DETERMINANTS OF QUALITY OF LIFE IN PATIENTS UNDER 45 YEARS WITH TREATED PAPILLARY THYROID CARCINOMA

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 459-496-Thyroid Neoplasia & Case Reports
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-492
Carla Maria Ramos Germano*1, Debora Bonato1, Victor H Maion2, Lucimar RS de Avo1, Debora G Melo1 and Bruno JB Fontanella1
1UFSCar, Sao Carlos, SP, Brazil, 2Santa Casa of Sao Carlos, Sao Carlos, SP, Brazil
Thyroid disorders are very common in the general population and papillary thyroid carcinoma (PTC) is a frequent endocrine cancer. PTC patients generally have a good prognosis and overall survival rates of treated individuals are above 95%. Nevertheless, previous studies suggest that PTC diagnosis and treatment can impair quality of life. The present study aimed to investigate possible determinants of quality of life in patients with treated papillary thyroid carcinoma (PTC) under 45 years, exploring them through the participants’ personal statements. A qualitative method applied to clinical problems was used, including the methodological technique of theoretical saturation to define the sample size. Informed consent was obtained from all patients and the study was approved by the institutional ethics committee. Sixteen patients with treated PTC, 15 women and 1 man, aged between 18 and 45 years, were asked to undergo a semi-structured in-depth interview about their life after treatment. All patients had a history of total thyroidectomy followed by radioiodine ablation, were free of metastatic disease and under levothyroxine treatment. The interviews were literally transcribed and their contents were independently analyzed by 4 researchers (1 medical student and three medical teachers, a pathologist, a psychiatrist and an endocrinologist) who decided afterwards, by common agreement, which categories were relevant to the proposed aim. Seven analytical categories were designed: experiences on prognosis and on the lifetime threat of disease, impact on social roles (family, friends and work), altered body perception, management of the concept of cancer etiology, review of some personal meanings of life, insertion in the conceptual universe of medicine and impact on labor. Fear of a relapse, health alertness, negative psychological mechanisms developed to cope with the disease trauma (as somatization), dependence to a lifetime hormonal replacement, changes in family dynamics, decrease in social role, disease “sequels” (except the cosmetic ones) and changes on labor, as a consequence of the disease or its treatment, were perceived to have a negative impact on quality of life. Some points were perceived by patients as having a positive impact in their quality of life as: positive cope mechanisms developed after the cancer experience (as altruism), change to healthier life habits, family support and review of some meanings of life. Therefore, the experience of being diagnosed and treated for PTC has led to positive and negative changes in patients’ quality of life. The utilization of a qualitative methodology applied to clinical problems has permitted an analysis and interpretation of the meaning of PTC experience (diagnosis and treatment) for the participant patients, leading to the identification of possible significant determinants of quality of life in young adults with treated PTC.

Nothing to Disclose: CMRG, DB, VHM, LRD, DGM, BJF

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

Sources of Research Support: CNPQ