BALANCING DEMANDS OF CANCER SURVEILLANCE AMONG SURVIVORS OF THYROID-CANCER

PURPOSE: The purpose of this qualitative study was to explore and desc ribe the demands of long-term cancer surveillance among survivors of t hyroid cancer and how these perceived demands influence their quality of life. DESCRIPTION OF STUDY.: The sample consisted of 34 participant s who had undergone thyroid hormone withdrawal before boyd scanning fo r evaluation of cancer recurrence and/or metastatic disease. Participa nts completed two self-report instruments: 1) a Demographic Data Tool, and 2) three open-ended questions about quality of life during thyroi d hormone withdrawal. The participants wrote down their answers to the demographics and open-ended questions. RESULTS: The 34 participants h ad a mean age of 40 years (range, 22-73 years); 85% were women, and 74 % were white. All were high school educated, and 32% were college grad uates. Sixty-eight percent were married, and 75% were employed either full-or part-time. Participants experienced profound changes in relati onship to withdrawal from thyroid hormone medication. These changes in physical well-being coupled with the potential for disease recurrence influenced their psychological and social well-being. Balancing the d emands of cancer surveillance (through body scanning and thyroid hormo ne withdrawal) against day-to-day living had a major influence on perc eptions of quality of life. CLINICAL IMPLICATIONS: Study results suppo rt other studies and clinical cal reports that physical symptoms relat ed to thyroid hormone withdrawal were profound! severe, and debilitati ng. First, participants with thyroid cancer had to learn through their own personal experiences what physical limitations were imposed durin g the period of surveillance testing. Second, the physical changes and anticipation of body scanning exerted a profound effect on psychologi cal and social well-being. Feelings of loss, anxiety, depression, and loss of concentration were very difficult to endure. Third, given the general characteristics of this population of thyroid cancer survivors who generally are younger and working, the experience of hypothyroidi sm can have a major impact on work schedules. Individuals who require a large amount of concentrated attention to work tasks may need to mod ify their work schedules during hypothyroid states. Findings suggest t hat individuals who are considered ''cured'' of their disease are a la rgely forgotten segment of cancer survivors. However, participants in this study continued to inform us of the process of cancer survivorshi p and the need for exploring quality-of-life concerns, regardless of p rognosis.