Quality of Life Research

, 20:1411 | Cite as

Psychological impact of thyroid surgery on patients with well-differentiated papillary thyroid cancer

  • Tae-Yon Sung
  • Yong-Wook Shin
  • Kee-Hyun Nam
  • Hang-Seok Chang
  • Yumie Rhee
  • Cheong Soo Park
  • Woong Youn Chung



Most patients with well-differentiated thyroid cancer (WDTC) have favorable prognosis and survive for many years. We investigated the effect of thyroid cancer surgery on subsequent psychological aspects.


Demographic parameters, clinical characteristics, and other data were obtained from self-administered questionnaires administered to WDTC patients at various times after thyroid cancer surgery. The questionnaires assessed psychological aspects based on three scales: a performance of everyday activities questionnaire developed for this study, the Hospital Anxiety and Depression Scale (HADS), and the Fear of Progression Questionnaire (FoP-Q).


The mean time since thyroid surgery and the survey was 3.5 years. More than half of the patients (60.7%) were able to perform all activities without limitations. The HADS scores indicated no anxiety or depression in most patients, and the FoP-Q scores indicated little fear of cancer progression. The time since surgery, type of surgery, use of postoperative radioiodine ablative therapy, and recurrence or metastasis had no significant effect on the psychological scores.


Our study indicates that most WDTC patients are psychologically stable after the thyroid cancer surgery.


Well-differentiated thyroid cancer Psychological aspects Hospital anxiety and depression scale Fear of disease progression 



Fear of progression questionnaire


Hospital anxiety and depression scale


Modified radical neck dissection


Quality of life


Radioiodine ablative therapy


Well-differentiated thyroid cancer


Yonsei University Severance Hospital


  1. 1.
    Grodski, S., Brown, T., Sidhu, S., Gill, A., Robinson, B., Learoyd, D., et al. (2008). Increasing incidence of thyroid cancer is due to increased pathologic detection. Surgery, 144, 1038–1043.PubMedCrossRefGoogle Scholar
  2. 2.
    Jossart, G. H., & Clark, O. H. (1994). Well differentiated thyroid cancer. Current Problems in Surgery, 31, 933–1912.PubMedCrossRefGoogle Scholar
  3. 3.
    Mazzaferri, E. L., & Jhiang, S. M. (1994). Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. American Journal of Medicine, 97, 418–428.PubMedCrossRefGoogle Scholar
  4. 4.
    Mazzaferri, E. L. (1999). An overview of the management of papillary and follicular thyroid carcinoma. Thyroid, 9, 421–427.PubMedCrossRefGoogle Scholar
  5. 5.
    Kebebew, E., & Clark, O. H. (2000). Differentiated thyroid cancer: “Complete” rational approach. World Journal of Surgery, 24, 942–951.PubMedCrossRefGoogle Scholar
  6. 6.
    Shaha, A. R. (2000). Thyroid cancer: Extent of thyroidectomy. Cancer Control, 7, 240–245.PubMedGoogle Scholar
  7. 7.
    DeGroot, L. J., Kaplan, E. L., McCormick, M., & Straus, F. H. (1990). Natural history, treatment, and course of papillary thyroid carcinoma. Journal of Clinical Endocrinology and Metabolism, 71, 414–424.PubMedCrossRefGoogle Scholar
  8. 8.
    Mazzaferri, E. L., & Young, R. L. (1981). Papillary thyroid carcinoma: A ten-year follow-up report on the impact of treatment in 576 patients. American Journal of Medicine, 70, 511–518.PubMedCrossRefGoogle Scholar
  9. 9.
    Schultz, P. N., Stava, C., & Vassilopoulou-Sellin, R. (2003). Health profiles and quality of life of 518 survivors of thyroid cancer. Head and Neck, 25, 349–356.PubMedCrossRefGoogle Scholar
  10. 10.
    Tagay, S., Herpertz, S., Langkafel, M., Erim, Y., Bockisch, A., Senf, W., et al. (2006). Health-related quality of life, depression and anxiety in thyroid cancer patients. Quality of Life Research, 15, 695–703.PubMedCrossRefGoogle Scholar
  11. 11.
    Botella-Carretero, J. I., Galan, J. M., Caballero, C., Sancho, J., & Escobar-Morreale, H. (2003). Quality of life and psychometric functionality in patients with differentiated thyroid carcinoma. Endocrine-Related Cancer, 10, 601–610.PubMedCrossRefGoogle Scholar
  12. 12.
    Dagan, T., Bedrin, L., Horowitz, Z., Chaushu, G., Wolf, M., Kronenberg, J., et al. (2004). Quality of life of well-differentiated thyroid carcinoma patients. The Journal of Laryngology & Otology, 118, 537–542.CrossRefGoogle Scholar
  13. 13.
    Alemida, J., Vartanian, F. G., & Kowalski, L. P. (2009). Clinical predictors of quality of life in patients with initial differentiated thyroid cancers. Archives of Otolaryngology-Head & Neck Surgery, 135, 342–346.CrossRefGoogle Scholar
  14. 14.
    Shah, M. D., Witterick, I. J., Eski, S. J., Pinto, R. P., & Freeman, J. L. (2006). Quality of life in patients undergoing thyroid surgery. The Journal of Otolaryngology, 35, 209–215.PubMedCrossRefGoogle Scholar
  15. 15.
    Tan, L. G., Nan, L., Thumboo, J., Sundram, F., & Tan, L. K. (2007). Health-related quality of life in thyroid cancer survivors. The Laryngoscope, 117, 507–510.PubMedCrossRefGoogle Scholar
  16. 16.
    Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 6, 361–370.CrossRefGoogle Scholar
  17. 17.
    Oh, S. M., Min, K. J., & Park, D. B. (1999). A study on the standardization of the hospital anxiety and depression scale for Koreans: A comparison of normal, depressed and anxious groups. Journal of Korean Neuropsychiatric Association, 38, 289–296.Google Scholar
  18. 18.
    Herschbach, P., Berg, P., Dankert, A., Duran, G., Engst-Hastreiter, U., Waadt, S., et al. (2005). Fear of progression in chronic diseases psychometric properties of the fear of progression questionnaire. Journal of Psychosomatic Research, 58, 505–511.PubMedCrossRefGoogle Scholar
  19. 19.
    Karvonen-Gutierrez, C. A., Ronis, D. L., Fowler, K. E., Terrell, J. E., Gruber, S. B., & Duffy, S. A. (2008). Quality of life scores predict survival among patients with head and neck cancer. Journal of Clinical Oncology, 26, 2754–2760.PubMedCrossRefGoogle Scholar
  20. 20.
    Hammerlid, E., Silander, E., Hörnestam, L., & Sullivan, M. (2001). Health-related quality of life three years after diagnosis of head and neck cancer–a longitudinal study. Head and Neck, 23, 113–125.PubMedCrossRefGoogle Scholar
  21. 21.
    Holloway, R. L., Hellewell, J. L., Marbella, A. M., Layde, P. M., Myers, K. B., & Campbell, B. H. (2005). Psychosocial effects in long-term head and neck cancer survivors. Head and Neck, 27, 281–288.PubMedCrossRefGoogle Scholar
  22. 22.
    Campbell, B. H., Marbella, A., & Layde, P. M. (2000). Quality of life and recurrence concern in survivors of head and neck cancer. Laryngoscope, 110, 895–906.PubMedCrossRefGoogle Scholar
  23. 23.
    Raison, C. L., & Miller, A. H. (2003). Depression in cancer: New developments regarding diagnosis and treatment. Biological Psychiatry, 54, 283–294.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Tae-Yon Sung
    • 1
  • Yong-Wook Shin
    • 2
  • Kee-Hyun Nam
    • 3
  • Hang-Seok Chang
    • 3
  • Yumie Rhee
    • 4
  • Cheong Soo Park
    • 3
  • Woong Youn Chung
    • 3
  1. 1.Department of Surgery, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
  2. 2.Department of NeuropsychiatrySeoul National University HospitalSeoulKorea
  3. 3.Department of SurgeryYonsei University College of MedicineSeoulKorea
  4. 4.Department of Internal MedicineYonsei University College of MedicineSeoulKorea

Personalised recommendations