Cancer-related Fear and Worry in Patients With Low-risk Thyroid Cancer: A Longitudinal Cohort Study.

Abstract

Little is known about how patients' emotions impact the choice between hemi- and total thyroidectomy (TT) for low-risk thyroid cancer (LR-TC) and how these emotions change after treatment. To investigate thyroid cancer-specific fear and worry both before and after treatment of LR-TC with hemi- or TT. This prospective cohort study enrolled adults with confirmed or likely LR-TC at 15 institutions. Participants completed measures of thyroid cancer-related fear and worry at the time of their treatment decision and 9 months later. Participants were categorized as having low, medium, or high levels of fear and worry in accordance with the literature. Those choosing hemithyroidectomy were compared to those choosing TT. Of 177 eligible patients, 125 (70.6%) enrolled and 114 completed both surveys (91.2% retention). Overall, 41 (36.0%) participants chose hemithyroidectomy and 73 (64.0%) chose TT. Across all participants, thyroid cancer-related fear and worry both decreased significantly after surgery (fear, 25.8 ± 6.4 to 23.1 ± 7.4; worry, 8.2 ± 2.4 to 5.4 ± 2.1, P < .001). The proportion of participants with high fear decreased from 64.9% to 50.9%, whereas the proportion with high worry decreased from 75.4% to 41.2% (P < .001 for both). At both time points, no differences existed between those choosing hemi- and TT in levels of worry or fear. Patients with LR-TC report lower levels of fear and worry 9 months after surgery regardless of the extent of surgery, suggesting that both surgeries provide an emotional benefit to some patients. Thyroid cancer-related fear and worry do not appear to influence patients' decisions to undergo hemi- or TT.