Quality-of-Life Changes in Patients with Thyroid Cancer After Withdrawal of Thyroid Hormone Therapy
Open accessAbstract
Quality of life (QOL) is an important consideration as patients survive longer with cancer and is an area of increasing interest in patients with thyroid cancer who undergo long-term cancer surveillance. However, there are few disease-specific QOL tools available to evaluate QOL in patients with thyroid cancer. The purposes of this longitudinal, repeated-measures study were to: (1) test a new instrument, the QOL-Thyroid Scale, during thyroid hormone withdrawal; and (2) to evaluate the impact of thyroid hormone withdrawal on patients' perceived changes in quality of life. The sample included 34 subjects (mean age 40 years) undergoing thyroid hormone withdrawal in preparation for scanning procedures. Subjects completed three instruments (demographic data tool, the QOL-Thyroid, and the FACT-G) at four specific time points in relationship to scanning. The results demonstrated that the QOL-Thyroid tool is a reliable and valid measure of QOL. Cronbach's alpha coefficient of r = .78 between QOL-Thyroid and FACT-G indicated good concurrent validity. Second, the impact of thyroid hormone withdrawal on QOL showed significant changes in physical, psychological, and social well-being across the four testing points. The greatest changes occurred between peak hormone withdrawal and thyroxine (T4) therapy. While it is generally known that patients suffer troublesome physical symptoms relating to thyroid hormone withdrawal, the negative psychological, family, and work sequelae are less apparent. In conclusion, the QOL-Thyroid is a reliable and valid measure for use in evaluating patients undergoing scanning procedures and may be used to identify and target teaching and support for high-risk areas in patients lives that are negatively affected by hormone withdrawal.
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Withdrawal of LT4 or LT3 leads to recurrence of hypothyroidism in patients who had thyroid surgery for thyroid cancer or were diagnosed with profound hypothyroidism.
“Although there are no randomized clinical trials comparing LT4 to placebo to treat hypothyroidism, it has clearly been demonstrated that LT4 or LT3 withdrawal leads to a recurrence of hypothyroidism in patients who have undergone thyroid surgery for thyroid cancer or who were diagnosed with profound hypothyroidism (44-46).”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [45]
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- Authors
- DOW, K. H., FERRELL, B. R., & ANELLO, C.
- Affiliations
- University of Central Florida (US)
- ORCID
- FERRELL, BETTY R.
- Venue
- Thyroid
- Publisher
- SAGE Publications
- Published
- 1997-08
- Volume
- 7
- Issue
- 4
- Pages
- 613-619
- ISSN
- 1050-7256 (ISSN-L)
- 1557-9077
- OpenAlex
- W1993041398
- Cited by
- 289
- References
- 14
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 5 · 2023: 6 · 2022: 6 · 2021: 9 · 2020: 7 · 2019: 6 · 2018: 8 · 2017: 10 · 2016: 14 · 2015: 17 · 2014: 10 · 2013: 6 · 2012: 13
- FWCI
- 2.62
- Type
- journal article
- Language
- en
- Open access
- Locations
- Thyroid (publishedVersion)
- PubMed (publishedVersion)
- Journal of International Crisis and Risk Communication Research (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- thyroid cancer, quality of life, thyroid hormone withdrawal, thyroxine therapy, cancer surveillance, thyroid imaging, FACT-G, psychometric validation
- MeSH terms
- Adult, Aged, Emotions, Female, Humans, Longitudinal Studies, Male, Middle Aged, Quality of Life, Thyroid Neoplasms, Thyroxine
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