27
C. TSH goals for pregnant patients, in general, are the same TSH as
determined preconception. Thyroxine dose may be adjusted toward
less TSH suppression if there are concerns that excess thyroxine may
have an adverse impact on the pregnancy. TSH should be monitored
approximately every 4 weeks until 16–20 weeks of gestation, and at
least once between 26 and 32 weeks of gestation. (GPS)
D. Monitoring using neck ultrasound and Tg is appropriate for pregnant
patients who have an incomplete response to therapy. If cross-
sectional imaging is needed, MRI should be performed. Pregnant
patients in excellent or indeterminate response categories should be
monitored as for non-pregnant patients. (C-L)
Recommendation 82
➤ Patients should be made aware of potential long-term side effects
of treatments and monitored with appropriate intervention and/or
referrals during follow-up. (GPS)
Recommendation 83
A. Patients should be informed that resources exist for patients and
families impacted by financial burden due to a diagnosis of thyroid
cancer. (GPS)
B. Clinicians should know that many patients diagnosed with thyroid
cancer experience financial burden engendered by the costs of
cancer diagnosis, treatment, and monitoring. Clinicians should
discuss these topics with patients and their families. (GPS)
Recommendation 84
A. Thyroid cancer survivors should be informed that services are
available to support psychosocial needs related to having a cancer
diagnosis. (GPS)
B. Clinicians treating patients diagnosed with thyroid cancer should be
prepared to help patients manage the psychosocial implications of
thyroid cancer diagnosis and management. (GPS)
