Long-term vocational adjustment of cancer patients diagnosed during adolescence

Abstract

Long-term vocational achievements of 40 survivors of cancer diagnosed during adolescence were examined and compared with 40 healthy sex-matched and age-matched controls. Patients' ages at diagnosis ranged from 13 to 19 years (mean, 16.15). Study subjects had survived cancer for over 5 years and were on no cancer therapy. Assessment measures included the Rand General Well-Being Scale, the Rand Functional Limitations and Physical Abilities Batteries, and a semistructured interview. The relation of physical disability and limitations caused by cancer to patients' achievements also was evaluated. Although cancer patients, on the average, were more concerned about their health and reported lower general spirits than controls, no differences were found between control and study groups with regard to overall general well-being. More cancer patients than controls reported that their health limited their ability to engage in vigorous activities. A greater functional deficit was found among unemployed than employed cancer patients. Employers and co-workers often were aware of the patient's diagnosis (85% and 67%, respectively). Cancer patients reported disease-related discrimination in hiring (7.4%), induction into the military (66.7%), and obtaining health, life, and disability insurance (31.5%). There was no significant relationship between health status and employment. Nevertheless, cancer patients had a higher average income than controls. Sixty-four percent of patients believed that changes in certain physical features of the workplace were necessary to facilitate readjustment to the job. Despite the disabilities experienced by cancer patients and generally negative public attitudes, long-term survivors have a good outlook on life and are competitive members of the workplace and society.

Quality of life in young adult survivors of childhood cancer

“…Of the 30 studies, 17 involved survivors of different cancers and did not attempt to distinguish between diagnostic groups in terms of outcome [1,2,3,5,6,8,11,14,16,17,18,21,25,38,39,40]. Three of these studies excluded survivors of a CNS tumour [1,21,38].…”

“…Three of these studies excluded survivors of a CNS tumour [1,21,38]. Six studies focused specifically on leukaemia survivors [12,20,27,32,45,46], and Mackie et al [23] included survivors who had been treated for ALL and Wilms tumour.…”

“…Four studies examined survivors treated for a bone tumour [7,29,30,41]; one study investigated Hodgkin's disease survivors [42]; and one study was found in which survivors treated for solid tumours, except for CNS tumours, were investigated [24]. The majority of the studies discussed in this review were conducted in the United States [2,5,8,11,12,14,16,17,18,21,25,28,30,33,38,39,40,42,45,46]. Three studies were conducted in Finland [1,24,32], 2 in the United Kingdom [6,23], 2 in The Netherlands [20,41], 1 in Norway [27], 1 in Austria [7], and 1 in Israel [3].…”

“…However, the QL of the survivors and their controls was explored by use of the SF-12 in the study by Moe et al [27] and with the Rand Health Insurance study General Well-being Measure by Tebbi et al [38]. Neither of these studies found any statistical differences between the groups with respect to physical health and QL.…”

“…The percentage of unemployed female survivors, however, was slightly higher than that in the U.S. population in general. Other studies found that survivors and controls did not differ with respect to employment status [3,6,14,21,27,38,46] and that the majority of long-term survivors old enough to be in the work force were employed in a range of professional, clerical, and skilled labour positions [7,38]. Two studies looked specifically at survivors of bone tumour survivors.…”