perceptions of Thyroidectomy Scars in Patients With Thyroid Cancer. J Surg Res 2022; 270:437-443. [PMID: 34798426 PMCID: PMC8712385 DOI: 10.1016/j.jss.2021.09.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/23/2021] [Accepted: 09/23/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Patients understandably have concerns about thyroidectomy scars. This study aimed to characterize patients' perceptions of their thyroidectomy scar before and up to 1-y after surgery. METHODS Patients with papillary thyroid cancer (n = 83) completed semi-structured interviews before and at 2-wks, 6-Wk, 6-mo, and 1-y post-thyroidectomy. Interviews probed about scar concerns and appearance. Content analysis was used to identify themes. RESULTS The majority of participants did not express concerns about scar appearance. When expressed, preoperative concerns often stemmed from previous surgery experiences or unease with neck incisions. Postoperatively, concerns about scar appearance decreased over time throughout the healing period with most patients being satisfied with their scar appearance by 6-mo after surgery. CONCLUSIONS Patients with papillary thyroid cancer express few concerns about scar thyroidectomy appearance. Surgeons can reassure patients who have preoperative concerns that most patients are satisfied with their scar appearance by 6-mo after surgery.
Collapse
Affiliation(s)
- Kathy Bach
- Division of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison Wisconsin USA, 53792
| | - Samantha Prince
- Division of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison Wisconsin USA, 53792
| | - Susan C. Pitt
- Division of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison Wisconsin USA, 53792
| | - Sarah Robbins
- Division of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison Wisconsin USA, 53792
| | - Nadine P. Connor
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison Wisconsin USA, 53792
| | - Cameron Macdonald
- Qualitative Health Research Consultants,111 King St #23, Madison Wisconsin USA 53703
| | - Rebecca S. Sippel
- Division of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison Wisconsin USA, 53792
| | - Kristin L. Long
- Division of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison Wisconsin USA, 53792
| |
Collapse
|
5
|
Lee SY, Shin JH. Experiences of Korean patients with Thyroid Cancer Receiving Radioactive Iodine Therapy after Total Thyroidectomy. Asia Pac J Oncol Nurs 2021; 9:161-166. [PMID: 35494094 PMCID: PMC9052837 DOI: 10.1016/j.apjon.2021.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022] Open
Abstract
Objective South Korea has a high incidence of thyroid cancer. This study aimed to describe and understand the nature of the experience of Korean patients with thyroid cancer undergoing radioactive iodine treatment after total thyroidectomy through an in-depth investigation of their experience. Methods Individual interviews using open questions were conducted with 22 participants living in South Korea. All were audio-recorded and transcribed verbatim. This study used the phenomenological analysis method proposed by Colaizzi to determine the essential subjects verified according to the four reliability criteria proposed by Guba and Lincoln. Results Three categories, 6 theme clusters, and 13 themes emerged from the study. The three categories identified were “broken life,” “solitude in a crowd,” and “positive changes in values.” The six theme clusters were “anxiety about death,” “an imperfect being,” “feeling social isolation,” “struggling alone,” “an active attitude toward life,” and “life support.” The themes that emerged the most were related to physical and psychological difficulties. Of the 13 themes, four themes were related to family-oriented values and culture. Conclusions This study suggests that nursing interventions are required to reduce the physical and psychological symptoms of Korean patients with thyroid cancer. It is necessary to build a support system with the patient's family members to consider family-oriented values and culture.
Collapse
|
6
|
Liu YH, Jin J, Liu YJ. Machine learning-based random forest for predicting decreased quality of life in thyroid cancer patients after thyroidectomy. Support Care Cancer 2021; 30:2507-2513. [PMID: 34782918 DOI: 10.1007/s00520-021-06657-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/24/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Decreased quality of life (QoL) in thyroid cancer patients after thyroidectomy is a common, but there is a lack of predictive methods for decreased QoL. This study aimed to construct a machine learning-based random forest for predicting decreased QoL in thyroid cancer patients 3 months after thyroidectomy. MATERIALS AND METHODS Two hundred and eighty-six thyroid cancer patients after thyroidectomy were enrolled in this prospective cross-sectional study from November 2018 to June 2019, and were randomly assigned to training and validation cohorts at a ratio of 7:3. The European Organization for Research and Treatment of Cancer quality of life questionnaire version 3 (EORTC QLQ-C30) questionnaire was used to assess the QoL 3 months after thyroidectomy, and decreased QoL was defined as EORTC QLQ-C30 < 60 points. The random forest model was constructed for predicting decreased QoL in thyroid cancer patients after thyroidectomy. RESULTS The mean QoL 3 months after thyroidectomy was 65.93 ± 9.00 with 21.33% (61/286) decreased QoL. The main manifestation is fatigue in symptom scales and social functioning dysfunction in functional scales. The top seven most important indices affecting QoL were clinical stage, marital status, histological type, age, nerve injury symptom, economic income and surgery type. For random forest prediction model, the areas under the curve in the training and validation courts were 0.834 and 0.897, respectively. CONCLUSION The present study demonstrated that random forest model for predicting decreased QoL in thyroid cancer patients 3 months after thyroidectomy displayed relatively high accuracy. These findings should be applied clinically to optimise health care.
Collapse
Affiliation(s)
- Yong Hong Liu
- Department of Breast Surgery, The Fourth Hospital of Hebei Medical University, No. 169 Tianshan Street, Shijiazhuang City, 050011, China
- Thyroid and Breast Surgery, Cangzhou Central Hospital, No. 16 Xinhua Road, Yunhe Qu, Cangzhou City, 061000, China
| | - Jian Jin
- Thyroid and Breast Surgery, Cangzhou Central Hospital, No. 16 Xinhua Road, Yunhe Qu, Cangzhou City, 061000, China
| | - Yun Jiang Liu
- Department of Breast Surgery, The Fourth Hospital of Hebei Medical University, No. 169 Tianshan Street, Shijiazhuang City, 050011, China.
| |
Collapse
|
7
|
Walshaw EG, Smith M, Kim D, Wadsley J, Kanatas A, Rogers SN. Systematic review of health-related quality of life following thyroid cancer. TUMORI JOURNAL 2021; 108:291-314. [PMID: 34387109 PMCID: PMC9310144 DOI: 10.1177/03008916211025098] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This systematic review provides a summary of all studies published between 2000 and 2019 using a health-related quality of life (HRQOL) patient-completed questionnaire to report outcomes following diagnosis and treatment of thyroid cancer. The search terms were “thyroid cancer” or “thyroid carcinoma,” “quality of life” or “health related quality of life,” and “questionnaire” or “patient reported outcome.” EMBASE, PubMed, Medline, PsycINFO, CINAHL, and HaNDLE-On-QOL search engines were searched between 2 February and 23 February 2020. A total of 811 identified articles were reduced to 314 when duplicates were removed. After exclusion criteria (not thyroid specific, no quality of life questionnaires, and conference abstracts) were applied, 92 remained. Hand searching identified a further 2 articles. Of the 94 included, 16 had a surgical, 26 a primarily medical, and 52 a general focus. There were articles from 27 countries. A total of 49 articles were published from 2015 through 2019 inclusive. A total of 72 questionnaires were used among the articles and a range of 7 to 2215 participants were included within each article. This review demonstrated an increasing number of publications annually. The scope of enquiry into aspects of HRQOL following thyroid cancer is broad, with relatively few addressing surgical aspects and many focusing on the impact of radio-iodine. More research is required into shared decision-making in initial management decisions and HRQOL and interventions aimed specifically at addressing long-term HRQOL difficulties.
Collapse
Affiliation(s)
| | - Mike Smith
- Dental student, Liverpool University, Liverpool, UK
| | - Dae Kim
- Consultant ENT and head & neck surgeon, St George's University Hospital, London, UK
| | - Jonathan Wadsley
- Consultant clinical oncologist, Weston Park Cancer Centre, Sheffield, UK
| | - Anastasios Kanatas
- Oral and maxillofacial surgery consultant, Leeds Teaching Hospitals and St James Institute of Oncology, Leeds Dental Institute and Leeds General Infirmary, Leeds, UK
| | - Simon N Rogers
- Faculty of Health and Social Care, Edge Hill University, Liverpool, UK.,Consultant, Liverpool Head and Neck Centre, Liverpool University Hospital, Liverpool, UK
| |
Collapse
|
8
|
Rossi AM, Hibler BP, Navarrete-Dechent C, Lacouture ME. Restorative oncodermatology: Diagnosis and management of dermatologic sequelae from cancer therapies. J Am Acad Dermatol 2020; 85:693-707. [PMID: 32781177 DOI: 10.1016/j.jaad.2020.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/13/2020] [Accepted: 08/01/2020] [Indexed: 12/19/2022]
Abstract
The long-term survival of patients with cancer has risen dramatically during the last few decades. Despite this remarkable success, the same treatments that have enabled cure or remission often secondarily affect the skin, hair, and nails. Conditions including scarring, striae distensae, persistent alopecia, pigmentary changes, nail alterations, chronic radiation dermatitis, and radiation fibrosis have been associated with anxiety, depression, decreased quality of life, and impaired function. These dermatologic changes are cosmetically disfiguring, may limit activities, and are a visual reminder of past illness. Interventions toward improving these untoward sequelae and restoring the appearance and function of skin and appendages are critical for normalization and may contribute to improved quality of life in cancer survivors. Here, we outline dermatologic sequelae of cancer therapies with a review of medical and procedural treatment strategies to restore dermatologic health in the survivorship population.
Collapse
Affiliation(s)
- Anthony M Rossi
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Dermatology, Weill Cornell Medicine, New York, New York.
| | - Brian P Hibler
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mario E Lacouture
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Dermatology, Weill Cornell Medicine, New York, New York
| |
Collapse
|
9
|
Hughes DT, Reyes-Gastelum D, Kovatch KJ, Hamilton AS, Ward KC, Haymart MR. Energy level and fatigue after surgery for thyroid cancer: A population-based study of patient-reported outcomes. Surgery 2019; 167:102-109. [PMID: 31582311 DOI: 10.1016/j.surg.2019.04.068] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/14/2019] [Accepted: 04/08/2019] [Indexed: 01/17/2023]
Abstract
INTRODUCTION The relationship between treatment for differentiated thyroid cancer and patient-report of decreased energy and fatigue remains unclear. METHODS Patients diagnosed with differentiated thyroid cancer from 2014 to 2015 included in the Georgia and Los Angeles, California cancer registries of the Surveillance, Epidemiology, and End Results program were surveyed 2 to 4 years after diagnosis, and responses were linked to data from the Surveillance, Epidemiology, and End Results registry. Multivariable logistic regression analysis determined characteristics associated with the report of worse energy level at 2 to 4 years compared to before treatment and current fatigue severity using adjusted odds ratios with 95% confidence intervals. RESULTS Of the 2,584 respondents, 988 (38.2%) reported much worse or somewhat worse energy and 1,310 (50.7%) reported moderate to very severe fatigue. The majority of patients were treated with total thyroidectomy with or without nodal dissection (total thyroidectomy with lymph node removal [49.3%] or total thyroidectomy [38.3%]). Only 12.3% had a thyroid lobectomy. Just over half were treated with radioactive iodine therapy (56.7%) and thyroid hormone suppression (50.2%) after the thyroidectomy. Younger age, history of depression, thyroid hormone suppression (odds ratio 1.48 [confidence interval 1.21-1.82]), and receipt of radioiodine (odds ratio 1.31 [confidence interval 1.10-1.56]) correlated with worse energy. Similarly, correlates of substantial fatigue included younger age, more comorbidities, history of depression, and thyroid hormone suppression (odds ratio 1.63 [confidence interval 1.34-1.99]). The presence of low serum calcium levels for >3 months after thyroidectomy was associated with worse energy (odds ratio 1.26 [confidence interval 1.02-1.54]) and substantial fatigue (odds ratio 1.49 [confidence interval 1.21-1.84]). CONCLUSION In addition to accepted risk factors such as depression and comorbidities, receiving radioactive iodine and reporting low calcium after thyroidectomy for differentiated thyroid cancer were associated with reports of worse energy compared to preoperative levels; thyroid hormone suppression was associated with reports of both worse energy and substantial post-treatment fatigue.
Collapse
Affiliation(s)
- David T Hughes
- Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI.
| | - David Reyes-Gastelum
- Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI
| | - Kevin J Kovatch
- Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI
| | - Ann S Hamilton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Kevin C Ward
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Megan R Haymart
- Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI
| |
Collapse
|
10
|
Overall Survival and Complications of Thyroidectomy in Patients with Thyroid Cancer. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2017. [DOI: 10.5812/ijcm.10931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
11
|
Typologies for Restructuring Relationships in Cancer Survivorship: Temporal Changes in Social Support and Engagement With Self-Management Practices. Cancer Nurs 2017; 41:E32-E40. [PMID: 28953505 DOI: 10.1097/ncc.0000000000000538] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cancer survivors with good social support are generally more motivated to undertake self-management behaviors and make lifestyle changes. However, the impact of changes in social support over time, from prediagnosis through treatment and into survivorship, on the health and recovery of cancer survivors with a range of cancer diagnoses has not been explored. OBJECTIVE The aim of this study was to examine how temporal changes in social support offered to cancer survivors by family and friends influence their engagement with self-management practices and adaptation to lifestyle changes. METHODS The interview study took place in a teaching hospital in the West Midlands, United Kingdom. Forty participants were purposively sampled. A narrative approach to data collection was chosen, and data were thematically analyzed. RESULTS Six typologies of restructuring relationships postcancer were identified. A greater understanding of the changes to social relationships that a cancer diagnosis can incur and the impact of this on people's outlook and ability to self-manage was developed. CONCLUSION The restructuring of social relationships by cancer survivors over time can impact their outlook and ability to self-manage in survivorship, shaping their engagement with health promoting activities and reconciling cancer within the wider context of their lives. IMPLICATIONS FOR PRACTICE Appropriate clinical nursing processes and tailored interventions are required to support cancer survivors and promote engagement with self-management practices. Nurses are a vital component of the social support that enables patients to make the best health and lifestyle choices available to them.
Collapse
|
12
|
Singer S, Husson O, Tomaszewska IM, Locati LD, Kiyota N, Scheidemann-Wesp U, Hofmeister D, Winterbotham M, Brannan C, Araújo C, Gamper EM, Kulis D, Rimmele H, Andry G, Licitra L. Quality-of-Life Priorities in Patients with Thyroid Cancer: A Multinational European Organisation for Research and Treatment of Cancer Phase I Study. Thyroid 2016; 26:1605-1613. [PMID: 27605136 DOI: 10.1089/thy.2015.0640] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND The objectives of this study were to determine quality of life (QoL) issues that are relevant to thyroid cancer patients cross-culturally, and to identify those with highest relevance to them in addition to the more general issues covered by the core European Organisation for Research and Treatment of Cancer QoL questionnaire (EORTC QLQ-C30). METHODS A systematic literature search provided a list of potentially relevant QoL issues to supplement the core questionnaire EORTC QLQ-C30, which is widely used in research and in care and addresses QoL issues relevant to all groups of cancer patients. A panel of experts revised this list, and thyroid cancer patients rated the issues regarding their relevance for QoL by selecting the 25 issues that they would include in a thyroid cancer-specific QoL module. RESULTS The literature search and expert discussion provided a list of 71 QoL issues that was rated by thyroid cancer patients (n = 110) from seven countries. All issues were of high priority to at least some of the patients. The most frequently selected issues were sudden attacks of tiredness, exhaustion, quality of sleep, employment, social support, fear of cancer progression, fear of second operation, difficulties swallowing, and globus sensation. CONCLUSIONS Thyroid cancer patients cross-culturally rate fatigue-related issues as highly important for their QoL, calling for increased efforts to find successful treatments for this problem. Vocational rehabilitation is also highly relevant for them and should therefore be an important aim of multidisciplinary care. The third important area of concern is psychological issues, especially fear of progression and of additional treatments.
Collapse
MESH Headings
- Adenocarcinoma, Follicular/pathology
- Adenocarcinoma, Follicular/rehabilitation
- Adenocarcinoma, Follicular/therapy
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Medullary/pathology
- Carcinoma, Medullary/therapy
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Neuroendocrine/therapy
- Carcinoma, Papillary/pathology
- Carcinoma, Papillary/rehabilitation
- Carcinoma, Papillary/therapy
- Combined Modality Therapy/adverse effects
- Cross-Cultural Comparison
- Europe
- Fatigue/etiology
- Fatigue/prevention & control
- Female
- Humans
- Internationality
- Male
- Middle Aged
- Neoplasm Staging
- Quality of Life
- Rehabilitation, Vocational
- Self Report
- Thyroid Cancer, Papillary
- Thyroid Neoplasms/pathology
- Thyroid Neoplasms/rehabilitation
- Thyroid Neoplasms/therapy
- Voluntary Health Agencies
Collapse
Affiliation(s)
- Susanne Singer
- 1 Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz , Mainz, Germany
| | - Olga Husson
- 2 CoRPS-Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University , Tilburg, The Netherlands
| | - Iwona M Tomaszewska
- 3 Department of Medical Education, Jagiellonian University Medical College , Krakow, Poland
| | - Laura D Locati
- 4 Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori , Milan, Italy
| | - Naomi Kiyota
- 5 Department of Medical Oncology and Hematology, Kobe University Hospital , Kobe, Japan
| | - Ulrike Scheidemann-Wesp
- 1 Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz , Mainz, Germany
| | - Dirk Hofmeister
- 6 Department of Medical Psychology and Medical Sociology, University Medical Centre , Leipzig, Germany
| | | | | | - Cláudia Araújo
- 8 Service of Surgical Oncology, Instituto Português de Oncologia do Porto Francisco Gentil , Porto, Portugal
| | - Eva M Gamper
- 9 Department of Nuclear Medicine and Department of Psychiatry and Psychotherapy, Medical University of Innsbruck , Innsbruck, Austria
| | - Dagmara Kulis
- 10 Translation Unit, European Organisation for Research and Treatment of Cancer (EORTC) Headquarters , Brussels, Belgium
| | - Harald Rimmele
- 11 National Association of Thyroid Cancer Patients "Bundesverband Schilddrüsenkrebs-Ohne Schilddrüse leben e.V.," Berlin, Germany
| | - Guy Andry
- 12 Surgery Department, Jules Bordet Institute , Brussels, Belgium
| | - Lisa Licitra
- 4 Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori , Milan, Italy
| |
Collapse
|
13
|
Park KA, Oh YJ, Kim KM, Eum SY, Cho MH, Son YH, Park SH, Woo KM, Lee YS, Kim S, Chang HS, Park CS. Navigation programs, are they helpful for perioperative care with thyroid cancer patients? Eur J Cancer Care (Engl) 2016; 26. [PMID: 27726224 DOI: 10.1111/ecc.12592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2016] [Indexed: 12/23/2022]
Abstract
The purpose of this study was to develop and evaluate a navigation program for patients with thyroid cancer. The navigation program was developed following an analysis of the unmet needs of patients who underwent surgery for thyroid cancer. Ninety-nine patients in the control group received usual care, and 95 in the navigation group were managed with a navigation program during the perioperative period. The effectiveness of the navigation program was assessed by administering a questionnaire to both groups. Overall satisfaction scores were significantly higher in the navigation than in the control group (p = .025), as were satisfaction scores on the continuity of information (p < .001), the continuity of management (p = .002), the continuity of relationships with healthcare providers (p<.001), and patient empowerment (p < .001). The newly developed navigation program for patients with thyroid cancer was effective in raising satisfaction levels and in actively managing the disease during the perioperative period.
Collapse
Affiliation(s)
- K A Park
- Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea.,Division of Nursing, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - Y J Oh
- Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea.,Division of Nursing, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - K M Kim
- Division of Nursing, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - S Y Eum
- Division of Nursing, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - M H Cho
- Division of Nursing, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - Y H Son
- Division of Nursing, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - S H Park
- Division of Nursing, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - K M Woo
- Division of Nursing, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - Y S Lee
- Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - S Kim
- Department of Clinical Nursing Science & Mo Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Korea
| | - H-S Chang
- Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - C S Park
- Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea
| |
Collapse
|
14
|
Hyun YG, Alhashemi A, Fazelzad R, Goldberg AS, Goldstein DP, Sawka AM. A Systematic Review of Unmet Information and Psychosocial Support Needs of Adults Diagnosed with Thyroid Cancer. Thyroid 2016; 26:1239-50. [PMID: 27350421 DOI: 10.1089/thy.2016.0039] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Patient education and psychosocial support to patients are important elements of comprehensive cancer care, but the needs of thyroid cancer survivors are not well understood. METHODS The published English-language quantitative literature on (i) unmet medical information and (ii) psychosocial support needs of thyroid cancer survivors was systematically reviewed. A librarian information specialist searched seven electronic databases and a hand search was conducted. Two reviewers independently screened citations from the electronic search and reviewed relevant full-text papers. There was consensus between reviewers on the included papers, and duplicate independent abstraction was performed. The results were summarized descriptively. RESULTS A total of 1984 unique electronic citations were screened, and 51 full-text studies were reviewed (three from the hand search). Seven cross-sectional, single-arm, survey studies were included, containing data from 6215 thyroid cancer survivor respondents. The respective study sizes ranged from 57 to 2398 subjects. All of the studies had some methodological limitations. Unmet information needs were variable relating to the disease, diagnostic tests, treatments, and co-ordination of medical care. There were relatively high unmet information needs related to aftercare (especially long-term effects of the disease or its treatment and its management) and psychosocial concerns (including practical and financial matters). Psychosocial support needs were incompletely met. Patient information on complementary and alternative medicine was very limited. CONCLUSIONS In conclusion, thyroid cancer survivors perceive many unmet information needs, and these needs extend to aftercare. Psychosocial information and supportive care needs may be insufficiently met in this population. More work is needed to improve knowledge translation and psychosocial support for thyroid cancer survivors.
Collapse
Affiliation(s)
- Yong Gyu Hyun
- 1 Department of Volunteer Resources, University Health Network, Toronto, Canada
| | - Ahmad Alhashemi
- 2 Clinical Endocrinology Fellowship, Division of Endocrinology, Department of Medicine, University of Toronto , Toronto, Canada
| | - Rouhi Fazelzad
- 3 University Health Network Library and Information Services , Princess Margaret Cancer Centre, Toronto, Canada
| | - Alyse S Goldberg
- 2 Clinical Endocrinology Fellowship, Division of Endocrinology, Department of Medicine, University of Toronto , Toronto, Canada
| | - David P Goldstein
- 4 Department of Otolaryngology-Head and Neck Surgery, University Health Network and University of Toronto , Toronto, Canada
| | - Anna M Sawka
- 5 Division of Endocrinology, Department of Medicine, University Health Network and University of Toronto , Toronto, Canada
| |
Collapse
|
15
|
Robinson-Smith G, Harmer C, Sheeran R, Bellino Vallo E. Couples' Coping After Stroke-A Pilot Intervention Study. Rehabil Nurs 2015; 41:218-29. [PMID: 25865578 DOI: 10.1002/rnj.213] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2015] [Indexed: 11/10/2022]
Abstract
PURPOSE This mixed-methods pilot study examined the impact of a psychoeducational intervention (PEI) to expand coping skills and identify themes for focused nursing strategies to assist poststroke couples. DESIGN Outcome variables, including dyadic coping, quality of life, depression, and self-care self-efficacy, were measured in experimental and control groups initially and after PEI was created with experimental couples in six home sessions. METHOD Repeated measures analysis of variance compared control (n = 5 stroke survivors; n = 5 spouses) and experimental groups' (n = 5 stroke survivors; n = 5 spouses) on outcomes. FINDINGS Significant increase occurred in experimental group stroke survivors in coping by oneself and quality of life; depressive symptoms decreased. Significant increase in positive dyadic coping occurred for experimental group spouses. PEI intervention generated a major theme. CONCLUSIONS Nurse-initiated cognitive coping intervention was supported by experimental group's elements. CLINICAL RELEVANCE Nurses may use psychoeducational techniques to motivate stroke couples.
Collapse
Affiliation(s)
| | | | - Robin Sheeran
- Bryn Mawr Rehabilitation Hospital, Main Line Health System, Malvern, PA, USA
| | | |
Collapse
|
16
|
Rosato L, Pacini F, Panier Suffat L, Mondini G, Ginardi A, Maggio M, Bosco MC, Della Pepa C. Post-thyroidectomy chronic asthenia: self-deception or disease? Endocrine 2015; 48:615-20. [PMID: 25033997 DOI: 10.1007/s12020-014-0353-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 06/28/2014] [Indexed: 02/05/2023]
Abstract
There is clinical evidence that post-total thyroidectomy (TT) patients can present persistent asthenia. The aim of this study was to evaluate the prevalence of asthenia symptoms in such patients, assess whether a chronic asthenia syndrome could be caused by TT or become evident after it. An observational study was carried out comparing two groups of 100 patients each, all with homogeneous characteristics. Group A was treated with total lobectomy (TL), Group B with TT. All patients presented normal thyroid hormone levels. The patients were interviewed in order to identify the ones affected by post-operative asthenia persisting for at least six months, with reduced ability to perform physical and mental work, not showing improvement with rest. The severity of the symptoms has been measured by means of the brief fatigue inventory (BFI). Statistical analysis was performed to evaluate statistically significative differences between groups and prognostic factors in TT group. The incidence of post-operative asthenia was 0 % after TL and 25 % after TT, with the operation being the only significant variable. Asthenia is well known as symptom of post-thyroidectomy, but it has not been adequately investigated as consequence of surgery. We demonstrated that the complete removal of the thyroid gland could determine chronic post-thyroidectomy asthenia, although with intensity limited to low/moderate. Post-thyroidectomy asthenia is a relevant sequela interfering with quality of life of at least 25 % of patients operated, suggesting the need to identify its real causes and limit the indication to TT only when strictly required.
Collapse
Affiliation(s)
- Lodovico Rosato
- Department of Surgery - Endocrine Surgical Unit, Ivrea Hospital, School of Medicine, ASL TO4, University of Turin, Turin, Italy
| | | | | | | | | | | | | | | |
Collapse
|
17
|
To J, Goldberg AS, Jones J, Zhang J, Lowe J, Ezzat S, Gilbert J, Zahedi A, Segal P, Sawka AM. A systematic review of randomized controlled trials for management of persistent post-treatment fatigue in thyroid cancer survivors. Thyroid 2015; 25:198-210. [PMID: 25382050 DOI: 10.1089/thy.2014.0418] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Fatigue that persists post-treatment is commonly reported by thyroid cancer (TC) survivors. METHODS A systematic review of published English language randomized controlled trials (RCTs) on interventions for management of persistent post-treatment fatigue in TC was conducted. This review excluded studies on short-term interventions used in preparation for radioactive iodine diagnostic scans or treatment. An electronic search was executed in six databases and supplemented by a hand search. Two reviewers independently reviewed all citations from the electronic search and relevant full-text studies. Two abstractors independently critically appraised included studies and abstracted the data. The data were qualitatively summarized. RESULTS A total of 1086 unique citations and 25 full-text studies were reviewed. Four studies summarizing the results of three RCTs were included. The interventions included: combination triiodothyronine with levothyroxine (L-T4) therapy compared to L-T4 alone (one RCT), reduction in degree of thyrotropin (TSH) suppression using L-T4 compared to maintenance of TSH suppression (one RCT), and supervised exercise compared to inactivity (two RCTs examining different fatigue outcomes in same population). Trial duration ranged from 10 weeks to six months. All trials had limitations, and the number of TC survivors included in respective RCTs ranged from 15 to 36. Hormonal treatment RCTs had mixed fatigue outcome results within respective trials. However, multiple measures suggesting improvement in fatigue were reported following the exercise intervention. CONCLUSIONS There is paucity of RCTs to guide evidence-based management of persistent post-treatment fatigue in TC survivors. RCTs of interventions for prevention or treatment of fatigue in TC survivors are needed.
Collapse
Affiliation(s)
- Joshua To
- 1 Department of Psychology, University of Waterloo , Waterloo, Canada
| | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Gallop K, Kerr C, Simmons S, McIver B, Cohen EEW. A qualitative evaluation of the validity of published health utilities and generic health utility measures for capturing health-related quality of life (HRQL) impact of differentiated thyroid cancer (DTC) at different treatment phases. Qual Life Res 2014; 24:325-38. [PMID: 25106505 DOI: 10.1007/s11136-014-0776-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2014] [Indexed: 01/22/2023]
Abstract
PURPOSE This study explored the impact of differentiated thyroid cancer (DTC) on health-related quality of life (HRQL) at different treatment phases and evaluated the validity of published DTC utilities and generic health utility measures (EQ-5D and SF-6D) for economic evaluation of treatments for radio-iodine (RAI) refractory DTC. METHODS Focus groups and interviews were conducted with DTC patients grouped by treatment phase. Qualitative thematic analysis was conducted on interview/focus group transcripts. A thematic coding framework was developed to compare experiences between treatment phases and inform development of a conceptual model. Model concepts were mapped to EQ-5D and SF-6D domains/items. RESULTS Eight focus groups and 11 individual interviews were conducted with 52 DTC patients. Fifty symptoms and HRQL concepts were identified. The impact of DTC and DTC treatment on emotional and cognitive functioning was reported across the treatment phases. The impact on daily activities, mobility, and energy levels was greatest for patients with recurring/persistent or RAI-refractory DTC. Of the 50 concepts, 25 and 27 mapped directly onto domains/items in the EQ-5D and SF-6D, respectively. The SF-6D covered a broader range of DTC impact on emotional/physical problems and daily/social activities than did the EQ-5D. CONCLUSIONS The conceptual model summarizes the wide-ranging impact of DTC and its treatment on patients' HRQL, particularly for those with recurring/persistent or RAI-refractory DTC. Findings suggest that published DTC utilities lack validity for RAI-refractory DTC and that the SF-6D may be more sensitive to HRQL impact of DTC than the EQ-5D.
Collapse
Affiliation(s)
- Katy Gallop
- ICON Patient Reported Outcomes, Seacourt Tower, West Way, Oxford, OX2 0JJ, UK
| | | | | | | | | |
Collapse
|
19
|
Dimov RS. The effect of neck dissection on quality of life in patients with differentiated thyroid cancer. Gland Surg 2014; 2:219-26. [PMID: 25083486 DOI: 10.3978/j.issn.2227-684x.2013.10.06] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 10/18/2013] [Indexed: 11/14/2022]
Abstract
Cervical lymph node metastases are very common in patients with differentiated thyroid cancer (DTC). The overall long term survival rate in patients with DTC is higher than 90%, with variations in subsets of groups. Despite that DTC has an excellent prognosis, lymphatic spread is associated with increased risk of loco-regional recurrence, which significantly impairs quality-of-life (QOL) and can alter prognosis of the patient. As a result, a rapid shift in patient care from a focus on overall survival to a focus on recurrence-free survival has recently noted. The appropriate lymph node dissection is of great importance in order to achieve this goal. This surgical strategy will prevent disease recurrence, which may require an additional and more morbid surgery. Traditionally, the main outcome measure in oncology patients has been survival, based on tumor control, but recently it has been increasingly recognized that the diagnosis and management of cancer can have a major effect on every aspect of the QOL of a patient. The aims of cancer treatment became not only to increase survival but also to preserve QOL, and measuring these changes has been considered to be of paramount importance.
Collapse
Affiliation(s)
- Rossen S Dimov
- General Surgery Clinic, Hospital "Kaspela"-Plovdiv, Medical University-Plovdiv, Bulgaria
| |
Collapse
|
20
|
Sawka AM, Naeem A, Jones J, Lowe J, Segal P, Goguen J, Gilbert J, Zahedi A, Kelly C, Ezzat S. Persistent posttreatment fatigue in thyroid cancer survivors: a scoping review. Endocrinol Metab Clin North Am 2014; 43:475-94. [PMID: 24891173 DOI: 10.1016/j.ecl.2014.02.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The relevance of persistent posttreatment fatigue (PPF) to thyroid cancer (TC) survivor populations is not known. This article presents a scoping review, which is an overview of published research activity. Uncontrolled data suggest that PPF is one of the most common complaints in TC survivors. Furthermore, statistically significantly worse levels of fatigue were reported in TC survivors, compared with the general population or healthy controls. There was some inconsistency among PPF risk factors. More research is needed on PPF in TC survivors, including long-term prospective cohort studies, research on fatigue severity prevalence, and randomized controlled trials of treatment strategies.
Collapse
Affiliation(s)
- Anna M Sawka
- Division of Endocrinology, Department of Medicine, University Health Network, 200 Elizabeth Street, 12th Floor, Toronto, Ontario M5G 2C4, Canada; Division of Endocrinology, Department of Medicine, University of Toronto, 200 Elizabeth Street, 12 EN-243, Toronto, Ontario M5G 2C4, Canada.
| | - Asima Naeem
- Division of Endocrinology, Department of Medicine, University Health Network, 200 Elizabeth Street, 12th Floor, Toronto, Ontario M5G 2C4, Canada
| | - Jennifer Jones
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8, Canada; Cancer Survivorship Program, Princess Margaret Hospital, University Health Network, 200 Elizabeth Street, Bcs-045, Toronto, Ontario M5G 2C4, Canada
| | - Julia Lowe
- Division of Endocrinology, Department of Medicine, University of Toronto, 200 Elizabeth Street, 12 EN-243, Toronto, Ontario M5G 2C4, Canada; Division of Endocrinology, Department of Medicine, Sunnybrook Health Sciences Center, 2075 Bayview Avenue, H Wing, Toronto, Ontario M4N 3M5, Canada
| | - Philip Segal
- Division of Endocrinology, Department of Medicine, University Health Network, 200 Elizabeth Street, 12th Floor, Toronto, Ontario M5G 2C4, Canada; Division of Endocrinology, Department of Medicine, University of Toronto, 200 Elizabeth Street, 12 EN-243, Toronto, Ontario M5G 2C4, Canada; Division of Endocrinology, Department of Medicine, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada
| | - Jeannette Goguen
- Division of Endocrinology, Department of Medicine, University of Toronto, 200 Elizabeth Street, 12 EN-243, Toronto, Ontario M5G 2C4, Canada; Division of Endocrinology, Department of Medicine, St. Michael's Hospital, 61 Queen Street East, 6th Floor, Toronto, Ontario M5C 2T2, Canada
| | - Jeremy Gilbert
- Division of Endocrinology, Department of Medicine, University of Toronto, 200 Elizabeth Street, 12 EN-243, Toronto, Ontario M5G 2C4, Canada; Division of Endocrinology, Department of Medicine, Sunnybrook Health Sciences Center, 2075 Bayview Avenue, H Wing, Toronto, Ontario M4N 3M5, Canada
| | - Afshan Zahedi
- Division of Endocrinology, Department of Medicine, University of Toronto, 200 Elizabeth Street, 12 EN-243, Toronto, Ontario M5G 2C4, Canada; Division of Endocrinology, Department of Medicine, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada; Division of Endocrinology, Department of Medicine, Women's College Hospital, 76 Grenville Street, Toronto, Ontario M5S 1B2, Canada
| | - Catherine Kelly
- Division of Endocrinology, Department of Medicine, University of Toronto, 200 Elizabeth Street, 12 EN-243, Toronto, Ontario M5G 2C4, Canada; Division of Endocrinology, Department of Medicine, Women's College Hospital, 76 Grenville Street, Toronto, Ontario M5S 1B2, Canada
| | - Shereen Ezzat
- Endocrine Oncology Site Group, Princess Margaret Hospital, University Health Network, 200 Elizabeth Street, 12NU-1200, Toronto, Ontario M5G 2C4, Canada
| |
Collapse
|
21
|
Yoon HJ, Seok JH. Clinical Factors Associated with Quality of Life in Patients with Thyroid Cancer. ACTA ACUST UNITED AC 2014. [DOI: 10.11106/jkta.2014.7.1.62] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Hyung-Jun Yoon
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong-Ho Seok
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
22
|
Husson O, Nieuwlaat WA, Oranje WA, Haak HR, van de Poll-Franse LV, Mols F. Fatigue among short- and long-term thyroid cancer survivors: results from the population-based PROFILES registry. Thyroid 2013; 23:1247-55. [PMID: 23578315 PMCID: PMC3783928 DOI: 10.1089/thy.2013.0015] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND The aims of this study were (i) to obtain insight into the prevalence of fatigue among short- and long-term thyroid cancer (TC) survivors, by comparing a sample of TC survivors with an age- and sex-matched normative population, and (ii) to investigate which demographic, clinical, and TC-specific health-related quality of life (HRQoL) characteristics were associated with fatigue. METHODS All patients found to have TC between 1990 and 2008, as registered in the Eindhoven Cancer Registry, received a cross-sectional survey on fatigue (Fatigue Assessment Scale), TC-specific HRQoL (THYCA-QoL), and psychological distress (Hospital Anxiety and Depression Scale). The fatigue scores were compared with those of an age- and sex-matched normative population (n=530). Multiple logistic regression analyses were conducted to investigate the independent associations between clinical and demographic characteristics, TC-specific HRQoL, and psychological distress with fatigue. RESULTS Eighty-six percent (n=306) responded. TC survivors were more often classified as fatigued or very fatigued (short-term <5 years: 43%; long-term 5-10 years: 44%; long-term 10-15 years: 47%; long-term >15 years: 39%) compared to the normative population (25%; p<0.001). Anxiety (odds ratio (OR) 1.15, 95% confidence interval [CI] 1.03-1.28) and depression (OR 1.43 [CI 1.22-1.68]) were associated with fatigue, as was also the case for TC-specific neuromuscular (OR 1.03 [CI 1.01-1.06]), concentration (OR 1.03 [CI 1.01-1.06]), and psychological TC-specific HRQoL (OR 1.06 [CI 1.02-1.10]). CONCLUSION Short- and long-term TC survivors report higher levels of fatigue than an age- and sex-matched normative population do. Both TC-specific HRQoL and psychological distress were associated with fatigue.
Collapse
Affiliation(s)
- Olga Husson
- Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
- Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, The Netherlands
| | | | - Wilma A. Oranje
- Department of Endocrinology, TweeSteden Hospital, Tilburg, The Netherlands
| | - Harm R. Haak
- Department of Endocrinology, Maxima Medical Centre, Eindhoven, The Netherlands
| | - Lonneke V. van de Poll-Franse
- Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
- Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, The Netherlands
| | - Floortje Mols
- Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
- Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, The Netherlands
| |
Collapse
|
23
|
Husson O, Haak HR, Oranje WA, Mols F, Reemst PHM, van de Poll-Franse LV. Health-related quality of life among thyroid cancer survivors: a systematic review. Clin Endocrinol (Oxf) 2011; 75:544-54. [PMID: 21615448 DOI: 10.1111/j.1365-2265.2011.04114.x] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Treatment and follow-up care procedures of thyroid cancer impose great challenges on survivors and could potentially affect their health-related quality of life (HRQoL). METHODS Two authors systematically reviewed the available literature on HRQoL of thyroid cancer survivors. A PubMed literature search for original articles published until February 2011 was performed. Twenty-seven articles, published between 1997 and 2010, which met the predefined inclusion criteria, were subjected to a quality checklist. RESULTS All selected studies, except one, were of adequate or good quality. Surgery had a negative impact on short-term HRQoL scores, but these scores returned to preoperational levels when time since surgery increased. Long-term thyroid hormone therapy (levothyroxine) can lead to abnormalities like hyperthyroidism. HRQoL was most affected during thyroid hormone withdrawal for radioiodine remnant ablation or follow-up procedures. The use of recombinant human thyroid stimulating hormone instead of hormone withdrawal leads to considerable improvements in HRQoL during follow-up testing. The results for (long-term) survivors were contradicting. While most (long-term) survivors report some specific long-lasting health problems, some studies found a lower HRQoL for thyroid cancer survivors compared with a healthy population or other reference groups, whereas other studies found similar HRQoL levels. CONCLUSION This review indicates that thyroid cancer survivors generally have a similar or slightly worse HRQoL compared with the normative population; however, they report some specific medical problems after cancer treatment and follow-up tests, which have a direct negative impact on their current HRQoL and could affect their long-term HRQoL. Specific longitudinal survivorship studies are lacking.
Collapse
Affiliation(s)
- Olga Husson
- Department of Medical Psychology and Neuropsychology, CoRPS - Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands.
| | | | | | | | | | | |
Collapse
|
24
|
Minimally invasive thyroidectomy: A comprehensive appraisal of existing techniques. Surgery 2011; 150:17-24. [DOI: 10.1016/j.surg.2011.02.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 02/17/2011] [Indexed: 11/18/2022]
|
25
|
Abdul-Sater L, Henry M, Majdan A, Mijovic T, Franklin JH, Brandt MG, Black MJ, Hier MP, Payne RJ. What Are Thyroidectomy Patients Really Concerned About? Otolaryngol Head Neck Surg 2011; 144:685-90. [DOI: 10.1177/0194599811399556] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective. To better appreciate perioperative concerns affecting patients considering thyroidectomy and to understand how they may vary according to patient characteristics. Study Design. Cross-sectional analysis. Setting. Tertiary referral center. Subjects and Methods. The authors recruited patients scheduled for thyroid surgery at the McGill University Thyroid Cancer Center. A total of 148 patients completed the 18-item Western Surgical Concern Inventory–Thyroid (WSCI-T) questionnaire. Psychometrics of the WSCI-T were assessed through a principal component analysis with varimax rotation and reliability analyses. Independent-samples t tests and 2-tailed Pearson correlations were ran, identifying areas of elevated concerns and their relationship to gender, age, and surgical procedure (total vs hemithyroidectomy). Results. The principal component analysis revealed the presence of 3 domains of presurgical concerns on the WSCI-T: Surgery-Related Concerns, Psychosocial Concerns, and Daily-Living Concerns. Reliability coefficients for the WSCI-T Total and subscales were satisfactory. Responses on the WSCI-T indicated on average a moderate overall level of concerns before thyroidectomy. Surgery-Related Concerns was the highest domain of concerns, followed by Daily-Living and Psychosocial Concerns, respectively. Patients were mainly worried about the nodule being cancerous, experiencing a change in voice, and surgical complications. Areas of minor concern included being judged or treated differently, becoming depressed, and feeling embarrassed. Women had higher overall levels of concern than men did. Although there were no significant differences in overall levels of concern according to age and surgical procedure, differences were noted at a subscale and item level. Conclusion. This study establishes a mean that will permit adequate physician counseling and a better management of patients’ perioperative worries.
Collapse
Affiliation(s)
| | - Melissa Henry
- McGill University, Montreal, Canada
- SMBD Jewish General Hospital, Montreal, Canada
| | - Agnieszka Majdan
- McGill University, Montreal, Canada
- SMBD Jewish General Hospital, Montreal, Canada
| | | | - Jason H. Franklin
- University of Western Ontario, Schulich School of Medicine & Dentistry, London, Canada
| | - Michael G. Brandt
- University of Western Ontario, Schulich School of Medicine & Dentistry, London, Canada
| | - Martin J. Black
- McGill University, Montreal, Canada
- SMBD Jewish General Hospital, Montreal, Canada
| | - Michael P. Hier
- McGill University, Montreal, Canada
- SMBD Jewish General Hospital, Montreal, Canada
| | - Richard J. Payne
- McGill University, Montreal, Canada
- SMBD Jewish General Hospital, Montreal, Canada
- McGill University Health Center, Montreal, Canada
| |
Collapse
|
26
|
Chien LY, Chou YH, Ko YL, Lee CF. Health-related quality of life among 3--4-year-old children born with very low birthweight. J Adv Nurs 2007; 56:9-16. [PMID: 16972913 DOI: 10.1111/j.1365-2648.2006.03974.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM This paper reports a study comparing health-related quality of life at 3-4 years of age among children born with very low birthweight (<or=1500 g) to a group of non-very low birthweight controls, and to examine biological, environmental, demographic and health factors associated with quality of life of children born with very low birthweight. BACKGROUND Advances in modern medicine have increased the survival of infants with very low birthweight, but its impact on quality of life of children during preschool years has been less studied. METHODS The study sample included 118 children born with very low birthweight and 170 non-very low birthweight controls in Taiwan. Primary caregivers of the study children completed structured questionnaires during the period November 2002 to April 2003. Health-related quality of life was measured using the Mandarin version of the TZO-AZL Preschool Children Quality of Life instrument. This tool has four dimensions: physical, emotional, cognitive and social functions. Higher scores indicate better quality of life. FINDINGS Children born with very low birthweight had statistically significantly lower mean quality of life scores in all the four dimensions compared with controls. Among the former, those who had current physical health problems scored lower in all dimensions of quality of life. Primary caregivers with higher educational levels and increased ages of the children were associated with improved scores in the emotional and social functions. Birth gestational age was negatively associated with cognitive function. Length of stay in the neonatal intensive care unit was negatively associated with scores for the social function aspect of quality of life. CONCLUSION Regular monitoring of the quality of life among very low birthweight children is needed. Nurses need to assess the child's current health state, birth gestational age, and the primary caregiver's educational level in order to identify those who are at risk for low quality of life and intervene early.
Collapse
Affiliation(s)
- Li-Yin Chien
- Institute of Community Health Nursing, National Yang-Ming University, Pei-Tou, Taipei, Taiwan.
| | | | | | | |
Collapse
|
27
|
|
28
|
Tagay S, Senf W, Schöpper N, Mewes R, Bockisch A, Görges R. [Protective factors for anxiety and depression in thyroid cancer patients]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2007; 53:62-74. [PMID: 17311732 DOI: 10.13109/zptm.2007.53.1.62] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Depression and anxiety are the most common mental symptoms in patients with thyroid cancer (DTC) and have an important influence on the quality of life. The aim of the current study was to identify protective factors of depression and anxiety in DTC patients. METHODS In a cross-sectional study 230 DTC patients were examined with Hospital Anxiety and Depression Scale (HADS-D), the Sense of Coherence Scale (SOC-13) and the Questionnaire of Social Support (F-SOZU). RESULTS Depression correlated highly significantly with anxiety (r = .633, p = 0,001). Social support and sense of coherence correlated highly significantly negative with depression as well as with anxiety (both p < or = 0,001). Although still significant, the correlation between age and anxiety was lower (r = -.19; p < or = 0,005). The TSH level as an indicator of hypothyreodism did not correlate with depression or with anxiety on a significant statistical level. Furthermore, variables such as education, religiosity and elapsed time interval since initial diagnosis were not correlated with depression and anxiety. DISCUSSION Our results support the thesis that low social support and low sense of coherence enhance vulnerability to depressive and anxiety symptoms.
Collapse
Affiliation(s)
- Sefik Tagay
- Klinik für Psychosomatische Medizin und Psychotherapie, Rheinische Kliniken/Universitätsklinik Duisburg-Essen.
| | | | | | | | | | | |
Collapse
|