COVID-19 Advice for patients with thyroid cancer

COVID-19 Advice for patients with thyroid cancer

(i) Patients who have completed treatment for thyroid cancer

Patients who have previously received treatment for thyroid cancer such as surgery, with or without radioiodine (remnant ablation or radioiodine therapy), are not considered at higher risk of infection from COVID-19.

(ii) Patients in whom surgery for thyroid cancer is planned

NHS England has stated that surgery for cancer should continue at present, although elective surgery is cancelled in many hospitals. More detailed advice about which operations should be prioritised will shortly be released to surgeons across the UK.

(iii) Radioactive iodine therapy

Patients awaiting radioiodine therapy may well find that their treatment is postponed. Whilst the treatment itself does not increase the risk of infection, subsequent radiation protection issues would seriously complicate the care of any patient who subsequently became unwell with COVID-19. In most cases radioiodine therapy is not urgent and can be safely delayed. If you have concerns please discuss with your own hospital team.

(iv) TSH suppressive therapy

Patients on suppressive doses of thyroxine (i.e have a TSH target of <0.1mU/l) should continue on their current dose. Being on suppressive dose of levothyroxine does not increase the risk of COVID-19 infection.

(v) Multikinase inhibitors and chemotherapy

Patients who are receiving multikinase inhibitors (such as Lenvatinib or Sorafenib), or chemotherapy are at increased risk of severe illness from coronavirus and should follow government advice regarding shielding- https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19.

They should expect to hear from their centre and to have a discussion about the advisability of continuing treatment at this time in their particular circunmstances.

(vi) Previous radiotherapy

Patients who have previously received external beam radiotherapy to the neck may be at increased risk of severe illness with coronavirus and should also consider self-isolating.

v1.0 23^rd March 2020

To be reviewed in 2 weeks