Quality of life of well-differentiated thyroid carcinoma patients

The thyroid gland is the second most common site for malignancy in the head and neck region. Quality of life (QOL) of thyroid cancer patients has not been studied directly. The QOL of long-term thyroid carcinoma patients was investigated. A standardized set of questions based on the University of Washington QOL questionnaire for head and neck cancer with specific domains associated with thyroid disease was created. This questionnaire was mailed to patients who underwent total thyroidectomy for well-differentiated cancer in the department of Otolaryngology-Head and Neck surgery at the Chaim Sheba Medical Centre in Israel between the years 1994-2000. Seventy-eight patients undergoing total thyroidectomy were identified. Forty-eight patients were excluded and 20 out of the 30 remaining patients responded to the questionnaires. Six were male and 14 female, 12 were under the age of 45 (these 12 patients were staged as stage 1). Eleven patients underwent neck dissection. General health and QOL were significantly better for the younger age group and so was the calcium balance score. General health and QOL were significantly better for patients undergoing neck dissection. The overall QOL score was 3.8 conforming with 'good' in the questionnaire. Surgery and initial radioiodine treatment scored 6.75 and 6.9 respectively in the distressing scale (0-10 range: 10 = most distressing). The highest distress was encountered during withdrawal from thyroid hormone. Women rated the importance of proper replacement therapy significantly higher than men. Global low scores were found for employment and for effective L-thyroxine replacement therapy. Overall, QOL in these patients was good although lower than expected when compared with other forms of cancer. Age and gender-related differences were noted. Better QOL in neck dissection patients is probably associated with age under 45 years. High distress scores for hormone withdrawal during periodical imaging correspond with former reports and supports use of Thyrogen®. Better hormone balance is warranted for this group.