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Patients With Thyroid Cancer Report Poor Quality of Life Despite ‘Good’ Diagnosis

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Key Points

  • Researchers used a questionnaire that assesses physical, psychological, social, and spiritual well-being to measure patient-reported quality of life. They found that thyroid cancer survivors reported an average of 5.56 out of 10 on the scale.
  • That was worse than the mean quality-of-life score of 6.75 that was reported by survivors of other cancer types (including colorectal and breast cancer) that have poorer prognoses and more invasive treatments.
  • Patients who were younger, female, and less educated, as well as those who participated in survivorship groups, all reported even worse quality of life than other study participants.

Thyroid cancer survivors report poor quality of life after diagnosis and treatment compared with other patients who are diagnosed with more lethal cancers, according to new research from the University of Chicago Medicine. The findings, published by Aschebrook-Kilfoy et al in the journal Thyroid, shed light on a rarely studied outcome for a growing group of patients who are expected to soon account for 10% of all American cancer survivors.

Patients with thyroid cancer have a nearly 98% 5-year survival rate, according to the National Cancer Institute. More than 95% survive a decade, leading some to call it a “good cancer.” But those successful outcomes mean few thyroid cancer survivorship studies have been conducted.

University of Chicago Medicine researchers Briseis Aschebrook-Kilfoy, PhD, Assistant Research Professor in Epidemiology, and Raymon Grogan, MD, Assistant Professor of Surgery, are trying to address that data gap. Together, they lead the North American Thyroid Cancer Survivorship Study (NATCSS).

Study Findings

For their most recent research, Drs. Aschebrook-Kilfoy and Grogan recruited 1,174 thyroid cancer survivors—89.9% female with an average age of 48—from across the United States and Canada. Participants were recruited through the thyroid cancer clinics at University of Chicago Medicine, the clinics of six other universities, as well as through thyroid cancer survivor support groups and social media.

The researchers then used City of Hope's Quality of Life thyroid tool, a questionnaire that assesses physical, psychological, social, and spiritual well-being to measure patient-reported quality of life. They found that thyroid cancer survivors reported an average of 5.56 out of 10 on the scale. That was worse than the mean quality-of-life score of 6.75 that was reported by survivors of other cancer types (including colorectal and breast cancer) associated with poorer prognoses and more invasive treatments.

“I think we all have this fear of cancer that has been ingrained in our society,” Dr. Grogan said. “So, no matter what the prognosis is, we're just terrified that we have cancer. I think this shows that.”

After treatment, thyroid cancer survivors face a lifetime of cancer surveillance and an anxiety-inducing high rate of recurrence, which could contribute to their findings.

Drs. Aschebrook-Kilfoy and Grogan also found that patients who were younger, female, and less educated, as well as those who participated in survivorship groups, all reported even worse quality of life than other study participants. However, after the 5-year mark, quality of life gradually starts to increase over time for both male and female thyroid cancer survivors.

The researchers will continue to track participants to further understand these data.

“The goal of this study is to turn it into a long-term, longitudinal cohort,” said Dr. Grogan, who hopes to develop a tool that physicians can use to assess the psychological well-being of thyroid cancer survivors. “But there was no way to do that with thyroid cancer because no one had ever studied quality of life or psychology of thyroid cancer before.” Psychological well-being is part of the Institute of Medicine's recommended survivorship care plans.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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