Working after cancer: in-depth perspectives from a setting with limited employment protection policies

Kong, Yek-Ching; Rauf, Negina; Subramaniam, Shridevi; Bustamam, Ros Suzanna; Wong, Li Ping; Ho, Gwo Fuang; Zaharah, Hafizah; Mellor, Matin; Yip, Cheng‐Har; Bhoo‐Pathy, Nirmala

doi:10.1007/s11764-020-00962-z

Cited by 10 publications

(10 citation statements)

References 24 publications

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“…Survivors who receive workplace accommodations or whose jobs have more favorable employment protection policies have better employment outcomes. 57,58 A recent study indicated that employer flexibility of location and hours may be important. 59 The ability to perform some work at home or adjust hours around medical appointments or fatigue (eg, total hours remain the same but with breaks built into the day) allowed survivors to continue working successfully.…”

Section: Role Of the Employer And Job Accommodationsmentioning

confidence: 99%

Survivorship, Version 1.2021

Tevaarwerk

Denlinger

Sanft

et al. 2021

Journal of the National Comprehensive Cancer Network

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The NCCN Guidelines for Survivorship are intended to help healthcare professionals working with cancer survivors to ensure that each survivor’s complex and varied needs are addressed. The Guidelines provide screening, evaluation, and treatment recommendations for consequences of adult-onset cancer and its treatment; recommendations to help promote healthful lifestyle behaviors, weight management, and immunizations in survivors; and a framework for care coordination. This article summarizes the recommendations regarding employment and return to work for cancer survivors that were added in the 2021 version of the NCCN Guidelines.

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Section: Role Of the Employer And Job Accommodationsmentioning

confidence: 99%

Survivorship, Version 1.2021

Tevaarwerk

Denlinger

Sanft

et al. 2021

Journal of the National Comprehensive Cancer Network

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“…26 Although many of the employees working in private sectors in Malaysia may have some form of employer-provided health insurance that enables them to seek cancer care in private hospitals, they have limited medical leave and therefore, are forced to go on unpaid leave. 27 This study seems to suggest that in resource-limited settings, adherence to targeted therapy may be substantially low because of the high cost of trastuzumab. Out of the 252 patients in our study with indications for HER2-targeted therapy in the public sector, only 18 had received it.…”

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Association Between Adherence to Clinical Practice Guidelines for Adjuvant Therapy for Breast Cancer and Survival in a Resource-Limited Setting

Song

Yip

Taib

et al. 2022

JCO Global Oncology

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PURPOSE Addressing unwarranted clinical variation in oncology practices is expected to lead to improved cancer outcomes. Particularly, the application and impact of treatment guidelines on breast cancer outcomes are poorly studied in resource-limited settings. We measured adherence to a set of locally developed adjuvant treatment guidelines in a middle-income setting. Importantly, the impact of guidelines adherence on survival following breast cancer was determined. METHODS Data of 3,100 Malaysian women with nonmetastatic breast cancer diagnosed between 2010 and 2017 were analyzed. Adherence to the Malaysian Clinical Practice Guidelines for Management of Breast Cancer second Edition was measured. Outcomes comprised overall survival and event-free survival. RESULTS Guideline adherence for chemotherapy, radiotherapy, hormonal therapy, and targeted therapy were 61.7%, 79.2%, 85.1%, and 26.2%, respectively. Older age was generally associated with lower adherence to guidelines. Compared with patients who were treated according to treatment guidelines, overall survival and event-free survival were substantially lower in patients who were not treated accordingly; hazard ratios for all-cause mortality were 1.69 (95% CI, 1.29 to 2.22), 2.59 (95% CI, 1.76 to 3.81), 3.08 (95% CI, 1.94 to 4.88), and 4.48 (95% CI, 1.98 to 10.13) for chemotherapy, radiotherapy, hormone therapy, and targeted therapy, respectively. Study inferences remain unchanged following sensitivity analyses. CONCLUSION Our study findings appear to suggest that adherence to treatment guidelines that have been adapted for resource-limited settings may still provide effective guidance in improving breast cancer outcomes.

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“…Thus, many cancer patients will try to return to work as soon as they can to offset the financial pressure of their medical bills. Adequate paid medical leave and time off work for hospital follow-ups, workplace flexibility and anti-discriminatory workplace policies are vital to promote and facilitate employment retainment and return to work for people with cancer [19,20].…”

Section: Discussionmentioning

confidence: 99%

Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: a qualitative study

FNU¹,

Kuan²,

Kong³

et al. 2022

ecancer

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Background: Evidence on the financial experiences of cancer survivors living in settings with pluralistic health systems remains limited. We explored the out-of-pocket costs, the resulting financial impact and the coping strategies adopted by cancer survivors in Malaysia, a middle-income country with a government-led tax-funded public health sector, and a predominantly for-profit private health sector. Methods: Data were derived from 20 focus group discussions that were conducted in five public and private Malaysian hospitals, which included 102 adults with breast, cervical, colorectal or prostate cancers. The discussions were segregated by type of healthcare setting and gender. Thematic analysis was performed.Results: Five major themes related to cancer costs emerged: 1) cancer therapies and imaging services, 2) supportive care, 3) complementary therapies, 4) non-medical costs and 5) loss of household income. Narratives on out-of-pocket medical costs varied not only by type of healthcare setting, clinical factors and socioeconomic backgrounds, but also by private health insurance ownership. Non-health costs (e.g. transportation, food) and loss of income were nonetheless recurring themes. Coping mechanisms that were raised included changing of cancer treatment decisions, continuing work despite ill health and seeking financial assistance from third parties. Unmet needs in coping with financial distress were especially glaring among the women. Conclusion:The long-term costs of cancer (medications, cancer surveillance, supportive care, complementary medicine) should not be overlooked even in settings where there is access to highly subsidised cancer care. In such settings, patients may also have unmet needs related to non-health costs of cancer and loss of income.

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Working after cancer: in-depth perspectives from a setting with limited employment protection policies

Cited by 10 publications

References 24 publications

Survivorship, Version 1.2021

Survivorship, Version 1.2021

Association Between Adherence to Clinical Practice Guidelines for Adjuvant Therapy for Breast Cancer and Survival in a Resource-Limited Setting

Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: a qualitative study

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