There were 170 patients with a history of pediatric thyroid cancer who were identified in the survey and 105 patients were available for the present study. Of these, only 67 were included for a variety of reasons. The average age of the patients was 34.2 years (range 18.8- 61.7 years) and they were followed for ~18 years. All patients had their thyroid removed completely and almost all (97%) received radioactive iodine therapy. Of these, 82% of patients were in remission of their cancer during their follow-up, with 10% having recurrent thyroid cancer and 7% having persistent thyroid cancer. Most patients were women (87%), were employed or were full-time students (90%) and were married or in a relationship (65%).
On most scales, survivors and controls did not differ; however, survivors reported more physical problems and limitations due to physical problems and mental fatigue. No differences were noted in anxiety and depression. The THYCA-QoL questionnaire identified that 84% of survivors did not have problems with their thyroid scar, 51-70% denied problems with symptoms related to low thyroid levels and 12% indicated not having interest in sex. Male survivors had higher levels of reduced motivation and depression as compared to females. Patients with recurrent or persistent thyroid cancer reported more symptoms and headaches were associated with higher doses of radioactive iodine. Unemployment was also associated with less QoL.
WHAT ARE THE IMPLICATIONS OF THIS STUDY?
This study confirms the good prognosis of pediatric thyroid cancer after 18 years of follow up, as only 1 out of 170 patients had died,. Although the study has some limitations, the data is encouraging as most patients were studying or working and were in relationships. It is also reassuring that there were no differences in anxiety or depression, social functioning, bodily pain, mental health, emotional problems or vitality, although some survivors reported less physical functioning and limitations due to physical functioning. It is unclear whether this could be associated with under-treatment or over-treatment of low thyroid hormone levels or low calcium levels. This study helps the providers caring for patients with pediatric thyroid cancer to reassure them about their future.
— Liuska Pesce, MD
ATA THYROID BROCHURE LINKS
Radioactive Iodine: https://www.thyroid.org/radioactive-iodine/
Thyroid Cancer (Papillary and Follicular): https://www.thyroid.org/thyroid-cancer/
Thyroid Surgery: https://www.thyroid.org/thyroid-surgery/
Thyroid Hormone Treatment: https://www.thyroid.org/thyroid-hormone-treatment/