Dr.Guttler’s Patient Thyroid Blog Post: #11 Quality of Life in Patients With Hypoparathyroidism After Treatment for Thyroid Cancer

Dr.Guttler’s Comments:

1. Thyroid cancers are usually treated with surgery.
2. However small low risk papillary thyroid cancer can be treated without surgery.
3. A major complication to be avoided if alternative therapy with radiofrequency ablation RFA is loss of parathyroid function.
4. Quality of life is changed after parathyroid damage during surgery similar to vocal cord damage.
5. Eighty-nine patients participated in this study,
6. 17/89 patients had surgical loss of parathyroid function.
7. Patients with surgical parathyroid damage reported significantly reduced QoL.
8. Thyroid cancer patients with parathyroid damage report significantly impaired QOL compared to thyroid cancer survivors without.
9. The lesson is avoid surgery if alternative therapy is effective.
10. Also avoid surgery if you have a benign goiter or nodule. that can be treated with RFA or ethanol.
11. Call me at 310-393-8860 or email to thyroid.manager@thyroid.com for an evaluation before the surgery.
12. Ask for Alicia
13. Dr.G.

J Clin Endocrinol Metab

. 2020 Dec 1;105(12)
Quality of Life in Patients With Hypoparathyroidism After Treatment for Thyroid Cancer
Matthias Büttner et al

Abstract

Purpose: Surgical complications such as hypoparathyroidism (HPT) or vocal cord palsy are seldom assessed when the quality of life (QOL) in thyroid cancer patients is investigated. The aim of this study was to measure the QOL difference in thyroid cancer survivors with and without HPT.

Methods: Participants for this analysis were enrolled in 13 countries from a study that pilot-tested a thyroid cancer-specific QOL instrument. They were included if they had been diagnosed with thyroid cancer at least 9 months previously. QOL was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core (EORTC QLQ-C30) and some items on HPT symptoms (eg, tingling in fingers or toes). HPT status and other clinical data were extracted from the patients’ medical charts. Comparisons of QOL domains between patients with and without HPT were performed using Mann-Whitney U test. The occurrence of HPT-related symptoms was compared using chi-square tests. Multiple ordinal regression analysis was performed to evaluate factors that might affect QOL.

Results: Eighty-nine patients participated in this study, 17 of whom were considered to have HPT. Patients in the HPT group reported significantly reduced QOL in 9 of the 15 scales of the EORTC QLQ-C30 compared to patients without HPT. Regression analysis showed that HPT was independently negatively associated with various scales of the QLQ-C30. Both groups showed a high prevalence of typical HPT symptoms.

Conclusion: Thyroid cancer patients with HPT report significantly impaired QOL compared to thyroid cancer survivors without HPT. The assessment of HPT should be considered when measuring QOL in thyroid cancer patients.