Health-related quality of life among thyroid cancer survivors
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1 Health-related quality of life among thyroid cancer survivors Center of Research on Psychology in Somatic diseases Drs. Olga Husson Tilburg University 17/09/2012 Acta Oncologica Symposium Copenhagen Background (1) Incidence rates are rising worldwide Aggressive surgical and postoperative treatment procedures Lifelong dependence on exogenous thyroid hormone Five-year relative survival >90% 1
2 Background (2) Ourliteraturereviewshowed 1 : Severeimpairmentsof HRQoLaftertreatmentand follow-up procedures Long-term thyroid cancer survivors understudied population Results contradictory: absence of thyroid cancer specifichrqolquestionnaire, smallsample sizes, lack of normative population. 1. Husson et al. (2011), Clinical Endocrinology Aims of the present study Comparing a sample of thyroid cancer survivors with an age-and sex-matched normative population on HRQoL Socio-demographic and clinical characteristics associated with (thyroid cancer specific) HRQoL 2
3 Methods(1): Setting and participants Population-based cross-sectional survey Thyroid cancer patients (diagnosed between ) were selected from the Eindhoven Cancer Registry (ECR). Data collection conducted in 2010 Methods(2): Data collection Medical specialists from 11 hospitals were involved Sent invitation letter and a questionnaire to the selected patients Questionnaires: EORTC QLQ-C30(HRQoL) 2 THYCA-QoL(Thyroid cancer specific HRQoL) 3 Single questions about socio-demographics Questionnaires were linked with disease history as registered by ECR; Stage, date of diagnosis, date of birth etc. 2. Aaronsonet al. (1993), J NatlCancerInst; 3. Hussonet al. (in press), Acta Oncologica 3
4 Results(1): Response 355 patients received a questionnaire 306 patients participated(86%) No differences between respondents and nonrespondents on socio-demographic and clinical variables Results(2): Participant characteristics Meanagetime survey: 56 (15) years Mean years since diagnosis: 9.6 (5.5) years 75% female 71% papillary; 20% follicular thyroid cancer 57% stage I, 20% stage II, 16% stage III 77% at least one comorbid condition 4
5 Results(3): EORTC QLQ-C30 functioning Scalesof the EORTC QLQ- C30 (0-100) Results(4): EORTC QLQ-C30 symptoms 5
6 Results(5) Thyroid cancer specific HRQoL Most common reported complaints were: Sympathetic problems (feeling chilly, hot flushes, and difficulty tolerating heat) Neuromuscular problems (cramp legs and pain joints/muscles) Abrupt attacks of fatigue Results (6): Associations clinical and sociodemographic variables with HRQoL Higher stage disease: more voice problems Fewer years since diagnosis: more voice, throat and scar problems Females: more sympathetic problems Comorbidcondition, low educationallevel and absence of partner: worsefunctioningand more symptoms(qlq-c30) 6
7 Results (7): Associations thyroid cancer specific problems with HRQoL Neuromuscularproblems: worse functioning on all scales, except cognitive Concentrationproblems: worse cognitive and social functioning Sympatheticproblemsand headache: worse global quality of life Psychologicalproblems: worse physical, emotional and social functioning and global quality of life Discussion Most clinical variables were not directly associated with HRQoL Comorbid conditions were associated with lower(thyroid cancer specific) HRQoL Thyroid cancer specific symptoms were most strongly associated with HRQoL this possibly indicates thyroid dysregulation 7
8 Conclusions Thyroid cancer specific problems last up to 20 years after diagnosis and are strongly associated with HRQoL. Awareness of these specific determinants of HRQoL could help health care practitioners to provide better supportive care. Thank you for your attention! Health-related quality of life and disease specific symptoms in (long-term) thyroid cancer survivors: a study from the population-based PROFILES registry. Olga Husson, Harm Haak, Laurien Buffart, Willy- Anne Nieuwlaat, Wilma Oranje, FloortjeMols, Johannes Kuijpens, Jan-Willem Coebergh, Lonneke van de Poll-Franse. Submitted for publication O.Husson@tilburguniversity.edu Website: Data available at: 8
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