Factors affecting the health-promoting behavior of thyroid cancer survivors: comparison by stage of cancer survivorship

Purpose The purpose of this study was to identify differences in factors affecting health-promoting behaviors according to the survival stage of thyroid cancer survivors. Methods This descriptive cross-sectional study analyzed data from 354 thyroid cancer survivors after diagnosis. The survivors were divided into three stages: (1) the acute stage (< 2 years after diagnosis), (2) extended stage (2–5 years after diagnosis), and (3) permanent stage (≥ 5 years after diagnosis). To measure health-promoting behavior, the revised Korean version of the Health Promoting Lifestyle Profile questionnaires was used. The factors affecting the health-promoting behavior included social support, self-efficacy, fear of recurrence, and symptoms. Multiple regression analysis was used to analyze factors affecting the health-promoting behavior according to survival stage. Result The factors affecting the health-promoting behavior of thyroid cancer survivors differed by survival stage. In the acute stage, the factors of health-promoting behavior were self-efficacy (t = 4.76, p < .001) and social support (t = 3.54, p < .001). In the extended stage, symptoms (t = − 3.65, p < .001), social support (t = 2.61, p = .011), fear of recurrence (t = 2.18, p = .032), and receipt of radioiodine treatment (t = − 2.18, p = .032) were found to be significant variables that affected health-promoting behaviors. In the permanent stage, social support (t = 2.79, p = .007), receipt of radioiodine treatment (t = − 3.21, p = .002), and age (t = − 2.77, p = .007) were significant variables that affected health-promoting behaviors. Conclusion The experience of thyroid cancer survivors varies as they progress through the survival stages; thus, health-promotion interventions should be tailored to each survival stage.

The effect of radioiodine treatment on the characteristics of TRAb in Graves’ disease

Background Graves’ disease (GD) is one of the most common autoimmune thyroid diseases (AITDs) in humans, and thyrotropin receptor antibody (TRAb) is a characterized autoantibody in GD. The use of radioactive iodine therapy (RAI) for GD treatment is increasing. Objectives We studied the biological properties of TRAb and evaluated the effect of RAI therapy on TRAb in GD patients. Methods In total, 225 patients (22 onset GD patients without 131I therapy, 203 GD patients treated with 131I therapy) and 20 healthy individuals as normal controls were included in this study. Clinical assessments were performed, and we examined in vitro the biological properties of TRAb in the 22 onset GD patients and 20 controls as well as 84 GD patients with 131I therapy. Results Serum TRAb and thyroid peroxidase antibody (TPOAb) levels increased in the initial year of RAI treatment, and both antibodies decreased gradually after one year. After 5 years from radioiodine treatment, TRAb and TPOAb levels decreased in 88% and 65% of GD patients, respectively. The proportion of patients positive for thyroid-stimulatory antibody (TSAb) was significantly higher in the 7–12-month group, and thyroid-blocking antibody (TBAb) levels were elevated after one year in half of the patients who received 131I treatment. Conclusions Treatment of GD patients with radioiodine increased TPOAb and TRAb (their main biological properties were TSAbs) within the first year after therapy, and the main biological properties of elevated TRAb were TBAbs after 1 year.

The RAI-6 Questionnaire: A New Screening Questionnaire to Monitor Complications of Radioiodine Treatment

Objective: The aim of this study is to develop a simple and efficient screening questionnaire to be able to routinely monitor potential radioiodine therapy-induced complications.Materials and Methods: A new radioiodine 6 (RAI-6) questionnaire containing six questions adressing salivary, ocular, and nasal symptoms as well as quality of life was developed. Validation of the RAI-6 questionnaire was assessed with a group of fifty-four patients diagnosed with differentiated thyroid carcinoma treated post-operatively with radioiodine therapy, and in a group of fifty healthy volunteers. The patient's group was subdivided into subgroups according to the radioiodine dose received: 23 patients received less or 30 mCi, 28 patients received 100 mCi, and three patients received between 200 and 300 mCi. We asked the patients to complete the RAI-6 questionnaire in a retrospective manner, regarding their situation before radioiodine therapy and regarding their actual symptoms after radioiodine therapy. The time needed to complete the RAI-6 was also assessed both in patients and in healthy volunteers.Results: The mean post radioiodine treatment RAI-6 score were significantly higher than the mean pre radioiodine RAI-6 scores (p &lt; 0.001) and the scores of healthy participants (p &lt; 0.001). The mean total RAI-6 scores increased significantly with increasing radioiodine dose. A total mean RAI-6 score of each question was also analysed and revealed that ocular and nasal discomfort as well as quality of life were the items which affected the patients most after radioiodine treatment. The mean time to fill the RAI-6 questionnaire was 2 min for patients and 49 s for healthy volunteers.Conclusion: The RAI-6 represents a new questionnaire which is easy and quick to complete. This simple screening tool can be recommended for general clinical practise and further epidemiological research.

Potential Use of Biomarker γ-H2AX on Peripheral Blood Patient Who Underwent Radioiodine Ablation Treatment in Indonesia

Thyroid cancer is one of the most common endocrine malignancies. Although the 10-year survival rate of differentiated thyroid cancer (DTC) is about 90% after conventional treatments, a small proportion of patients still suffer from tumor recurrence or drug resistance. DNA doublestrand breaks (DSBs) are important cellular lesions that can result from ionizing radiation exposure. The biomarker for DSB formation is the phosphorylated form of the histone H2 variant H2AX (γ-H2AX). We propose the use of γ-H2AX as a DNA DSB biomarker in thyroid cancer patients receiving radioiodine treatment as a possibility to detect the potential of instability genome after receiving the treatment. Evaluating DNA DSB damage with γ-H2AX biomarker might be important in managing thyroid cancer.

Oxidative stress and radioiodine treatment of differentiated thyroid cancer

It is hypothesized that the oxidative stress level in thyroid cancer patients is additionally upregulated by radioactive iodine (RAI) treatment, that may exert an important impact on future health concerns. In our study, we evaluated the oxidative stress level changes using the measurement of malondialdehyde (MDA) concentration in patients with differentiated thyroid cancer (DTC) undergoing RAI treatment. Considering the results obtained in the study group, the serum levels of MDA in DTC patients were significantly higher compared to the healthy subjects (p < 0.05). The MDA concentration was significantly higher on the third day after RAI (p < 0.001) and significantly lower one year after RAI (p < 0.05) in DTC patients compared to the baseline concentration. Moreover, the redox stabilization after RAI treatment in patients with DTC during a year-long observation was demonstrated. Accordingly, an increased oxidative stress impact on the related biochemical parameters reflecting the health conditions of the DTC patients was determined. Our study showed that increased oxidative stress reflected by MDA measurements in DTC patients is further enhanced by RAI, but this effect is no longer observed one year after the therapy.

The Association Between The Interval of Radioiodine Treatment and The Response and Adverse Effect in Patients with Non-Progressive Lung Metastases From Differentiated Thyroid Cancer

Purpose To assess the association between the interval of radioiodine treatment (RT) and short-term response and adverse effects in patients with non-progressive lung metastases from differentiated thyroid cancer (DTC).Methods A total of 147 neighboring RT course pairs from 78 patients with 131I-avid non-progressive lung metastases from DTC were retrospectively analyzed. The courses were categorized into two groups by interval of neighboring therapeutic 131-I administrations (≤12 months and >12 months). The short-term therapy response and adverse effects of the two groups were evaluated.Results No significant differences were found between the two groups in the change rate of thyroid stimulating hormone (TSH) stimulated serum thyroglobulin (ΔsTg%) (P=0.806) or the change rate of metastasis lesion long diameter (ΔLLD%) (P=0.246). In the subanalysis considering the number of treatments (3 and >3 times), no significant difference was found (P>0.05). No difference was found in biochemical response (interval ≤12m: P=0.325, interval >12m:P=0.456) or structural response (interval ≤12m: P=0.760, interval >12m: P=0.563) between the former and latter courses with regard to different intervals. No difference was found in adverse events between former and latter courses with regard to different intervals (P>0.05).Conclusions The interval of RTs is not associated with the short-term response or adverse effects in patients with non-progressive lung metastases from DTC. Appropriately prolonging the interval in specific patients seems to be feasible, and the interval of RT should be individually managed in clinical practice.