Working after a metastatic cancer diagnosis: Factors affecting employment in the metastatic setting from ECOG‐ACRIN's Symptom Outcomes and Practice Patterns study

Abstract

Background Improved survival for individuals with metastatic cancer accentuates the importance of employment for cancer survivors. Better understanding of how metastatic cancer affects employment is a necessary step towards the development of tools to assist survivors in this important realm. Methods We analyzed the Eastern Cooperative Oncology Group’s “Symptom Outcomes and Practice Patterns (SOAPP)” study to investigate what factors were associated with employment of 680 metastatic cancer patients. Univariable and multivariable logistic regression analyses were conducted to compare patients stably working (Group A) to patients no longer working (Group B). Results There were 668 metastatic working-age participants in our analysis; 236 (35%) worked full or part-time while 302 (45%) stopped working due to illness. Overall, 58% reported some change in employment due to illness. Better performance status and non-Hispanic White ethnicity/race were significantly associated with continuing to work despite a metastatic cancer diagnosis on multivariable analysis. Disease type, time since metastatic diagnosis, number of metastatic sites, location of metastatic disease, and treatment status had no significant impact. Among the potentially modifiable factors, receiving hormonal treatment (if a viable option) and decreasing symptom interference were associated with continuing to work. Conclusions A significant percentage of metastatic patients remain employed; symptom burden was associated with change to no longer working. Modifiable factors resulting in work interference should be minimized so that patients with metastatic disease may continue working, if desired. Improvements in symptom control and strategies developed to help address work place difficulties have promise to improve this aspect of survivorship.

Impact of Myeloproliferative neoplasms on patients’ employment status and work productivity in the United States: results from the living with MPNs survey

“…The adverse impacts of MPNs on employment were as severe as the effects observed in some patients with other terminal cancers or chronic debilitating/disabling diseases that have a significant symptom burden. In a study of patients with metastatic breast, colorectal, lung, or prostate cancer, 58% reported an unstable work status, including 45% who had stopped working because of their disease [ 12 ]. In a study of patients with moderate to severe rheumatoid arthritis, 17% reported changing jobs because of their disease [ 13 ].…”

“…Negative changes in patients’ work life can also have important non-financial implications. In other cancer settings, such changes have been linked to a diminished quality of life [ 12 ], psychiatric disorders (eg, depression) [ 13 ], and feelings of a suspension of life and/or normalcy [ 12 , 14 ].…”

Managing work and cancer treatment: Experiences among survivors of hematological cancer

“…6,9 Several studies have evaluated employment outcomes among cancer survivors, but to the best of our knowledge these studies have focused primarily on individuals diagnosed with solid tumors, and particularly breast cancer. [10][11][12] Employment-related issues confronting survivors of hematological cancer are relatively understudied despite the higher likelihood of these individuals leaving the workforce compared with survivors of other cancers (eg, breast cancer, prostate cancer, melanoma, thyroid cancer, and uterine cancer). 13 Hematological cancers have a variety of subtypes that differ in terms of age at onset, aggressiveness, and survival rates.…”

Factors Related to Employment Situation among Korean Cancer Survivors: Results from a Population-Based Study

“…However, Kim et al, (2014) reported that the difference due to gender and employment status were not significantly associated. Furthermore, many studies conducted in Western countries report that gender does not affect their employment situation (Spelten et al, 2002;Sesto et al, 2013;Tevaarwerk et al, 2016). In our study, participants in 20/30s and 40/50s, who represent the relatively younger groups, had increased odds of being employed compared to the older group of those 60 years old and above.…”