The effect of thyroid hormone withdrawal performed to evaluate the success of I-131 ablation on quality of life and psychological symptoms in female patients with low-risk differentiated thyroid cancer

Authors : Osman KUPIK, Bayram ŞEN, Medeni ARPA, Uğur AVCI, Hasan GÜNDOĞDU, Süleyman KALCAN, Hasan GÜÇER, Şafak AKIN, Murat TUNCEL

Pages : 66-72

Doi:10.32322/jhsm.1196968

View : 55 | Download : 12

Publication Date : 2023-01-12

Article Type : Research Paper

Abstract :Aim: There is a need to evaluate the treatment response in patients who have undergone radioiodine treatment insert ignore into journalissuearticles values(RIT); for differentiated thyroid cancer. Diagnostic tests that are used for this purpose include radioiodine whole-body scan insert ignore into journalissuearticles values(WBS); and serum thyroglobulin insert ignore into journalissuearticles values(Tg); measurement, which are most accurate during thyroid-stimulating hormone insert ignore into journalissuearticles values(TSH); stimulation. However, temporary discontinuation of thyroid hormone therapy to increase TSH insert ignore into journalissuearticles values(withdrawal); may be associated with the morbidity of hypothyroidism. The study aimed to show the effects of thyroid hormone withdrawal insert ignore into journalissuearticles values(THW); on quality of life and psychological symptoms in female patients with low-risk, well-differentiated papillary thyroid cancer. Material and Method: We applied the short form-36 insert ignore into journalissuearticles values(SF-36); and Symptom Checklist-90-R insert ignore into journalissuearticles values(SCL-90-R); questionnaires to the patients in the euthyroid state who have referred a median of 9 months insert ignore into journalissuearticles values(6-13 months); after RIT to perform a dWBS and to evaluate stimulated Tg. We applied the same questionnaire again when thyroid-stimulating hormone insert ignore into journalissuearticles values(TSH); was > 30 μIU/mL 4 weeks after THW insert ignore into journalissuearticles values(hypothyroid state);. Results: 52 patients were evaluated insert ignore into journalissuearticles values(median age 48 years, range 23-65 years);. There was a statistically significant worsening in anxiety, psychosis, additional items, and general symptoms of the SCL-90-R questionnaire. With the SF-36 questionnaire, we observed statistically significant worsening in physical functioning, role limitation due to physical health, energy/fatigue, emotional well-being, social functioning, and general health change. Conclusion: THW worsened the patients’ psychological symptoms and quality of life. To reduce the side effects of hypothyroidism, treatment response assessment with TSH stimulation should be used only in a selected group of patients. 
Keywords : Thyroid cancer, hypothyroidism, life quality, psychological symptom

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