Thyroid Cancer and Telemedicine During the COVID-19 Pandemic

Abstract

The COVID-19 pandemic has forced endocrinologists to utilize telemedicine to care for their patients. There is limited information on the experience of endocrinologists in managing patients with thyroid cancer virtually. We sent a nine-item questionnaire to endocrinologists and endocrine surgeons at our institution to better understand the barriers and benefits of caring for patients with thyroid cancer via telemedicine, as well as how we can incorporate telemedicine into our future care of patients with this malignancy. Of the nine physicians who responded, the majority of them listed technological issues with the virtual platform as a challenge in caring for patients with thyroid cancer remotely. Additional barriers included difficulty in expressing empathy, decreased ability to coordinate care with the interdisciplinary team, and lack of the physical exam. Benefits included compliance with social distancing measures and convenience for patients with American Thyroid Association (ATA) low-risk thyroid cancer who presented for follow-up visits. Overall, physicians were satisfied or strongly satisfied with caring for patients with thyroid cancer remotely, especially low-risk patients on long-term follow-up. That said, post-pandemic, they recommend that some patients be seen in-person, including symptomatic patients and ATA high-risk patients. While the COVID-19 pandemic has allowed endocrinologists to manage patients with thyroid cancer remotely, the providers have faced challenges, some of which can be improved upon. Further studies will help determine how telemedicine affects patient outcomes, including satisfaction, disease progression, and survival, which will better inform how we may incorporate this practice into our future care of patients with thyroid cancer.

Anxiety During the COVID-19 Pandemic: A Web-Based Survey of Thyroid Cancer Survivors

“…[23][24][25] At the forefront of these changes was a rapid conversion from office visits to telemedicine in order to limit travel and potential exposure for both patients and health care providers. 26,27 Most participants in our survey reported a change in the way they interacted with their doctors during the pandemic, and most, in fact, preferred to stay away from health care facilities. However, less than 1 in 5 respondents had a discussion with their health care provider about how the pandemic had affected or may affect their thyroid cancer treatment, and less than half were satisfied with the amount of information they had received from their doctor's office regarding COVID-19 changes.…”

“…In a survey of endocrinologists during COVID-19, providers reported difficulty connecting with patients on an emotional level via telemedicine. 26 This connection is essential, as doctor-patient communication may be one of the best tools to alleviate anxiety and fear among our patients. Studies before the COVID-19 pandemic have highlighted the importance of attentive and empathetic doctor-patient communication in reducing emotional distress in cancer patients, 29 and during the pandemic, clear patient-centered communication was found to buffer the adverse psychological effects of the fear of COVID-19 among cancer patients.…”

Virtual Access to Subspecialty Care

“…Telehealth has been used in endocrinology for underserved patient populations that lack access to specialty care due to location. 37 , 38 , 39 It has been found to be safe and associated with time savings, cost savings, and high patient and provider satisfaction. 37 , 39 , 40 …”

“… 37 , 38 , 39 It has been found to be safe and associated with time savings, cost savings, and high patient and provider satisfaction. 37 , 39 , 40 …”

Charting the Unknown Association of COVID-19 with Thyroid Cancer, Focusing on Differentiated Thyroid Cancer: A Call for Caution

“…Future health strategies for the management of (D)TC should be customized according to different pandemic phases. Additionally, more data are required to determine the impact of telemedicine on (D)TC management [ 133 ].…”