Although thyroid cancer has a mortality rate lower than many other forms of cancer, it is the most rapidly increasing cancer diagnosis in the United States, having tripled in the last 30 years. In cases of low-risk thyroid cancer, patient choice plays a critical role in the approach to surgical treatment. But how do patients make these choices, and what factors are considered in the process? Under the leadership of Dr. Julie Ann Sosa, Chief of Endocrine Surgery, a transdisciplinary endocrine neoplasia research team has received a Cancer Survivorship Pilot Research Award from the Duke Cancer Institute, which will allow them to examine patient choice and perspective regarding surgery options when diagnosed with low-risk thyroid cancer.
Treatment options for thyroid cancer consist of a thyroidectomy, total removal of the thyroid, or a lobectomy, removal of half of the thyroid. Despite being a more aggressive and invasive procedure, thyroidectomy was endorsed by the American Thyroid Association as the primary surgical treatment for all patients with differentiated thyroid cancer larger than 1 cm until earlier this year. Recent studies, however, fail to support that total removal of the thyroid affords better survival than a lobectomy for low-risk cancer scenarios. In fact, partial removal of the thyroid results in fewer complications and potentially superior quality of life post-surgery.
The Duke research team will use a discrete-choice experiment (DCE) to examine the decision-making process for patients newly diagnosed with low-risk thyroid cancer. DCEs allow patients to choose between two hypothetical scenarios, and in the case of this experiment, the benefits and risks associated with both a total thyroidectomy and a less-invasive lobectomy. The aims of the study are to determine the preferences of patients when faced with two possible surgical procedures, as well as whether there are commonalities or preference patterns among patients of certain demographics.
Joining Dr. Sosa is co-principal investigator Dr. Sara Ahmadi, Assistant Professor of Medicine, Endocrinology. The other investigators include Dr. Shelby Reed, Professor of Medicine, and Dr. Susan Spratt, Associate Professor of Medicine, Endocrinology. The team has been awarded a $25,000 grant for their study titled “Patient Preference for Thyroid Cancer Surgery Strategies: A Discrete-Choice Experiment Study.” They hope to receive additional funding in the future to continue this important experiment.