Distress, anxiety, depression and unmet needs in thyroid cancer survivors: a longitudinal study

Margherita Dionisi-Vici, Marta Fantoni, Rossana Botto, Alice Nervo, Francesco Felicetti, Ruth Rossetto, Marco Gallo, Emanuela Arvat, Riccardo Torta, Paolo Leombruni, Margherita Dionisi-Vici, Marta Fantoni, Rossana Botto, Alice Nervo, Francesco Felicetti, Ruth Rossetto, Marco Gallo, Emanuela Arvat, Riccardo Torta, Paolo Leombruni

Abstract

Purpose: Despite a good prognosis, thyroid cancer (TC) survivors often report psychological distress and decreased quality of life. This longitudinal study aims to evaluate TC survivors' levels of distress, anxiety, depression and unmet needs, checking potential life events.

Methods: Distress Thermometer, Hospital Anxiety Depression Scale, Supportive Care Need Survey (short form) and Interview for Recent Life Events were administered to 73 TC survivors (T0) and 44 of them were re-tested one year later (T1). Participants were at 0-5, 5-10 or >10 years from the end of their cancer-related treatments.

Results: At T0, distress, anxiety and depression mean scores were 6.4, 6.8 and 5.3, while at T1 they were 5.5, 4.8 and 5.1. Only anxiety scores decreased significantly between T0 and T1. 50.7% of patients had unmet psychological needs at T0 and 50.0% at T1. Most participants were satisfied in the communicative/ informative (T0:79.5%; T1: 77.3%) and social/health care areas (T0:74.0%; T1:75.0%). The most experienced stressful events detected concerned their working areas.

Conclusions: Results confirmed that patients reported distress, anxiety and depression concerns even many years after the end of treatments. Both medical and psychological surveillance are relevant to improving TC survivors' wellbeing.

Keywords: Anxiety; Long-term survivors; Longitudinal; Psychological distress; Thyroid cancer; Unmet needs.

Conflict of interest statement

The authors declare no competing interests.

© 2021. The Author(s).

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics. CA Cancer J. Clinicians. 2018;6:7–30. doi: 10.3322/caac.21442.
    1. Hodgkinson K, Butow P, Hunt GE, et al. The development and evaluation of a measure to assess cancer survivors’ unmet supportive care needs: the CaSUN (Cancer Survivor’s Unmet Needs measure) Psycho-Oncol. 2007;16:796–804. doi: 10.1002/pon.1137.
    1. McIntyre C, Jacques T, Palazzo F, Farnell K, Tolley N. Quality of life in differentiated thyroid cancer. Int. J. Surg. 2018;50:133–136. doi: 10.1016/j.ijsu.2017.12.014.
    1. Pollack LA, Greer GE, Rowland JH, et al. Cancer survivorship: a new challenge in comprehensive cancer control. Cancer Cause Control. 2005;16:51–59. doi: 10.1007/s10552-005-0452-x.
    1. Economou D, Sun V. Survivorship care planning and quality of life. Cancer Treat. Res. 2018;174:271–282. doi: 10.1007/978-3-319-65421-8_16.
    1. Kimberly DM, Siegel R, Lin CC, Mariotto AB, Kramer J, Rowland JH, Stein KD, Alteri R, Jemal A. Cancer Treatment and Survivorship Statistics. CA Cancer J. Clinicians. 2016;66:271–289. doi: 10.3322/caac.21349.
    1. Siegel RL, Miller KD, Jemal A. Cancer Statistics. CA Cancer J. Clinicians. 2016;66:7–30. doi: 10.3322/caac.21332.
    1. Wiener, C.H., Cassisi, J.E., Paulson, D., Husson, O., Gupta, R.A.: Information support, illness perceptions, and distress in survivors of differentiated thyroid cancer. Journal of Health Psychology, 1-9 (2017)
    1. Husson O, Haack HR, Buffart LM, Nieuwlaat WA, Oranje WA, Mols F, Kuijpens JL, Coebergh JW, Van de Poll-Franse LV. Health-related quality of life and disease specific symptoms in long-term thyroid cancer survivors: A study from the population-based PROFILES registry. Acta Oncologica. 2013;52:249–258. doi: 10.3109/0284186X.2012.741326.
    1. Tagay S, Herpertz S, Langkafel M, Erim Y, et al. Health-related quality of life, anxiety and depression in thyroid cancer patients under short term hypothyroidism and TSH-suppressive levothyroxine treatment. Eur. J. Endocrinol. 2005;153:755–763. doi: 10.1530/eje.1.02047.
    1. Tagay S, Herpertz S, Langkafel M, Erim Y, et al. Health-related quality of life, depression and anxiety in thyroid cancer patients. Qual. Life Res. 2006;15:695–703. doi: 10.1007/s11136-005-3689-7.
    1. Dogan S, Sahbaz NA, Aksakal N, Tutal F, Torun BC, Yildirim NK, Ozkan M, Oxcinar B, Erbil Y. Quality of life after thyroid surgery. J. Endocrinological Investig. 2017;40:1085–1090. doi: 10.1007/s40618-017-0635-9.
    1. Applewhite MK, James BC, Kaplan SP, et al. Quality of life in thyroid cancer is similar to that of other cancers with worse survival. World J. Surg. 2016;40:551–561. doi: 10.1007/s00268-015-3300-5.
    1. Randle RW, Bushman NM, Orne J, Balentine CJ, Wendt E, Saucke M, et al. Papillary thyroid cancer: the good and bad of the “good cancer”. Thyroid. 2017;27:902–907. doi: 10.1089/thy.2016.0632.
    1. Banach R, Bartès B, Farnell K, Rimmele H, et al. Results of the thyroid cancer alliance international patient/survivor survey: psychosocial/informational support needs, treatment side effects and international differences in care. Hormones. 2013;12:428–438. doi: 10.1007/BF03401308.
    1. Morley S, Goldfarb M. Support needs and survivorship concerns of thyroid cancer patients. Thyroid. 2015;25:649–656. doi: 10.1089/thy.2015.0032.
    1. Singer S, Husson O, Tomaszewska IM, Locati D, et al. Quality of life priorities in patients with thyroid cancer: a multinational European organization for research and treatment of cancer phase I study. Thyroid. 2016;26:1605–1613. doi: 10.1089/thy.2015.0640.
    1. Hyun YG, Alhashemi A, Fazelzad R, Goldberg AS, Goldstein DP, Sawka AM. A systematic review of unmet information and psychosocial support needs of adults diagnosed with thyroid cancer. Thyroid. 2016;26:1239–50. doi: 10.1089/thy.2016.0039.
    1. Gallop K, Kerry C, Simmons S, et al. A qualitative evaluation of the validity of published health utilities and generic health utility measures for capturing health-related quality of life (HRQoL) impact of differentiated thyroid cancer (DTC) at different phases. Qual. Life Res. 2015;24:325–338. doi: 10.1007/s11136-014-0776-7.
    1. Gamper EM, Wintner LM, Rodrigues M, Buxbaum S, et al. Persistent quality of life impairments in differentiated thyroid cancer patients: results from a monitoring program. Eur. J. Nucl. Med. Mol. Imaging. 2015;42:1179–1188. doi: 10.1007/s00259-015-3022-9.
    1. James BC, Ascherbrook-Kilfoy B, White MG, Applewhite M, Kaplan SP, Angelos P, Kaplan EL, Grogan RH. Quality of life in thyroid cancer-assessment of physician perceptions. J. Surgical Res. 2018;226:94–99. doi: 10.1016/j.jss.2017.11.069.
    1. Ascherbrook-Kilfoy B, James B, Nagar S, et al. Risk factors for decreased quality of life in thyroid cancer survivors: initial findings from the North American thyroid cancer survivorship study. Thyroid. 2015;25:1313–1321. doi: 10.1089/thy.2015.0098.
    1. Roth AJ, Kornblith AB, Batel-Copel L, Peabody E, Scher HI, Holland JC. Rapid screening for psychologic distress in men with prostate carcinoma: a pilot study. Cancer. 1998;82:1904–8. doi: 10.1002/(SICI)1097-0142(19980515)82:10<1904::AID-CNCR13>;2-X.
    1. Grassi L, Johansen C, Annunziata MA, Capovilla E, Costantini A, Gritti P, Torta R, Bellani M, Italian Society of Psycho-Oncology Distress Thermometer Study Group Screening for distress in cancer patients: a multicenter, nationwide study in Italy. Cancer. 2013;119:1714–21. doi: 10.1002/cncr.27902.
    1. Buchmann L, Ashby S, Cannon R, Hunt JP. Psychological distress in patients with thyroid cancer. Otolaryngol.-Head. Neck Surg. 2015;152:644–649. doi: 10.1177/0194599814565761.
    1. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr. Scandinavica. 1983;67:361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x.
    1. Castelli L, Binaschi L, Caldera P, Mussa A, Torta R. Fast screening of depression in cancer patients: the effectiveness of the HADS. Eur. J. Cancer Care. 2011;20:528–33. doi: 10.1111/j.1365-2354.2010.01217.x.
    1. McElduff P, Boyes A, Zucca A, Girgis A. Supportive Care Needs Survey: A guide to administration, scoring and analysis. Newcastle: Centre for Health Research & Psycho-oncology; 2004.
    1. Zeneli A, Fabbri E, Donati E, Tierney G, Pasa S, Berardi MA, Maltoni M. Translation of supportive care needs survey short form 34 (SCNS-SF34) into Italian and cultural validation study. Supportive Care Cancer. 2016;24:843–848. doi: 10.1007/s00520-015-2852-0.
    1. Fava GA, Osti RMA. Versione italiana della scala di Paykel per gli eventi stressanti. Firenze: Organizzazioni speciali; 1982.
    1. Roerink HPP, de Ridder, Prins J, Hujbers A, Hans JH, de Wilt HM, Repping-Wuts H, Stikkelbroeck NMML, Timmers HJ, Hermus RMM. High level of distress in long-term survivors of thyroid carcinoma: Results of rapid screening using the distress thermometer. Acta Oncologica. 2013;52:128–137. doi: 10.3109/0284186X.2012.723822.
    1. Mystakidou K, Tsilika E, Parpa E, Katsouda E, Galanos A, Vlahos L. Assessment of anxiety and depression in advanced cancer patients and their relationship with quality of life. Qual. Life Res. 2015;14:1825–1833. doi: 10.1007/s11136-005-4324-3.
    1. Sanson-Fischer R, Girgis A, Boyes A, Bonevsky B, Burton L, Cook P. The unmet supportive care needs of patients with cancer. Supportive Care Review Group. Cancer. 2000;88:226–237. doi: 10.1002/(SICI)1097-0142(20000101)88:1<226::AID-CNCR30>;2-P.
    1. Carey M, Lambert S, Smits R, Paul C, Sanson-Fisher R, Clinton-McHarg T. The unfulfilled promise: a systematic review of interventions to reduce the unmet supportive care needs of cancer patients. Support Cancer Patients. 2012;20:207–219. doi: 10.1007/s00520-011-1327-1.
    1. Goldfarb M, Casillas J. Unmet information and support needs in newly diagnosed thyroid cancer: comparison of adolescents/young adults (AYA) and older patients. J. Cancer Survivorship. 2014;8:394–401. doi: 10.1007/s11764-014-0345-7.
    1. Duan H, Gamper E, Becherer A, Hoffmann M. Quality of life aspects in the management of thyroid cancer. Oral. Oncol. 2015;51:S1–5. doi: 10.1016/j.oraloncology.2015.03.008.
    1. Dubey C, De Maria J, Hoeppli C, Betticher DC, Eicher M. Resilience and unmet supportive care needs in patients with cancer during early treatment: a descriptive study. Eur. J. Oncol. Nurs. 2015;19:582–588. doi: 10.1016/j.ejon.2015.03.004.
    1. Sawka AM, Brierley JD, Tsang RW, Rotstein L, Ezzat S, Goldstein DP. Unmet information needs of low-risk thyroid cancer survivors. Thyroid. 2016;26:474–475. doi: 10.1089/thy.2015.0569.
    1. Husson O, Mols F, Oranje WA, Haak HR, Nieuwlaat WA, Netea-Maier RT, Smit JW, van de Poll-Franse LV. Unmet information needs and impact of cancer in (long-term) thyroid cancer survivors: results of the PROFILES registry. Psychooncology. 2014;23:946–52. doi: 10.1002/pon.3514.
    1. Singer S, Lincke T, Gamper E, Bhaskaran K, Schreiber S, Hinz A, Schulte T. Quality of life in patients with thyroid cancer compared with the general population. Thyroid. 2012;22:117–24. doi: 10.1089/thy.2011.0139.
    1. van Velsen EFS, Massolt ET, Heersema H, Kam BLR, van Ginhoven TM, Visser WE, Peeters RP. Longitudinal analysis of quality of life in patients treated for differentiated thyroid cancer. Eur. J. Endocrinol. 2019;181:671–679. doi: 10.1530/EJE-19-0550.

Source: PubMed

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