Treatment related morbidity in differentiated thyroid cancer-a survey of clinicians.

Background: Differentiated thyroid cancer (DTC) has excellent long term survival in most patients. Long-term treatment related morbidity is therefore important, but may not be well characterised. The aim of this study was to conduct an electronic survey of clinicians involved in the care of patients with DTC to determine their views on treatment related morbidity. Methods: A nine item questionnaire was developed, piloted locally and sent by email to members of three United Kingdom (UK) medical organisations (Thyroid Cancer Forum, British Association of Endocrine and Thyroid Surgeons, British Thyroid Association). Results: 125 responses were received. Less than 5% of respondents had a formal protocol to detect morbidity associated with TSH suppression. Over 50% agreed that morbidity from TSH suppression is not well defined. The majority of responders also agreed that the long-term morbidity of hypocalcaemia, significant voice change and TSH suppression in DTC are not well characterised. Physicians perceived treatment related morbidity to be a bigger problem than surgeons (P = 0.019). Conclusion: Clinicians treating thyroid cancer agree that long-term treatment related morbidity from DTC is not well characterised. A study of the prevalence and severity of treatment related morbidity and its impact on health of patients with DTC is warranted.