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Chan RJ, Nekhlyudov L, Duijts SFA, Hudson SV, Jones JM, Keogh J, Love B, Lustberg MB, Mehnert-Theuerkauf A, Nathan P, Ness KK, Sheppard VB, Smith K, Tevaarwerk A, Yu X, Feuerstein M. Future research in cancer survivorship. J Cancer Surviv 2021; 15:659-667. [PMID: 34460055 DOI: 10.1007/s11764-021-01102-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, 5042, Australia.
| | | | - Saskia F A Duijts
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Shawna V Hudson
- Rutgers Robert Wood Johnson Medical School and Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | | | | | - Brad Love
- Center for Health Communication, University of Texas, Austin, TX, USA
| | | | | | - Paul Nathan
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Kirsten K Ness
- FAPTA, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Vanessa B Sheppard
- School of Medicine and the Massey Cancer Center Office of Outreach Engagement and Health Disparities, Virginia Commonwealth University, Richmond, VA, USA
| | - Katherine Smith
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Amye Tevaarwerk
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Xinhua Yu
- University of Memphis School of Public Health, Memphis, TN, USA
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Granell M, Senín A, Barata A, Cibeira MT, Gironella M, López-Pardo J, Motlló C, Garcia-Guiñón A, Ben-Azaiz R, Abella E, Soler A, Canet M, Martí JM, Martino R, Sierra J, de Larrea CF, Oriol A, Rosiñol L. Predictors of return to work after autologous stem cell transplantation in patients with multiple myeloma. Bone Marrow Transplant 2021; 56:2904-2910. [PMID: 34404917 DOI: 10.1038/s41409-021-01429-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/16/2021] [Accepted: 07/30/2021] [Indexed: 11/09/2022]
Abstract
Return to work (RTW) is a marker of functional recovery in cancer patients, with quality of life, financial and social implications. We investigated frequency and factors associated with RTW in a cohort of patients younger than 66 years, with newly diagnosed multiple myeloma (MM), uniformly treated with a bortezomib-based induction followed by autologous stem cell transplantation (ASCT). Socio-economic and working status data were collected by a self-administered questionnaire. One hundred and eighty-six patients entered the study. Of whom, 145 (78%) where employed at diagnosis, which was more frequent in younger (median 55 vs. 60 years, p < 0.001), men (59.3% vs. 34.2%, p = 0.004), and with college studies (44.8% vs. 24.4%, p = 0.008). Forty-three (30%) of the 145 patients who had a job at diagnosis, RTW after ASCT in a median of 5 (range 1-27) months. Factors independently associated with RTW were having three or more children (HR 2.87, 95% CI 1.33-6.18), college studies (HR 2.78, 95% CI 1.21-6.41), and a family income >40 × 103€/year (HR 2.31, 95% CI 1.12-4.78). In conclusion, the frequency of RTW herein reported in MM patients seems lower than reported in other malignancies. The risk factors observed may guide the design RTW programs.
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Affiliation(s)
- Miquel Granell
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Alicia Senín
- Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Badalona, Spain
| | - Anna Barata
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain. .,Health Outcomes and Behavior Department, Moffitt Cancer Center, Tampa, FL, US.
| | - Maria-Teresa Cibeira
- Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Mercedes Gironella
- Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Jordi López-Pardo
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Motlló
- Hematology Department, Hospital Sant Joan de Déu Manresa, Barcelona, Spain
| | | | - Randa Ben-Azaiz
- Hematology Department, Hospital del Mar-IMIM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eugènia Abella
- Hematology Department, Hospital del Mar-IMIM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alfons Soler
- Hematology Department, Hospital Universitari Parc Taulí Sabadell, Barcelona, Spain
| | - Marta Canet
- Hematology Department, Hospital Universitari Mútua de Terrassa, Barcelona, Spain
| | - Josep Ma Martí
- Hematology Department, Hospital Universitari Mútua de Terrassa, Barcelona, Spain
| | - Rodrigo Martino
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jorge Sierra
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carlos Fernández de Larrea
- Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Albert Oriol
- Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Badalona, Spain
| | - Laura Rosiñol
- Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
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Jones JM, Saeed H, Katz MS, Lustberg MB, Forster VJ, Nekhlyudov L. Readdressing the Needs of Cancer Survivors During COVID-19: A Path Forward. J Natl Cancer Inst 2021; 113:955-961. [PMID: 33367655 PMCID: PMC7799033 DOI: 10.1093/jnci/djaa200] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/01/2020] [Accepted: 12/03/2020] [Indexed: 12/17/2022] Open
Abstract
The growing number of cancer survivors and the high prevalence of cancer-related physical and psychosocial effects pose important and pressing challenges to health systems. The coronavirus disease 2019 (COVID-19) pandemic has led to further stressors on cancer survivors and health care systems. As the pandemic continues to have substantial impact on the world, it is critical to focus attention on the health care needs of cancer survivors. In this commentary, we propose an adoption of essential steps that should be part of a continuous adaptive approach to promote effective cancer survivorship care during ongoing COVID-19 waves and beyond.
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Affiliation(s)
- Jennifer M Jones
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Hina Saeed
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Matthew S Katz
- Department of Radiation Medicine, Lowell General Hospital, Lowell, MA, USA
| | - Maryam B Lustberg
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State Comprehensive Cancer Center, Columbus, OH, USA
| | - Victoria J Forster
- Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Larissa Nekhlyudov
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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Greidanus MA, de Rijk AE, de Boer AGEM, Bos MEMM, Plaisier PW, Smeenk RM, Frings-Dresen MHW, Tamminga SJ. A randomised feasibility trial of an employer-based intervention for enhancing successful return to work of cancer survivors (MiLES intervention). BMC Public Health 2021; 21:1433. [PMID: 34289828 PMCID: PMC8293550 DOI: 10.1186/s12889-021-11357-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 06/16/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Employers express a need for support during sickness absence and return to work (RTW) of cancer survivors. Therefore, a web-based intervention (MiLES) targeted at employers with the objective of enhancing cancer survivors' successful RTW has been developed. This study aimed to assess feasibility of a future definitive randomised controlled trial (RCT) on the effectiveness of the MiLES intervention. Also preliminary results on the effectiveness of the MiLES intervention were obtained. METHODS A randomised feasibility trial of 6 months was undertaken with cancer survivors aged 18-63 years, diagnosed with cancer < 2 years earlier, currently in paid employment, and sick-listed < 1 year. Participants were randomised to an intervention group, with their employer receiving the MiLES intervention, or to a waiting-list control group (2:1). Feasibility of a future definitive RCT was determined on the basis of predefined criteria related to method and protocol-related uncertainties (e.g. reach, retention, appropriateness). The primary effect measure (i.e. successful RTW) and secondary effect measures (e.g. quality of working life) were assessed at baseline and 3 and 6 months thereafter. RESULTS Thirty-five cancer survivors were included via medical specialists (4% of the initially invited group) and open invitations, and thereafter randomised to the intervention (n = 24) or control group (n = 11). Most participants were female (97%) with breast cancer (80%) and a permanent employment contract (94%). All predefined criteria for feasibility of a future definitive RCT were achieved, except that concerning the study's reach (90 participants). After 6 months, 92% of the intervention group and 100% of the control group returned to work (RR: 0.92, 95% CI: 0.81-1.03); no difference were found with regard to secondary effect measures. CONCLUSIONS With the current design a future definitive RCT on the effectiveness of the MiLES intervention on successful RTW of cancer survivors is not feasible, since recruitment of survivors fell short of the predefined minimum for feasibility. There was selection bias towards survivors at low risk of adverse work outcomes, which reduced generalisability of the outcomes. An alternative study design is needed to study effectiveness of the MiLES intervention. TRIAL REGISTRATION The study has been registered in the Dutch Trial Register ( NL6758/NTR7627 ).
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Affiliation(s)
- M A Greidanus
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - A E de Rijk
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Duboisdomein 30, Maastricht, The Netherlands
| | - A G E M de Boer
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - M E M M Bos
- Department of Medical Oncology, Erasmus Medical Center, Doctor Molewaterplein 40, Rotterdam, The Netherlands
| | - P W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, Dordrecht, The Netherlands
| | - R M Smeenk
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, Dordrecht, The Netherlands
| | - M H W Frings-Dresen
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - S J Tamminga
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
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Tevaarwerk A, Denlinger CS, Sanft T, Ansbaugh SM, Armenian S, Baker KS, Broderick G, Day A, Demark-Wahnefried W, Dickinson K, Friedman DL, Ganz P, Goldman M, Henry NL, Hill-Kayser C, Hudson M, Khakpour N, Koura D, McDonough AL, Melisko M, Mooney K, Moore HCF, Moryl N, Moslehi JJ, O'Connor T, Overholser L, Paskett ED, Patel C, Peterson L, Pirl W, Rodriguez MA, Ruddy KJ, Schapira L, Shockney L, Smith S, Syrjala KL, Zee P, McMillian NR, Freedman-Cass DA. Survivorship, Version 1.2021. J Natl Compr Canc Netw 2021; 19:676-685. [PMID: 34214969 DOI: 10.6004/jnccn.2021.0028] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
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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Affiliation(s)
| | | | - Tara Sanft
- 3Yale Cancer Center/Smilow Cancer Hospital
| | | | | | - K Scott Baker
- 6Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | | | - Andrew Day
- 8UT Southwestern Simmons Comprehensive Cancer Center
| | | | | | | | | | - Mindy Goldman
- 13UCSF Helen Diller Family Comprehensive Cancer Center
| | | | | | - Melissa Hudson
- 16St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | | | | | | | | | - Kathi Mooney
- 20Huntsman Cancer Institute at the University of Utah
| | - Halle C F Moore
- 21Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | | | | | | | - Electra D Paskett
- 25The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | - Lindsay Peterson
- 26Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | | | | | - Lillie Shockney
- 30The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | - Karen L Syrjala
- 6Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | - Phyllis Zee
- 32Robert H. Lurie Comprehensive Cancer Center of Northwestern University; and
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Boelhouwer IG, Vermeer W, van Vuuren T. Late effects of cancer (treatment) and work ability: guidance by managers and professionals. BMC Public Health 2021; 21:1255. [PMID: 34187437 PMCID: PMC8240423 DOI: 10.1186/s12889-021-11261-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/10/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The prevalence of the group of workers that had a cancer diagnosis in the past is growing. These workers may still be confronted with late effects of cancer (treatment) possibly affecting their work ability. As little is known about the guidance of this group, the aim of this study was to explore the experiences and ideas of managers and professionals about the guidance of these workers in the case of late effects of cancer (treatment). Given the positive associations with work ability of the job resources autonomy, social support by colleagues and an open organisational culture found in several quantitative studies, these job resources were also discussed. Further ideas about the influences of other factors and points of attention in the guidance of this group of workers were explored. METHODS Semi-structured interviews were conducted with managers (n = 11) and professionals (n = 47). Data-collection was from November 2019 to June 2020. The data were coded and analysed using directed content analyses. RESULTS The late effects of cancer or cancer treatment discussed were physical problems, fatigue, cognitive problems, anxiety for cancer recurrence, and a different view of life. The self-employed have less options for guidance but may struggle with late effects affecting work ability in the same way as the salaried. Late effects may affect work ability and various approaches have been described. Autonomy, social support of colleagues and an open organisational culture were regarded as beneficial. It was indicated that interventions need to be tailor-made and created in dialogue with the worker. CONCLUSIONS Especially with respect to cognitive problems and fatigue, guidance sometimes turned out to be complicated. In general, the importance of psychological safety to be open about late effects that affect work ability was emphasized. Moreover, it is important to take the perspective of the worker as the starting point and explore the possibilities together with the worker. Autonomy is an important factor in general, and a factor that must always be monitored when adjustments in work are considered. There is a lot of experience, but there are still gaps in knowledge and opportunities for more knowledge sharing.
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Affiliation(s)
- Ingrid G Boelhouwer
- Department of Applied Psychology, Amsterdam University of Applied Sciences, Wibauthuis/Wibautstraat 3b, 1091 GH, Amsterdam, The Netherlands.
| | - Willemijn Vermeer
- Department of Applied Psychology, Amsterdam University of Applied Sciences, Wibauthuis/Wibautstraat 3b, 1091 GH, Amsterdam, The Netherlands
| | - Tinka van Vuuren
- Faculty of Management, Open University of The Netherlands, Heerlen, The Netherlands / Loyalis Knowledge & Consult, Heerlen, The Netherlands
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Supporting Self-Employed Cancer Survivors to Continue Working: Experiences of Social Welfare Counsellors and Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084164. [PMID: 33920753 PMCID: PMC8071140 DOI: 10.3390/ijerph18084164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/01/2021] [Accepted: 04/03/2021] [Indexed: 11/22/2022]
Abstract
Few studies have investigated the support needed or received by self-employed cancer survivors to continue working. In Norway, the Labour and Welfare Administration (NAV) is responsible for supporting people both practically and financially to continue or return to work following ill health. Social welfare counsellors (NAV counsellors) are responsible for guiding workers in their effort to return to work. This study aimed to investigate NAV counsellors’ experiences of supporting self-employed cancer survivors. We also report how self-employed people experienced the support they received from NAV during and after cancer treatment. We conducted individual in-depth interviews among seven self-employed cancer survivors and seven NAV counsellors with experience in supporting self-employed cancer survivors. The survivors experienced NAV as largely absent and considered that the support offered was not very useful. The NAV counsellors stated that self-employed workers are in a difficult situation and that regulations and means of support were primarily designed to fit salaried workers. While they felt they were supposed to function as an “employer” for the self-employed, they found this difficult because of lack of time, expertise and means for supporting self-employed. These findings suggest that the social welfare system in Norway is not adapted to support sick self-employed people appropriately.
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58
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A multidisciplinary working model for promoting return to work of cancer survivors. Support Care Cancer 2021; 29:5151-5160. [PMID: 33611646 DOI: 10.1007/s00520-021-06074-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 02/11/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Despite wide recognition of the necessity of an integrative maintenance and return to work (RTW) program for cancer survivors, no such program has been described in the literature. AIMS To examine a working model of an integrative multidisciplinary health care approach for promoting RTW, using the Delphi method. METHODS A working model for promoting cancer survivors' RTW by oncology health professionals was subjected to two rounds of evaluation by an expert panel in accordance with the Delphi research method. Twenty-six international experts in oncology (social workers, nurses, psychologists, physicians, and cancer patients) participated in the first round and 16 participated in the second round. RESULTS The mean score of the working model's applicability was 6.07 (SD = 1.07, range = 1-7). The model outlines in detail an integrative approach for promotion of RTW according to two axes: the oncology health professionals' role and the timeline axis featuring four stages of oncology treatment and follow-up. CONCLUSIONS Our proposed model addresses the need for an integrated program that may increase the rate of RTW and improve the quality of life of cancer survivors. The model should be subjected to further evaluation, especially its adaptability to different health systems in different countries.
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Nitecki R, Fu S, Lefkowits C, Smith BD, Meyer LA, Melamed A, Giordano SH, Rauh-Hain JA. Employment disruption following the diagnosis of endometrial cancer. Gynecol Oncol 2021; 160:199-205. [PMID: 33183765 PMCID: PMC7779695 DOI: 10.1016/j.ygyno.2020.10.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/31/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Oncologic treatment has been associated with unemployment. As endometrial cancer is highly curable, it is important to assess whether patients experience employment disruption after treatment. We evaluated the frequency of employment change following endometrial cancer diagnosis and assessed factors associated with it. METHODS A cohort of patients 18-63 years-old who were diagnosed with endometrial cancer (January 2009-December 2017) were identified in the Truven MarketScan database, an insurance claims database of commercially insured patients in the United States. All patients who were working full- or part-time at diagnosis were included and all employment changes during the year following diagnosis were identified. Clinical information, including use of chemotherapy and radiation, were identified using Common Procedural Terminology codes, and International Statistical Classification of Diseases codes. Cox proportional hazards models incorporating measured covariates were used to evaluate the impact of treatment and demographic variables on change in employment status. RESULTS A total of 4381 women diagnosed with endometrial cancer who held a full-time or part-time job 12 months prior to diagnosis were identified. Median age at diagnosis was 55 and a minority of patients received adjuvant therapy; 7.9% received chemotherapy, 4.9% received external-beam radiation therapy, and 4.1% received chemoradiation. While most women continued to work following diagnosis, 21.7% (950) experienced a change in employment status. The majority (97.7%) of patients had a full-time job prior to diagnosis. In a multivariable analysis controlling for age, region of residence, comorbidities, insurance plan type and presence of adverse events, chemoradiation recipients were 34% more likely to experience an employment change (HR 1.34, 95% CI 1.01-1.78), compared to those who only underwent surgery. CONCLUSION Approximately 22% of women with employer-subsidized health insurance experienced a change in employment status following the diagnosis of endometrial cancer, an often-curable disease. Chemoradiation was an independent predictor of change in employment.
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Affiliation(s)
- Roni Nitecki
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Shuangshuang Fu
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Carolyn Lefkowits
- Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Department of Internal Medicine, Palliative Care, University of Colorado Denver, Aurora, CO, United States of America
| | - Benjamin D Smith
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, United States of America
| | - Larissa A Meyer
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Alexander Melamed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States of America
| | - Sharon H Giordano
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - J Alejandro Rauh-Hain
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
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Ohara K, Suzuki M, Niigata N, Shirai C, Idoguti Y, Kawahira M. [Factors associated with unemployment or job change due to the treatment of designated intractable diseases]. SANGYŌ EISEIGAKU ZASSHI = JOURNAL OF OCCUPATIONAL HEALTH 2020; 63:143-153. [PMID: 33342960 DOI: 10.1539/sangyoeisei.2020-039-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Unemployment or job change due to treatment for a disease is affected by various factors such as disease type, degree of disability, and workplace patient support. This study aimed to clarify the factors affecting the unemployment/job-change rate among workers who had designated intractable diseases. METHODS A questionnaire survey was administered to 3210 designated patients with intractable diseases who underwent applications for renewal of medical care subsidies at the Hirakata City Public Health Center during fiscal year 2019 (July-December). Of these patients, 539 workers aged 20-59 years who were employed as regular workers, temporary contract worker/dispatched workers, and part-time workers when they became designated intractable diseases were subjects of the analysis. Unemployment/job-change due to the treatment for a designated intractable disease was treated as an event occurrence, while the absence of unemployment/job-change due to disease at the time of the survey were considered censored cases. The Kaplan-Meier method was used to determine the trend of the unemployment/job-change rate associated with the duration of work. The Cox proportional hazard model was used to examine the relationship between unemployment/job-change and factors such as gender, age at onset, disease groups, activities of daily living, types of employment, experienced workplace supports (e.g., reduced working hours and hourly paid leave), and existence of insoluble medical difficulties at the workplace. RESULTS The unemployment/job-change rate due to treatment for designated intractable disease was 19.4%. Significantly independent factors of unemployment/job-change were the following: 50s at onset (compared to those in their 30s, HR = 2.55, 95% CI (1.21-5.37)), requiring outing assistance (compared to going out alone, 2.31 (1.13-4.71)), being a temporary contract worker/dispatched worker (compared to a regular worker, 2.66 (1.20-5.89)), existence of insoluble medical difficulties at workplace (4.15 (2.43-7.09)). Experienced workplace support was not a significant factor in preventing unemployment/job-change. CONCLUSIONS Age at onset, degree of disability, form of employment, and existence of insoluble medical difficulties at the workplace were significantly associated with unemployment/job change due to treatment for designated intractable diseases. The relationship between workplace patient supports and unemployment/job-change was not clear, but to reduce medical difficulties in the workplace, workplace supports must be expanded. Given that workplace support is not an obligatory effort for employers, it is necessary to establish a system where employers can easily promote workplace support.
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Affiliation(s)
- Kenryo Ohara
- Occupational Health Section, Hirakata City Office
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61
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Coenen P, Zegers AD, Stapelfeldt CM, de Maaker-Berkhof M, Abma F, van der Beek AJ, Bültmann U, Duijts SFA. Cross-cultural translation and adaptation of the Readiness for Return To Work questionnaire for Dutch cancer survivors. Eur J Cancer Care (Engl) 2020; 30:e13383. [PMID: 33277767 DOI: 10.1111/ecc.13383] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/25/2020] [Accepted: 11/19/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Effective interventions supporting cancer survivors in work participation are lacking, possibly due to the poor fit between interventions and cancer survivors' needs. The 'Readiness for Return To Work' (RRTW) questionnaire could facilitate intervention development tailored to cancer survivors' needs. We performed a cross-cultural translation and adaptation of this questionnaire into Dutch and pre-tested its psychometric properties among cancer survivors. METHODS Questionnaire translation and adaptation were conducted using a systematic approach of: forward translation, synthesis, backward translation, consolidation of translations with an expert committee, and pre-testing. Pre-testing consisted of interviewing 40 cancer survivors, who completed the questionnaire. RESULTS The translated and adapted RRTW questionnaire showed reasonable psychometric properties, that is high item-to-stage correlations and internal consistency for all RRTW stages, except for the prepared for action - self-evaluative stage. CONCLUSIONS The translated and adapted RRTW questionnaire may be useful for tailoring interventions to support cancer survivors in returning to and maintaining at work. However, some items showed poor psychometric properties and several factors, important for work participation, are not captured, for example personal, disease-, treatment- and/or work-related characteristics. We recommend to further test the RRTW questionnaire and to use it in combination with additional measurement instruments when developing tailored work participation interventions.
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Affiliation(s)
- Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Amber D Zegers
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Christina Malmose Stapelfeldt
- Department of Public Health, Aarhus University, Aarhus C, Denmark.,DEFACTUM Social & Health Services and Labour Market, Aarhus C, Denmark
| | - Marianne de Maaker-Berkhof
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Femke Abma
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Saskia F A Duijts
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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The associations between late effects of cancer treatment, work ability and job resources: a systematic review. Int Arch Occup Environ Health 2020; 94:147-189. [PMID: 32929528 PMCID: PMC7873002 DOI: 10.1007/s00420-020-01567-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 08/25/2020] [Indexed: 01/11/2023]
Abstract
Objective The aim of this review is to evaluate associations between possible late effects of cancer treatment (i.e. physical complaints, fatigue, or cognitive complaints) and work ability among workers beyond 2 years after cancer diagnosis who returned to work. The role of job resources (social support, autonomy, leadership style, coaching, and organizational culture) is also evaluated. Methods The search for studies was conducted in PsycINFO, Medline, Business Source Premier, ABI/Inform, CINAHL, Cochrane Library and Web of Science. A quality assessment was used to clarify the quality across studies. Results The searches included 2303 records. Finally, 36 studies were included. Work ability seemed to decline shortly after cancer treatment and recover in the first 2 years after diagnosis, although it might still be lower than among healthy workers. No data were available on the course of work ability beyond the first 2 years. Late physical complaints, fatigue and cognitive complaints were negatively related with work ability across all relevant studies. Furthermore, social support and autonomy were associated with higher work ability, but no data were available on a possible buffering effect of these job resources on the relationship between late effects and work ability. As far as reported, most research was carried out among salaried workers. Conclusion It is unknown if late effects of cancer treatment diminish work ability beyond two years after being diagnosed with cancer. Therefore, more longitudinal research into the associations between possible late effects of cancer treatment and work ability needs to be carried out. Moreover, research is needed on the buffering effect of job resources, both for salaried and self-employed workers. Electronic supplementary material The online version of this article (10.1007/s00420-020-01567-w) contains supplementary material, which is available to authorized users.
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Nekhlyudov L, Duijts S, Hudson SV, Jones JM, Keogh J, Love B, Lustberg M, Smith KC, Tevaarwerk A, Yu X, Feuerstein M. Addressing the needs of cancer survivors during the COVID-19 pandemic. J Cancer Surviv 2020; 14:601-606. [PMID: 32335850 PMCID: PMC7183255 DOI: 10.1007/s11764-020-00884-w] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Larissa Nekhlyudov
- Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Saskia Duijts
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
| | - Shawna V Hudson
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, Brunswick, NJ, USA.,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Jennifer M Jones
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Justin Keogh
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Brad Love
- Center for Health Communication, Moody College of Communication and Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Maryam Lustberg
- The Ohio State Comprehensive Cancer Center, Columbus, OH, USA
| | - Katherine Clegg Smith
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Amye Tevaarwerk
- Hematology/Oncology, University of Wisconsin-Madison, Madison, WI, USA.,Carbone Cancer Center, Madison, WI, USA
| | - Xinhua Yu
- Division of Epidemiology, Biostatistics and Environmental Health, University of Memphis, Memphis, TN, USA
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Horsbøl TA, Dalton SO, Ammitzbøll G, Johansen C, Andersen EAW, Jensen PT, Frøding LP, Lajer H, Kjaer SK. Gynaecological cancer leads to long-term sick leave and permanently reduced working ability years after diagnosis. J Cancer Surviv 2020; 14:867-877. [PMID: 32564197 DOI: 10.1007/s11764-020-00899-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 05/29/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The aim of the study was to investigate overall patterns in labour market affiliation, risk for permanently reduced work ability and prevalence of long-term sickness absence among women diagnosed with gynaecological cancer. METHODS We followed 8451 women diagnosed with ovarian, endometrial or cervical cancer, and 72,311 women with no history of cancer in nationwide registers for up to 19 years (mean 7.5 years). We computed hazards ratios for permanently reduced working ability and annual proportions of long-term sick leave. RESULTS Patterns of labour market affiliation varied by cancer diagnosis and stage. The hazard of permanently reduced working ability was increased for survivors of all three cancers but most pronounced for women diagnosed with advanced ovarian cancer. The highest hazard ratios were found 2-5 years after diagnosis, and they persisted for years in all groups and throughout the follow-up period of 19 years in women diagnosed with advanced cervical cancer. In the subgroups of women who continued to be potentially active on the labour market, long-term sick leave was more prevalent among cancer survivors than women with no history of cancer up to 10 years after diagnosis. CONCLUSIONS Women diagnosed with localised as well as advanced gynaecological cancer are at prolonged risk for permanently reduced working ability and long-term sick leave. IMPLICATIONS FOR CANCER SURVIVORS Gynaecological cancer can have long-term as well as permanent consequences for working ability, and survivors who remain active on the labour market might have to take more sick leave even years after cancer diagnosis than other women at their age.
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Affiliation(s)
- Trine Allerslev Horsbøl
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.
| | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.,National Research Center for Equality in Cancer, Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Rådmandsengen 5, 4700, Næstved, Denmark
| | - Gunn Ammitzbøll
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.,National Research Center for Equality in Cancer, Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Rådmandsengen 5, 4700, Næstved, Denmark
| | - Christoffer Johansen
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.,Late Effect Research Unit CASTLE, Copenhagen University Hospital, Blegdamsvej 58, 2100, Copenhagen, Denmark
| | | | - Pernille Tine Jensen
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.,Faculty of Health, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus, Denmark
| | | | - Henrik Lajer
- Department of Gynaecology, Copenhagen University Hospital, Juliane Maries Vej 10, 2100, Copenhagen, Denmark
| | - Susanne K Kjaer
- Department of Gynaecology, Copenhagen University Hospital, Juliane Maries Vej 10, 2100, Copenhagen, Denmark.,Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
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65
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de Boer AGEM, Greidanus MA, Dewa CS, Duijts SFA, Tamminga SJ. Introduction to special section on: current topics in cancer survivorship and work. J Cancer Surviv 2020; 14:101-105. [PMID: 32206965 PMCID: PMC7182612 DOI: 10.1007/s11764-020-00868-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 02/13/2020] [Indexed: 01/22/2023]
Abstract
Work is a key contributor to quality of life and an important aspect of cancer survivorship. We call attention to current topics in cancer survivorship and work with 12 articles on cancer survivorship and work in this special section. The focus is on less studied diagnostic groups such as gastrointestinal cancer and prostate cancer, and on long-term effects of cancer diagnosis and treatment on work. Furthermore, studies are included on topics not generally studied including cognitive limitations and pain, the role of the employer on work outcomes among different types of cancer survivors and some countries not typically covered in the existing literature on work and cancer survivorship. We conclude that to improve sustainable work participation in cancer survivors, personalised, tailored interventions should be provided. A prerequisite for this is the identification of groups and individuals at high risk for adverse work outcomes. In order to develop such interventions, research involving new approaches such as matching data registries, participatory approaches and the involvement of many stakeholders and survivors with these different types of cancer diagnoses is necessary. IMPLICATIONS FOR CANCER SURVIVORS: The goal of sustainable work participation in cancer survivors can be improved by the delivery of a personalised or risk-based tailored intervention. Furthermore, successful work outcomes often involve many stakeholders who should all be included Implications for Cancer Survivors. The goal of sustainable work participation in cancer survivors can be improved by the delivery of a personalised or risk-based tailored intervention. Furthermore, successful work outcomes often involve many stakeholders who should all be included.
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Affiliation(s)
- A G E M de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
| | - M A Greidanus
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - C S Dewa
- Departments of Psychiatry and Behavioral Sciences and Public Health Sciences, University of California, Davis, CA, USA
| | - S F A Duijts
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - S J Tamminga
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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