Lessons Learned From the "Good" Cancer
Thyroid cancer has the fastest growing incidence rate of any cancer in the U.S. in the past 30 years, but it also has the highest survival rate (98 percent of patients are alive after 10 years). While it is not clear if patients or physicians – or both – started it, thyroid cancer has earned the designation “the good cancer.”
And yet, a cancer diagnosis is still cancer, and like any cancer, its treatment comes with side effects. Recently, the thyroid cancer team at the UW Carbone Cancer Center developed a surgery-focused clinical trial from which they expect to help patients make informed decisions between more extensive surgery with lower risk of recurrence and less surgery with a greater recurrence risk.
In addition to performing physical tests to measure changes to voice or swallow function after surgery, the clinicians are generating a wealth of qualitative data through interviews with each patient for one hour preoperatively and at several times post-surgery. They are still addressing the surgical questions in the study, but it is the interviews that are changing the way the team works with their patients.
“For example, we do a swallow study on a patient and it looks good, then we do a swallow questionnaire and they do pretty well, but when we talk to the patient, they talk about their swallowing challenges for 30 minutes,” said Rebecca Sippel, MD, chief of endocrine surgery at UW and a member of the Cancer Center. “It’s showing us that some of our best tests are not capturing everything patients are experiencing from a quality of life standpoint, and we’d like to understand what they are going through so we can figure out how to better support them.”
While the study, which is still being conducted, includes only thyroid cancer patients, Sippel expects it will inform clinicians who treat any patient with a better-prognosis cancer, such as early-stage breast or prostate cancers that have high survival rates.
“I think we’ve learned that this concept of the good cancer is a real struggle for these patients because it downplays their diagnosis and invalidates their experience,” Sippel said, noting that 94 percent of study participants independently mentioned they had the ‘good’ cancer in interviews. “This study is helping us understand how to better support patients, to help them with their decisions and to help them develop the appropriate social support networks, and it should translate to many other cancer types.”
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Date Published: 03/07/2017