title: The most common factors influencing on quality of life of thyroid cancer patients after thyroid hormone withdrawal.
abstract: BACKGROUND
  The aim of study was to evaluate which factors impact mostly on life-quality of patients with differentiated thyroid carcinoma after thyroid hormone withdrawal.
  
  
  METHODS
  150 patients were enrolled in the study by using Quality of life- Thyroid version questionnaire in which they expressed their physical, psychological, social and spiritual well-being. The answers have been interpreted on a scale from 0 to 10. All patients underwent four weeks levothyroxine withdrawal in preparation for I-131 procedures and thyroglobulin testing.
  
  
  RESULTS
  Individual statements on the physical subscale showed that patients had most difficulties with fatigue, intolerance to cold and heat, sleep changes and weight gain, but with higher average values than expected. Fatigue was one of the most common physical difficulties. Female patients had significantly more difficulties than male respondents. Five most expressed psychological difficulties have been stress caused by initial diagnosis, followed by stress caused by surgical treatment, fear of metastases, stress caused by initial radioiodine ablation treatment and fear of cancer recurrence. Generally, results revealed troubles mostly in physical symptoms relating to thyroid hormone withdrawal, as well as psychological distress caused by initial diagnosis. Respondents with higher educational level achieved a significantly higher score than less educated patients (p=0.026, Mann-Whitney U test). Illness was very distressing for their families (median value 1, range: 0 to 10) and they reported insufficient support from others (1, range: 0 to 10), but they did not feel isolated. Family and work consequences were less apparent.
  
  
  CONCLUSIONS
  The results of QOL-Thyroid questionnaire help to identify high-risk areas in patients' lives that are negatively affected by hormone withdrawal. Regarding the wide definition of quality of life, a positive impact on patients' recovery could be achieved by directing attention to most expressed difficulties noted in this questionnaire.
authors.affiliation: Clinical Department of Nuclear Medicine and Radiation Protection, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia, mateja.rubic@gmail.com.
authors.forename: Mateja
authors.initials: M
authors.lastname: Rubic
authors.forename: Sanja Kusacic
authors.initials: SK
authors.lastname: Kuna
authors.forename: Vanja
authors.initials: V
authors.lastname: Tesic
authors.forename: Tatjana
authors.initials: T
authors.lastname: Samardzic
authors.forename: Marija
authors.initials: M
authors.lastname: Despot
authors.forename: Drazen
authors.initials: D
authors.lastname: Huic