Thyroid Cancer No Surgery: Patient Reaction to the diagnosis of possible or definite thyroid cancer.

Patient Reaction to the diagnosis of possible or definite thyroid cancer.

Thyroid 31(4)2021

S.Pitt et al

DR.Guttler’s comments:

1. 85 patients interviewed before thyroid surgery.

2. Many had 1 cm nodules.

3. Initial shock anxiety, fear, and strong desire to get it out.

4. After that a period of urgency lead to the need to get it done.

5. Waiting for the surgery was difficult.

6. This series of reactions was the same for both suspicious nodules and cancer nodules.

7. Waiting for the surgery while the cancer was still in their neck and also could be spreading was difficult.

8. Surgery was the way to return them to normal.

9. This lead to many minimizing the risks of complications with surgery.

10. Education about the risks with this slow growing cancer reassured some but not all about the dangers of surgery.

11. Patient reaction to the diagnosis pose a barrier to barriers to implementing less aggressive treatment methods.

12. This is why offering active surveillance AS instead of surgery is not acceptable to many patients.

13. Recent use of radiofrequency ablation for small papillary thyroid cancer is now being used in many centers as a third track to surgery and AS.

14. “GET IT OUT” Actual quotes from some of the 85 patients in the study.
    

15. “It’s Cancer”  “Just hearing the word cancer was a little hard”  “I think I was in shock”

16. “Get it Done” “It needs to come out” ” I am anxious to get it done and over with” ” I care less about the scar” ” I care how I look but it’s most important to get it out.”

17. “It could be spreading” “I got alot of hopes on this surgeon” ” Get it done and over with.” ” To top it off it had to be cancer.” ” Take it out” ” It may be slow growing but what if it got into the lymph nodes?”
    

18. “Surgery will fix it” ” I am going back to normal and routine the way it was before I had the diagnosis.” ” I can’t wait until I am able to say I am cancer-free, and it was just a small bump I had to deal with.”
    

19. 1/3 of the 85 cases had small nodules that were possible candidates for AS or RFA.

20. At my center I am offering Thyroid RFA for small thyroid cancers and indeterminate nodules as alternative to surgery or active surveillance.

21. Call me at 310-393-8860 or email to thyroid.manager@thyroid.com.

22. Ask for Alicia.

23. Dr.G.