Health-related quality of life, anxiety and depression in thyroid cancer patients under short-term hypothyroidism and TSH-suppressive levothyroxine treatment

Tagay, Sefik; Herpertz, Stephan; Langkafel, Mathias; Erim, Yeşim; Freudenberg, Lutz S.; Schöpper, Nicole; Bockisch, Andreas; Senf, Wolfgang; Görges, Rainer

doi:10.1530/eje.1.02047

Cited by 99 publications

(93 citation statements)

References 27 publications

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“…showed a decreased HRQOL and a high prevalence of anxiety in DTC patients on T4 suppression therapy, but the prevalence of depression was not increased [23]. Similarly, we found significantly increased HADS-A scores in our subjects compared to that of the general population control.…”

Section: Discussionsupporting

confidence: 71%

“…also reported that depression and anxiety in patients with DTC are highly correlated with QOL. The most important determinants for depression and anxiety in their study were social support and a sence of coherence; whereas TSH did not show a statistically significant association with depression or anxiety [23]. In addition, it has been reported that patients with head and neck cancers who are more optimistic have a higher HRQOL [28].…”

Section: Discussionmentioning

confidence: 99%

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Decreased health-related quality of life in disease-free survivors of differentiated thyroid cancer in Korea

Lee

Kim

Tan

et al. 2010

Health Qual Life Outcomes

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BackgroundConcern regarding the health-related quality of life (HRQOL) of long-term survivors of thyroid cancer has risen due to the rapid increase in the incidence of thyroid cancer, which generally has an excellent prognosis. The aim of this study was to evaluate the status of HRQOL in disease-free survivors of differentiated thyroid carcinoma (DTC) and to evaluate the important determinants of HRQOL.MethodsThis was a cross-sectional study in which we interviewed consecutive disease-free survivors of DTC. Three different validated questionnaires ("EORTC QLQ-C30" for various functional domains, the "brief fatigue inventory (BFI)" and the "hospital anxiety and depression scale" (HADS)) were used. Data from a large, population based survey of 1,000 people were used as a control.ResultsThe response rate for the questionnaires was 78.9% (316/401). Disease-free survivors of DTC showed a decreased HRQOL in all five functional domains (physical, role, cognitive, emotional, and social) on the EORTC QLQ-C30 compared with controls (P < 0.01). BFI and HADS-anxiety scores also showed greater distress in disease-free survivors of DTC than in controls (P < 0.05). A multiple regression analysis for the determinants of HRQOL showed that the HADS-anxiety, HADS-depression, and BFI scores were the most significant components of decreased HRQOL.ConclusionsAlthough disease-free survivors of DTC are expected to have disease-specific survival comparable to the general population, they experience a significantly decreased HRQOL. Anxiety, depression, and fatigue were the major determinants of the decreased HRQOL. Supportive psychological care should be integrated into the management of long-term survivors of DTC.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Decreased health-related quality of life in disease-free survivors of differentiated thyroid cancer in Korea

Lee

Kim

Tan

et al. 2010

Health Qual Life Outcomes

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“…Expanding these results, another study examined the frequency of physical complaints, health-related QoL, anxiety, and depression in 130 DTC patients hospitalized for diagnostic procedures or thyroid remnant ablation with radioiodine under short-term hypothyroidism (46). The results were compared with those of 100 DTC out-patients under suppressive doses of LT4 following radioiodine treatment.…”

Section: Quality Of Lifementioning

confidence: 99%

Short-term hypothyroidism after Levothyroxine-withdrawal in patients with differentiated thyroid cancer: clinical and quality of life consequences

Duntas¹,

Biondi²

2007

eur j endocrinol

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Acute hypothyroidism induced by thyroid hormone withdrawal in patients with differentiated thyroid cancer during monitoring for remnant or metastatic disease, seriously affects multiple organs and systems, and especially in severe cases can impair quality of life. Indeed, it may induce untoward cardiovascular effects and can be hazardous in patients with underlying cardiovascular disease, particularly in the elderly. Moreover, acute hypothyroidism deranges the lipid profile and exacerbates neuropsychiatric illness. The introduction of recombinant human TSH (rhTSH) as a diagnostic and therapeutic tool in the care of patients with thyroid cancer has widened the scope of disease management. The use of rhTSH prevents derangement of various systems at approximately equivalent societal costs to that of withdrawal and promotes compliance while preserving the patient's normal daily functioning and productivity. Its reliability allied with its safety render this compound a valid alternative in the monitoring of patients with differentiated thyroid carcinoma as well as providing an alternative therapeutic procedure whenever LT4-withdrawal may be hazardous or in cases of patient non-compliance.

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“…Levothyroxine withdrawal causes a short-term hypothyroidism in these patients and compels symp toms such as fatigue, decreased appetite, fluid retention and constipation [6,7]. Besides, previous findings have shown that these episodes of hypothyroidism have noticeable negative effects on patients' quality of life (QOL) and their psychometric functionality [8,9].…”

Section: Introductionmentioning

confidence: 99%

Quality of Life, Anxiety and Depression in Patients with Differentiated Thyroid Cancer under Short Term Hypothyroidism Induced by Levothyroxine Withdrawal

et al. 2016

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SummaryBackground: We studied quality of life (QOL), anxiety, and depression in patients with differentiated thyroid cancer (DTC) either during treatment with levothyroxine or during withdrawal from levothyroxine when whole-body scanning (WBS) needed to be performed. Methods: DTC patients projected to undergo WBS were included in the study. They were studied at two time-points -the day before levothyroxine withdrawal, and one month after levothyroxine with drawal. They were asked to fill WHOQOL-Bref, BDI-II, and HADS questionnaires at both time-points, and blood samples were taken to measure TSH, Tg, and TgAb levels. Results: Twenty-nine subjects (11 males) with a mean age of 42.6 ± 14.1 years entered the study. From the first to second time-point, the mean TSH level increased from 0.73 to 106.9 U/ml and the mean Tg level increased from 20.4 to 63.6 ng/ml. QOL scores decreased in four dimensions (physical health: 67.8 to 25.7; psychological: 58.9 to 38.9; social relationship: 67.5 to 56; and environment: 57.2 to 48.8). Patients also felt more depressed (48.3% to 93.2%) and anxious (65.5% to 89.6%). All changes were statistically significant (p < 0.005). Conclusion: We found decreased QOL after short-term hypothyroidism, especially in physical health and psychological dimensions. We also found that patients became significantly depressed and anxious after levothyroxine withdrawal. Our findings suggest that alternative therapies, such as those employing rhTSH, should be considered for these patients. Psycho-oncological support might also be useful in helping them overcome their symptoms during short-term hypothyroidism; however, consider ing the reversibility of their symptoms, supportive care might be more effective.

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Health-related quality of life, anxiety and depression in thyroid cancer patients under short-term hypothyroidism and TSH-suppressive levothyroxine treatment

Cited by 99 publications

References 27 publications

Decreased health-related quality of life in disease-free survivors of differentiated thyroid cancer in Korea

Decreased health-related quality of life in disease-free survivors of differentiated thyroid cancer in Korea

Short-term hypothyroidism after Levothyroxine-withdrawal in patients with differentiated thyroid cancer: clinical and quality of life consequences

Quality of Life, Anxiety and Depression in Patients with Differentiated Thyroid Cancer under Short Term Hypothyroidism Induced by Levothyroxine Withdrawal

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