A. Dougherty2, N. Robinson2, M. Ozkan2, I. Khan2, K. Roche2, E. Evans2, C. Jensen1, B. Sinco2, K. Bushaw1, M. Saucke1, A. G. Antunez3, C. I. Voils1, S. C. Pitt2 1University Of Wisconsin, Madison, WI, USA 2University Of Michigan, Ann Arbor, MI, USA 3Brigham And Women’s Hospital, Boston, MA, USA
Introduction: Thyroid cancer diagnosis is often accompanied by strong negative emotions, such as fear and anxiety, but little is known about these emotions in patients with benign thyroid nodules. This study examined the effect of a hypothetical cancer diagnosis, treatment information provision, and emotional support by surgeons on patients with a benign thyroid nodule.
Methods: Patients <30-days after a benign thyroid nodule biopsy were enrolled in randomized trial and asked to imagine their biopsy was thyroid cancer then write down their feelings about this diagnosis. Participants then watched a video depicting a patient-surgeon discussion of thyroid cancer treatment options with or without added emotional support from the surgeon (1:1 allocation). Validated measures assessed state anxiety and thyroid cancer-related fear at baseline and after watching the video. Thematic analysis evaluated participants’ feelings about their hypothetical diagnosis. T-tests and Pearson chi-squared were used to analyze quantitative measures. All participants were debriefed at the end of the study to ensure they knew their thyroid nodule was not cancerous.
Results: Of 208 eligible patients, 118 participated (56.7%). Most participants were female (85.6%), White (88.1%), and had a thyroid nodule measuring ≤3 cm (62.7%). Overall, 45.8% had bilateral nodules, and 18.6% reported symptoms. Less than a quarter of participants (22.9%) thought they were more likely to get thyroid cancer than the average person. Participants had significantly higher state anxiety after performing the thought exercise and watching the video (9.1 (3.2) vs. 11.5 (4.0), p<0.001). However, thyroid cancer-related fear decreased over the same time period (26.5 (6.3) vs. 24.8 (7.0), p<0.001). Added emotional support by the surgeon in the video did not affect participants' level of anxiety or fear. Themes that emerged from participants imagining they have thyroid cancer are shown in the Table along with exemplary quotes. Emotions described by participants (bolded in the table) were predominantly negative.
Conclusion: This study demonstrates that patients with benign thyroid nodules experience increased anxiety when thinking about having thyroid cancer. Provision of treatment-related information from a surgeon, but not emotional support, decreases their cancer-related fear. Patients with benign thyroid nodules may benefit emotionally from being provided with information about thyroid cancer prior to or at the time of their biopsy.
