Cancer survivorship and work: Symptoms, supervisor response, co-worker disclosure and work adjustment

Abstract

Introduction: Recent improvements in cancer treatment have not only increased cancer survivorship but also peoples' ability to work during and following treatment. However, the impact that both diagnosis and treatment has on cancer survivors' ability to fully engage in paid work is not yet entirely understood. This study aims to explore the role of symptoms, work adjustments and cancer disclosure to supervisors and co-workers on working during primary cancer treatment and return to work following treatment. Method: 328 cancer survivors responded to a 33 item questionnaire that assessed cancer-specific variables e.g. type and treatment, symptoms experienced during and following treatment, disclosure of cancer and adjustments and supports available at work. Multivariate logistic regressions were run to determine the association of symptoms, disclosure and work adjustments and working during treatment and returning to work following treatment. Results:The findings indicate that opportunities to work flexibly (OR=2.43, CI 1.21-4.02), disclosure to colleagues (OR=3.03, CI 1.28-8.19), difficulties managing fatigue (OR=2.08, CI 1.22-3.85), and paid time off to attend all medical appointments (OR=.4, CI .30-.87) were associated with continuing to work during treatment. Correlates of return to work included difficulties managing fatigue (OR=1.49, CI 1.42-6.18), managing the stress of cancer (OR=2.80, 1.05-5.34), managing physical changes associated with cancer (OR=.46, CI .13-.95), received advice from their doctor about work (OR=1.47, CI 1.09-2.84) and return to work meeting with employer (OR 1.99, 1.2-5.09). Conclusions: This study highlights the importance of symptom management in cancer survivors who work and the potential impact of workplace adjustments on the ability of cancer survivors to navigate in the world of work.

Return to Work After Early-stage Breast Cancer: A Cohort Study into the Effects of Treatment and Cancer-related Symptoms

“…In contrast, social support and a supportive work environment facilitated return to work [8][9][10][11]. Discretion over work hours and amount of work were also positively associated with return to work of cancer survivors [12].…”

Predictors of employment among cancer survivors after medical rehabilitation – a prospective study

“…Since an increasing number of patients are likely to return to work after diagnosis and treatment completion, there is an increasing recognition of the short and long-term impact of cancer and both its physical and psychosocial consequences on employment during the last years (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Unfavorable cancer and treatment consequences include a variety of physical and functional disabilities, and psychological distress that may adversely affect a patient's work ability, work satisfaction, as well as employment status (14)(15)(16)(17).…”

“…Overall, studies indicate a steady increase of return to work (RTW) from on average 40% at six months post diagnosis to 62% at 12 months, 73% at 18 months, and 89% at 24 months. Factors significantly associated with a greater likelihood of being employed or RTW include perceived employer accommodation, flexible working arrangements, counseling, training and rehabilitation services, younger age, higher education, male gender, a lower physical symptom burden, cancer remission, shorter length of sick leave, and continuity of care (7,14,17,(23)(24)(25)(26)(27)(28).…”

Theoretical perspectives upon the return to work of cancer patients: The difficult path of integration in the organization

“…Kessler et al (2001) concluded that fatigue, observed as an illness factor, may be associated with a low level in work ability, affecting performance in this manner. Pryce, Munir and Haslam (2007) also noted that fatigue is perceived by subjects as one of the main difficulties when RTW, affecting the work ability. Besides fatigue, other physical factors like nausea or lack of energy alongside psychological factors like depression, feeling bored or useless can contribute to low levels in performance and ability at work Steiner et al 2008).…”