The impact of thyroid cancer and post-surgical radioactive iodine treatment on the lives of thyroid cancer survivors: a qualitative study.
BACKGROUND
Adjuvant treatment with radioactive iodine (RAI) is often considered in the treatment of well-differentiated thyroid carcinoma (WDTC). We explored the recollections of thyroid cancer survivors on the diagnosis of WDTC, adjuvant radioactive iodine (RAI) treatment, and decision-making related to RAI treatment. Participants provided recommendations for healthcare providers on counseling future patients on adjuvant RAI treatment.


METHODS
We conducted three focus group sessions, including WDTC survivors recruited from two Canadian academic hospitals. Participants had a prior history of WDTC that was completely resected at primary surgery and had been offered adjuvant RAI treatment. Open-ended questions were used to generate discussion in the groups. Saturation of major themes was achieved among the groups.


RESULTS
There were 16 participants in the study, twelve of whom were women (75%). All but one participant had received RAI treatment (94%). Participants reported that a thyroid cancer diagnosis was life-changing, resulting in feelings of fear and uncertainty. Some participants felt dismissed as not having a serious disease. Some participants reported receiving conflicting messages from healthcare providers on the appropriateness of adjuvant RAI treatment or insufficient information. If RAI-related side effects occurred, their presence was not legitimized by some healthcare providers.


CONCLUSIONS
The diagnosis and treatment of thyroid cancer significantly impacts the lives of survivors. Fear and uncertainty related to a cancer diagnosis, feelings of the diagnosis being dismissed as not serious, conflicting messages about adjuvant RAI treatment, and treatment-related side effects, have been raised as important concerns by thyroid cancer survivors.
Sawka
Anna M
AM
Division of Endocrinology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. sawkaam@yahoo.com
Goldstein
David P
DP
Brierley
James D
JD
Tsang
Richard W
RW
Rotstein
Lorne
L
Ezzat
Shereen
S
Straus
Sharon
S
George
Susan R
SR
Abbey
Susan
S
Rodin
Gary
G
O'Brien
Mary Ann
MA
Gafni
Amiram
A
Thabane
Lehana
L
Goguen
Jeannette
J
Naeem
Asima
A
Magalhaes
Lilian
L
D003625:Data Collection; D003657:Decision Making; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D011182:Postoperative Care / Q000523:psychology; D011788:Quality of Life; D017741:Survivors; D013964:Thyroid Neoplasms / Q000523:psychology* / Q000628:therapy
D007457:Iodine Radioisotopes