Fatigue and quality of life among thyroid cancer survivors without persistent or recurrent disease

Abstract

Background: Cancer-related fatigue is one of the most important issues for patients, but research on this topic is sparse. This study aimed to determine the prevalence of fatigue in postoperative patients with papillary thyroid carcinoma (PTC) and to identify the clinical features associated with fatigue. Methods: We conducted a cross-sectional study on 292 thyroid cancer survivors. Fatigue and quality of life were the study outcomes, measured using the Cancer Fatigue Scale (CFS) and the SF-36 version 2.0. Furthermore, correlations of demographic characteristics and hormonal data with the CFS scores were assessed by univariable and multivariable analyses. Results: The prevalence of fatigue was 41.8% (95% CI: 36.1, 47.5). The CFS score was significantly correlated the free T3 level (Pearson's r = −0.123, 95%CI: −0.234, −0.008). Multiple regression analysis revealed that the free T3 level and having a job were significant predictors of the CFS score, with unstandardized regression coefficients of −2.52 (95% CI: −4.94, −0.09) and 2.85 (95% CI: 0.49, 5.20), respectively. The median Z-scores were negative for General Health (−0.28) and Vitality (−0.15) subscales of the SF-36.The CFS score was a significant predictor of summary scores of the SF-36. The free T3 level was significantly associated with the physical component summary score with an unstandardized coefficient of 3.20 (95%CI: 0.77, 5.63). Conclusions: Fatigue was prevalent and associated with poor quality of life among PTC survivors. Thyroid functional status, particularly the level of free T3, may be worth to be considered in alleviating the burden.

Quality of Life of Survivors of Thyroid Cancer Is Not Inferior to That in Subjects without Cancer: Long-Term after Over 5 Years

“…Most studies previously evaluated HRQoL according to treatment modality in only thyroid cancer survivors without comparative data and focused on depression, anxiety, fatigue, and concern about recurrence of thyroid cancer. Some articles evaluated HRQoL without valid tools or normative data [ 9 - 11 , 15 ]. After developing, validating, and translating questionnaires such as the EQ-5D [ 41 ], Thyroid Cancer Survivors’ Association (ThyCA)QoL [ 42 ], Thyroid-Specific Patient Reported Outcome (ThyPRO) [ 43 ], and European Organization for Research and Treatment of Cancer (EORTC)-Quality of Life Questionnaire-30 (EORTC-QLQ-C30) [ 44 ], several studies have adapted these tools.…”

“…Previous studies have reported that thyroid cancer survivors experience physical or psychological distress [9][10][11][12][13][14]. These studies had small sample sizes and short-term follow-up period [10,11,13] or lacked a healthy control group [9][10][11][12]15]. These studies also lacked valid tools to evaluate health-related (HR) QoL [9][10][11].…”

Health-related quality of life in long-term differentiated thyroid cancer survivors: A cross-sectional Tunisian-based study

“…Some authors have hypothesized that a high level of free T3 is associated with altered physical performance and fatigue in DTC survivors undergoing TSH suppression. They suggest considering thyroid functional status, particularly the level of free T3, to alleviate the burden on HRQoL ( 37 ). The recent trend of individualizing treatment and avoiding aggressive interventions in low-risk cases of thyroid cancer is expected to have a positive impact on the HRQoL of long-term survivors ( 38 ).…”

Effect of Psychological Intervention on Differentiated Thyroid Cancer Patients in the Treatment with Radioactive Iodine

“…The scale has a high sensitivity and specificity and usually set a cut-off value of 19 to identify fatigue in cancer patients. 16 …”

“…15 The cancer fatigue scale (CFS) is a 15-item scale used to assess fatigue in cancer patients with a total score ranging from 0 (no fatigue) to 60 (maximum). 16 The scale has 3 subscales including physical (maximum score of 28), affective (maximum score of 16), and cognitive (maximum score of 16). The scale has a high sensitivity and specificity and usually set a cut-off value of 19 to identify fatigue in cancer patients.…”