Establishing a nurse-led thyroid cancer follow-up clinic
Thyroid cancer is a complex disease requiring management by a large multidisciplinary team. The number of patients with a diagnosis of thyroid cancer is significantly increasing year-on-year, and traditional models of consultant-led follow up are no longer sustainable. Although nurse-led cancer follow-up clinics are becomining increasingly common, thyroid cancer nurse-led follow-up clinics are rare. An excellent understanding of the disease, treatment and management of risk of disease recurrence is essential for safe patient care, and is discussed in this article. The clinic discussed uses the skill set of head and neck nurse specialists, including psychological support, coping strategies for long-term side effects of treatment and non-medical prescribing. A patient survey of the service revealed high levels of patient satisfaction and a desire to continue face-to-face consultations rather than telephone clinics.
The past 30 years have seen a rapid increase in the number of patients diagnosed with thyroid cancer, currently around 3700 cases per year (Figure 1) (Cancer Research UK, 2021). Thyroid cancer is a very rare disease and accounts for less than 1% of all cancers. However, the incidence of thyroid cancer in the UK has increased by 164% since the early 1990s (Cancer Research UK, 2021). In 2015-2017 there were 3685 new cases of thyroid cancer diagnosed in the UK. Thyroid cancer predominantly affects young women aged 35 to 39 years, and there appears to be little, if any, impact from deprivation rates on its incidence (Cancer Research UK, 2021).
Patients typically present with a painless lump at the root of the neck that gradually increases in size. Other symptoms can include:
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