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Patients' Reaction to Diagnosis with Thyroid Cancer or an Indeterminate Thyroid Nodule
Journal article   Open access   Peer reviewed

Patients' Reaction to Diagnosis with Thyroid Cancer or an Indeterminate Thyroid Nodule

Susan C Pitt, Megan C Saucke, Elizabeth M Wendt, David F Schneider, Jason Orne, Cameron L Macdonald, Nadine P Connor and Rebecca S Sippel
Thyroid (New York, N.Y.), v 31(4), pp 580-588
Apr 2021
DOI: https://doi.org/10.1089/thy.2020.0233
PMID: 33012267
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1089/thy.2020.0233View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

Adult Anxiety - etiology Anxiety - psychology Biopsy, Fine-Needle Fear Female Grounded Theory Health Knowledge, Attitudes, Practice Humans Interviews as Topic Male Middle Aged Neoplasm Staging Patient Education as Topic Patients - psychology Predictive Value of Tests Qualitative Research Randomized Controlled Trials as Topic Thyroid Cancer, Papillary - pathology Thyroid Cancer, Papillary - psychology Thyroid Cancer, Papillary - surgery Thyroid Neoplasms - pathology Thyroid Neoplasms - psychology Thyroid Neoplasms - surgery Thyroid Nodule - pathology Thyroid Nodule - psychology Thyroid Nodule - surgery Thyroidectomy Tumor Burden Waiting Lists
Little is known about the experiences and concerns of patients recently diagnosed with thyroid cancer or an indeterminate thyroid nodule. This study sought to explore patients' reactions to diagnosis with papillary thyroid cancer (PTC) or indeterminate cytology on fine needle aspiration. We conducted semistructured interviews with 85 patients with recently diagnosed PTC or an indeterminate thyroid nodule before undergoing thyroidectomy. We included adults with nodules ≥1 cm and Bethesda III, IV, V, and VI cytology. The analysis utilized grounded theory methodology to create a conceptual model of patient reactions. After diagnosis, participants experienced shock, anxiety, fear, and a strong need to "get it out" because "it's cancer!" This response was frequently followed by a sense of urgency to "get it done," which made waiting for surgery difficult. These reactions occurred regardless of whether participants had confirmed PTC or indeterminate cytology. Participants described the wait between diagnosis and surgery as difficult, because the cancer or nodule was "still sitting there" and "could be spreading." Participants often viewed surgery and getting the cancer out as a "fix" that would resolve their fears and worries, returning them to normalcy. The need to "get it out" also led some participants to minimize the risk of complications or adverse outcomes. Education about the slow-growing nature of PTC reassured some, but not all patients. After diagnosis with PTC or an indeterminate thyroid nodule, many patients have strong emotional reactions and an impulse to "get it out" elicited by the word "cancer." This reaction can persist even after receiving education about the excellent prognosis. Understanding patients' response to diagnosis is critical, because their emotional reactions likely pose a barrier to implementing guidelines recommending less extensive management for PTC.

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52 citations in Web of Science
50 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Endocrinology & Metabolism
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