Quality of life in differentiated thyroid cancer

Background: The incidence of thyroid cancer has increased significantly over the last ten years and conversely the mortality has decreased. With 85% of patients with thyroid cancer surviving for ten years or longer it is increasingly important to study the quality of life in these patients and identify which aspects of the patients' health and wellbeing could be improved. Methods: During the first UK patient-doctor thyroid cancer forum, patient attendees filled in an anonymized questionnaire. Patients with a diagnosis of differentiated thyroid cancer were studied, and patients less than 6 months from diagnosis were excluded. The questionnaire included demographic data, the EQ-5D-3L validated tool, information on post-operative outcomes; scar satisfaction, use of calcium supplements > 6months post-operatively, vocal cord palsy, anti-depressant use and psychological counselling. Results: 82 completed questionnaires were used for the study. The median age at diagnosis was 42 years (range 18-72), and there was a female: male ratio of 6:1. EQ-5D utility health scores: the mean weighted health outcome of the average population in the UK is 0.86 (SD 0.23). Our group had a significantly lower quality of life compared to the average UK population, with a mean weighted health outcome of 0.776 (SD 0.26, p value < .0004). Conclusion: This study assesses quality of life in a group of self-selected patients who attended the patient-doctor thyroid cancer forum and, although accepting there is a sampling bias, the conference provided an opportunity to assess the quality of life of patients with differentiated thyroid cancer. The study has found that the average quality of life in this group of patients is lower than that of the UK population, and lower than that of patients with breast, colorectal and prostate cancer. A large number of these patients suffer with fatigue, and depression requiring anti-depressants and/or counselling.