Cancer-related Fear and Worry in Patients with Low-Risk Thyroid Cancer: A Longitudinal Cohort Study

Stephanie Lee; Alexis G Antunez; Brandy Sinco; Megan C Saucke; Kyle J Bushaw; Sophie Dream; Abbey Fingeret; Masha J Livhits; Aarti Mathur; Alexandria D McDow; Sanziana Roman; Corrine I Voils; Susan C Pitt

doi:10.1210/clinem/dgae688

Cancer-related Fear and Worry in Patients with Low-Risk Thyroid Cancer: A Longitudinal Cohort Study

J Clin Endocrinol Metab. 2024 Oct 14:dgae688. doi: 10.1210/clinem/dgae688. Online ahead of print.

Authors

Affiliations

¹ University of Michigan, Ann Arbor, MI.
² Brigham and Women's Hospital, Boston, MA.
³ University of Wisconsin-Madison, Madison, WI.
⁴ Medical College of Wisconsin, Milwaukee, WI.
⁵ University of Nebraska, Omaha, NE.
⁶ University of California-Los Angeles; Los Angeles, CA.
⁷ Johns Hopkins University, Baltimore, MD.
⁸ Indiana University, Indianapolis, IN.
⁹ University of California - San Francisco; San Francisco, CA.
¹⁰ William S. Middleton Memorial Veterans Hospital, Madison, WI.

PMID: 39400115
DOI: 10.1210/clinem/dgae688

Abstract

Context: Little is known about how patients' emotions impact the choice between hemi- and total thyroidectomy (TT) for low-risk thyroid cancer (LR-TC) and how these emotions change after treatment.

Objective: To investigate thyroid cancer-specific fear and worry both before and after treatment of LR-TC with hemi- or TT.

Methods: This prospective cohort study enrolled adults with confirmed or likely LR-TC at 15 institutions. Participants completed measures of thyroid cancer-related fear and worry at the time of their treatment decision and 9-months later. Participants were categorized as having low, medium, or high levels of fear and worry in accordance with the literature. Those choosing hemi-thyroidectomy were compared to those choosing TT.

Results: Of 177eligible patients, 125 (70.6%) enrolled and 114 completed both surveys (91.2% retention). Overall, 41 (36.0%) participants chose hemi-thyroidectomy and 73 (64.0%) chose TT. Across all participants, thyroid cancer-related fear and worry both decreased significantly after surgery (fear 25.8±6.4 to 23.1±7.4; worry 8.2±2.4 to 5.4±2.1, p<0.001). The proportion of participants with high fear decreased from 64.9% to 50.9%, while the proportion with high worry decreased from 75.4% to 41.2% (p<0.001 for both). At both time points, no differences existed between those choosing hemi- and TT in levels of worry or fear.

Conclusion: Patients with LR-TC report lower levels of fear and worry 9-months after surgery regardless of the extent of surgery, suggesting that both surgeries provide an emotional benefit to some patients. Thyroid cancer-related fear and worry do not appear to influence patients' decisions to undergo hemi- or TT.

Keywords: Thyroid cancer; fear; longitudinal cohort; worry.

© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected]. See the journal About page for additional terms.