BACKGROUND
Thyroid cancer is common and the most common type of thyroid cancer is papillary thyroid cancer. Fortunately, papillary thyroid cancer usually has very good outcomes and prognosis as we have very effective therapies. Because of this excellent prognosis, the treatment of thyroid cancer no longer involves a one-size-fits-all approach. For thyroid cancers that have a low-risk for recurrence and measure between 1 to 4 cm in size, treatment options include total thyroidectomy or thyroid lobectomy. Both options offer good long-term outcomes and have their own advantages. The decision about which type of surgery would be best requires a conversation between the patient and provider on the benefits and risks of both options.

In this study, researchers examine patient and provider experiences and perspectives on the decision-making process for patients undergoing surgery for low-risk thyroid cancer.

THE FULL ARTICLE TITLE
Yang W, et al. Understanding the factors that influence shared-decision making around surgical resection of low-risk thyroid cancers: a prospective qualitative study. Thyroid 2026;36(1):81–88; doi: 10.1177/10507256251408856. PMID: 41467962.

SUMMARY OF THE STUDY
For this study, interviews were performed with 19 patients, 6 thyroid surgeons and 2 thyroid cancer nurse specialists. The patients included in the study had a diagnosis of low-risk papillary or follicular thyroid cancer without adverse features and were not on thyroid hormone therapy.

Through the interviews several themes were identified and some of these themes are highlighted here. Patients reported that they were provided a significant amount of information about treatment options and many patients expressed the way in which the information was shared was not sufficient for decision making. Some reported a lack of interaction when provided with the information and some reported receiving information about the treatment options shortly after receiving a cancer diagnosis which affected their ability to process the information.

Patients and providers both reported that there were several factors that influence the decision-making process. For many patients minimizing the number and extent of surgery was a priority. The second factor was to preserve normal thyroid and avoid long-term need for thyroid hormone replacement. The third factor that influenced treatment decision was the patient’s willingness to accept the risk of cancer recurrence.

Most patients in the study felt they decided on the final treatment plan themselves and that their provider’s recommendation was an important part of the decision process. Among the providers in the study, half of them supported patients making their own decision and the other half felt the recommendation by a multidisciplinary team should be given importance.

WHAT ARE THE IMPLICATIONS OF THIS STUDY?
The study highlights the challenges associated with shareddecision making for the surgical treatment of low-risk thyroid cancer and the importance of recognizing how patients are able to digest the vast amount of information provided and feel included in the discussion. It also outlines some of the important considerations that play a factor in a patient’s decision to pursue thyroidectomy or thyroid lobectomy.

— Poorani Goundan, MD

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