Bridging Gaps in Care and Empowering Patients Facing Thyroid Cancer

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Patient Empowerment Network (PEN) is dedicated to helping educate and empower patients and care partners in the thyroid cancer community. Thyroid cancer research and treatment options are ever-changing, and it’s vital for patients and families to educate themselves about clinical trials, treatment advancements, barriers to and disparities in care. With this goal in mind, PEN introduced the [ACT]IVATED Thyroid Cancer program, which aims to inform, empower, and engage patients to stay updated about the latest in thyroid cancer care.

Thyroid cancer awareness needs more visibility for multiple reasons. Thyroid cancer incidence is higher in women with 70 to 75 percent of cases occurring in women. And many patients may not be aware that thyroid cancer is the most common cancer in patients who are age 15 through age 33.

PEN is pleased to add information about thyroid cancer to educate more patients and their families. Cancer survivor Lisa Hatfield interviewed expert Dr. Megan Haymart from the University of Michigan as part of the [ACT]IVATED Thyroid Cancer program.

Thyroid Cancer Disparities and Challenges

Thyroid cancer patients may be impacted by a variety of disparities in incidence, diagnosis, and care. Raising awareness about these disparities can help patients and patient advocates work toward closing disparity gaps. Dr. Megan Haymart discussed the thyroid cancer gender disparity that impacts more women than men. “So about 70 to 75 percent of all thyroid cancer cases occur in women. And this is very similar to other endocrine diseases, especially other thyroid conditions. So hypothyroidism, hyperthyroidism, those are also more common in women. And so we think that the reason for this is probably multifactorial. So one, there’s probably something about thyroid conditions in a biologic level that differs between men and women.”

Thyroid cancer patients may be affected by socioeconomic barriers to care. Dr. Megan Haymart discussed potential barriers to optimal care. “And there’s strong data for thyroid cancer and other cancers as well, that sometimes what’s happening is individuals who are lower socioeconomic status or a minority race or ethnicity are sometimes clustering at low volume hospitals. And so they may not be getting the best care because of where they’re going.”

Socioeconomic impacts on thyroid cancer extend to other disparities too. Dr. Megan Haymart shared about a difference that often goes along with socioeconomic status. “And then related to socioeconomic status, we also know that there can be differences based on education level as well.”

Thyroid cancer may feel more overwhelming for young patients. Dr. Megan Haymart shared the different types of stress that young thyroid cancer patients may feel. “…it’s very stressful especially for younger patients who are at a transition point in their life, related to college, related to starting new jobs, related to starting a family, all their friends are healthy and they get a cancer diagnosis, it can be very stressful and overwhelming. And so if you’re worried, if you’re stressed, that’s normal. Patients shouldn’t feel bad about that. No one should make them feel bad about it.”

Thyroid Cancer Care Solutions and Successes

 Thyroid cancer care is changing and becoming more personalized to each patient and their preferences for treatment. Dr. Megan Haymart discussed how she’s encouraged about the future of  thyroid cancer treatment. “…one that I’m the most excited about with the guidelines is the guidelines are going to emphasize tailored care more and shared decision-making more. And so I think these are key. And so for a lot of thyroid cancer management, there is not one right or wrong treatment option. It depends a little bit on the patient and what their preferences are.”

For thyroid cancer patients, it’s important to see care providers who diagnose and treat a high number of patients with thyroid cancer. Dr. Megan Haymart shared her  advice. “…if you feel that you’re not getting the answers that you want, don’t be afraid to get a second opinion…make sure that you’re seeing high volume physicians who see a lot of patients with thyroid cancer. This is for both the surgeons and the endocrinologists, because we know that outcomes are better when individuals see high volume physicians. “ 

It’s also important for thyroid cancer patients to be comfortable with the  care provider and that the provider is truly listening to them. Dr. Megan Haymart shared her expert advice.  “…if patients feel like they’re being dismissed, if they’re anxious, if they’re worried, if they’re stressed, if they feel like their questions aren’t being answered, you can always get a second opinion or see someone else.” 

Switching to a different thyroid cancer care provider isn’t necessarily as complicated as some patients might think. Dr. Megan Haymart discussed the importance of patients advocating for themselves. “And so I think it’s very important to advocate for yourself and don’t be afraid to look around. And if the center that’s closest to you isn’t the best center for thyroid cancer, and if there’s a better one that’s 30 minutes away, and you’re capable of getting there, I would encourage you to go.”

Delving deeper into the patient experience, PEN’s Thyroid Cancer Empowerment Lead Carly Flumer was diagnosed at the age of 27. And though she experienced many challenges through her cancer journey and still does as a survivor, Carly has also discovered new passions as a result of her experience. “…there have many silver linings of having cancer. I found my passion in helping other cancer patients through different avenues, I’ve made friends and joined communities of people who “get it,” and I found new strength in who I am as a person.” Learn more and connect with Carly here.

[ACT]IVATED Thyroid Cancer Program Resources 

The [ACT]IVATED Thyroid Cancer program series takes a three-part approach to inform, empower, and engage both the overall thyroid cancer community and thyroid cancer patient groups who experience health disparities. The series includes the following resources:

 Though there are thyroid cancer disparities, patients and care partners can be proactive in educating themselves to help work toward optimal care. We hope you can take advantage of these valuable resources to aid in your thyroid cancer care for yourself or for your loved one.

Addressing Socioeconomic Disparities in Thyroid Cancer Care: Impact and Mitigation Strategies

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Addressing Socioeconomic Disparities in Thyroid Cancer Care: Impact and Mitigation Strategies from Patient Empowerment Network on Vimeo.

What are socioeconomic disparities in thyroid cancer care, and how can these disparities be mitigated? Expert Dr. Megan Haymart from the University of Michigan discusses the impact of socioeconomic status and education status and shares actionable patient advice for optimal care.

[ACT]IVATION TIP

“…make sure that you’re seeing high volume physicians who see a lot of patients with thyroid cancer. This is for both the surgeons and the endocrinologists, because we know that outcomes are better when individuals see high volume physicians.”

Download Resource Guide

See More from [ACT]IVATED Thyroid Cancer

Related Resources:

Emerging Advancements in Thyroid Cancer Treatment

Emerging Advancements in Thyroid Cancer Treatment

 Advancing Thyroid Cancer Care: Tailored Treatment and Patient Involvement

Advancing Thyroid Cancer Care: Tailored Treatment and Patient Involvement

 Personalized Treatment Approaches in Advanced Thyroid Cancer Management

Personalized Treatment Approaches in Advanced Thyroid Cancer Management

Transcript:

Lisa Hatfield:

Dr. Haymart, how does socioeconomic status impact the diagnosis and treatment outcomes of thyroid cancer patients? And what strategies can be employed to mitigate these effects?

Dr. Megan Haymart:

So there’s strong data that socioeconomic status does have an impact on diagnosis and treatment. And so we know that individuals’ access to insurance makes a difference. We know that patients can be at risk for different levels of financial hardship. So a fee of $5,000 means a lot, different things based on how much reserve individuals have. And so we know that this is a real issue.

And then related to socioeconomic status, we also know that there can be differences based on education level as well. And so in order for patients to mitigate these differences, I think it’s complicated. Like I think really there needs to be systematic changes. So it doesn’t all rest on the patient, but for patients, my activation tip would be, one, ask the questions.

And so, if you feel that you’re not getting the answers that you want, don’t be afraid to get a second opinion. And my other activation tip for this question would be to make sure that you’re seeing high volume physicians who see a lot of patients with thyroid cancer. This is for both the surgeons and the endocrinologists, because we know that outcomes are better when individuals see high volume physicians.

And there’s strong data for thyroid cancer and other cancers as well, that sometimes what’s happening is individuals who are lower socioeconomic status or a minority race or ethnicity are sometimes clustering at low volume hospitals. And so they may not be getting the best care because of where they’re going.

And so I think it’s very important to advocate for yourself and don’t be afraid to look around. And if the center that’s closest to you isn’t the best center for thyroid cancer, and if there’s a better one that’s 30 minutes away, and you’re capable of getting there, I would encourage you to go.

Is There a Gender Disparity in Thyroid Cancer?

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Is There a Gender Disparity in Thyroid Cancer? from Patient Empowerment Network on Vimeo.

Is there a thyroid cancer gender disparity? Expert Dr. Megan Haymart from the University of Michigan discusses the incidence rate of thyroid conditions and thyroid cancer in men versus women and proactive patient advice for those who feel dismissed or unsupported.

[ACT]IVATION TIP

“…if patients feel like they’re being dismissed, if they’re anxious, if they’re worried, if they’re stressed, if they feel like their questions aren’t being answered, you can always get a second opinion or see someone else.”

Download Resource Guide

See More from [ACT]IVATED Thyroid Cancer

Related Resources:

Thyroid Cancer Explained: Types, Staging, and Patient Communication

Thyroid Cancer Explained: Types, Staging, and Patient Communication

 Overcoming Thyroid Cancer Care Barriers

Overcoming Thyroid Cancer Care Barriers

 Understanding Thyroid Cancer Treatment Options and Follow-Up Care

Understanding Thyroid Cancer Treatment Options and Follow-Up Care

Transcript:

Lisa Hatfield:

Dr. Haymart, how does the prevalence of thyroid cancer differ between men and women, and what factors contribute to this gender disparity?

Dr. Megan Haymart:

So about 70 to 75 percent of all thyroid cancer cases occur in women. And this is very similar to other endocrine diseases, especially other thyroid conditions. So hypothyroidism, hyperthyroidism, those are also more common in women. And so we think that the reason for this is probably multifactorial. So one, there’s probably something about thyroid conditions in a biologic level that differs between men and women.

We also think that there can be some screening bias, meaning that women are more likely to see doctors. They might be more likely to have neck ultrasounds. Some of these thyroid cancers that are picked up are really small and maybe shouldn’t have been picked up. And so I think it’s probably multifactorial.

Something that my patients sometimes tell me and I totally believe them, and I just want everyone to be aware because it’s a lot of females and it’s also very commonly young females. So thyroid cancer is the most common cancer in individuals aged 15 to 33. The median age of thyroid cancer patients is about 50. Sometimes patients feel that their worry and concern about their cancer is dismissed and so I want them to know that they’re not alone.

You know it’s very stressful especially for younger patients who are at a transition point in their life, related to college, related to starting new jobs, related to starting a family, all their friends are healthy and they get a cancer diagnosis, it can be very stressful and overwhelming. And so if you’re worried, if you’re stressed, that’s normal. Patients shouldn’t feel bad about that. No one should make them feel bad about it.

So even though most patients are going to do great with this cancer, it is still a cancer diagnosis. It does still impact patients’ lives and that word cancer can be very stressful. So I just don’t want patients to feel alone if they feel like they’re being dismissed or people don’t realize how stressful that diagnosis could be.

So my activation tip for this is if patients feel like they’re being dismissed, if they’re anxious, if they’re worried, if they’re stressed, if they feel like their questions aren’t being answered, you can always get a second opinion or see someone else. So that’s one thing. And my other activation tip for this is that if they feel like they’re not getting the answers or the support from their physician, there are other online resources that are available that can also help with worry and stress related to a cancer diagnosis.

Overcoming Thyroid Cancer Care Barriers

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Overcoming Thyroid Cancer Care Barriers from Patient Empowerment Network on Vimeo.

What are some thyroid cancer barriers to care and treatment? Expert Dr. Megan Haymart from the University of Michigan discusses obstacles that disadvantaged patients may encounter and  proactive patient advice to help ensure their best care. 

[ACT]IVATION TIP

“…ask your surgeon, how many operations have you done within the past year? High volume surgeons typically do 25 or more. And so I think that’s really important because you’re going to have a lower risk of complications. And so I would encourage all patients to speak up and to make sure they ask these questions.”

Download Resource Guide

See More from [ACT]IVATED Thyroid Cancer

Related Resources:

Thyroid Cancer Explained: Types, Staging, and Patient Communication

Thyroid Cancer Explained: Types, Staging, and Patient Communication

 Is There a Gender Disparity in Thyroid Cancer?

Is There a Gender Disparity in Thyroid Cancer?

 Understanding Thyroid Cancer Treatment Options and Follow-Up Care

Understanding Thyroid Cancer Treatment Options and Follow-Up Care

Transcript:

Lisa Hatfield:

Dr. Haymart, what are the current barriers that disadvantaged patient populations face in receiving a timely diagnosis and, even more important, treatment of their thyroid cancer?

Dr. Megan Haymart:

So there are disparities in the care of thyroid cancer patients from diagnosis to treatment and even survivorship. For diagnosis, we know that there are certain groups that are at higher risk for presenting with advanced stage disease, so especially minority populations, Black and Hispanic. We don’t know why that is. We don’t fully know why that is at least, but my activation tip for diagnosis would be that if you feel a lump in your neck that doesn’t go away after a few weeks, especially lower in your neck, talk to your doctor.

We also see disparities in treatment. And I think we know a little bit more about why those occur. So there’s been recent data by Dr. Chen, who works with my group, who found that when patients call to get into the clinic, if they don’t speak English as their primary language, if they speak Spanish or Mandarin, they may have difficulty getting into the clinic for a visit. And so we think there are language barriers that occur.

We also know that there’s differences in treatment based on what doctors patients are seeing. So if patients are seeing low volume surgeons who don’t do a lot of operations, they may not get the best treatment for them, which could lead to downstream consequences, including increased risk of recurrence or complications from the surgery itself.

And so my activation tip for this question is that if English is not your primary language and if you run into obstacles scheduling an appointment, if you have any family members or friends that speak English that you can pull in to help you, I think that’d be important. Hopefully, eventually the system will be better where that’s no longer an obstacle, but for now I think that’s important to know.

And then my other activation tip for this question is, you want to make sure you know who your surgeon is in regards to if they’re a high or low volume surgeon. That’s extremely tricky to know, even for me as a physician. I know thyroid cancer because I do thyroid cancer, but if you asked me about GI cancer, I wouldn’t know. And so you have to ask your surgeon, how many operations have you done within the past year? High volume surgeons typically do 25 or more. And so I think that’s really important because you’re going to have a lower risk of complications. And so I would encourage all patients to speak up and to make sure they ask these questions.

Lisa Hatfield:

Okay, thank you. Would it be appropriate for a patient to ask specifically how many of those surgeries that physician has done every year?

Dr. Megan Haymart:

Yeah, it’s totally appropriate to ask because you can’t find that information on the web. So unless you have a doctor colleague or a friend who knows thyroid well, and knows who those high volume surgeons are, they might be able to identify them. But otherwise, if you’re just referred to your local surgeon, I think it’s very appropriate to ask them, how many surgeries have you done in the past year? What are some of the complications that might happen? How often do you see that in your patient setting? I think those would be very appropriate questions.