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Schellack S, Breidenbach C, Rick O, Kowalski C. Predictive factors for return to work among cancer survivors in Europe: A systematic review. Crit Rev Oncol Hematol 2024; 200:104422. [PMID: 38897312 DOI: 10.1016/j.critrevonc.2024.104422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 06/21/2024] Open
Abstract
Of the 4.4 million people diagnosed with cancer in Europe each year, around 36 % are of working age. Return-to-work rates vary across Europe. Work is important for the individual, as well as for society, and this review aims to provide an overview of the predictors for the return to work (RTW) process in European cancer survivors of working age. A systematic literature search was conducted. The present review included quantitative and qualitative study designs published since 2013. In total, the review included 85 papers examining cancer survivors with various cancer diagnoses in 18 European countries. Identified predictive factors for RTW related to the social system, treatment, disease, health behavior, the individuals' psychosocial, work, and sociodemographic situations. There is a need for a standardized definition and operationalization of RTW. Providers can use these results to identify survivors at risk and support cancer survivors in their RTW process.
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Affiliation(s)
- Sophie Schellack
- German Cancer Society, Kuno-Fischer-Straße 8, Berlin 14057, Germany.
| | | | - Oliver Rick
- Center for Oncology Rehabilitation, Clinic Reinhardshoehe, Quellenstraße 8-12, Bad Wildungen 34537, Germany
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Bellini A, Keegan THM, Li Q, Maguire FB, Lyo V, Sauder C. Disparities in the Occurrence of Long-Term Effects of Bone Marrow Suppression after Treatment in Adolescent Young Adult Breast Cancer Survivors. Ann Surg Oncol 2024:10.1245/s10434-024-15707-w. [PMID: 39012466 DOI: 10.1245/s10434-024-15707-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 05/29/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Many adolescent and young adult (AYA) patients with breast cancer (BC) receive adjuvant therapy as initial treatment, with long-term bone marrow suppression as a potential complication, but no studies have evaluated the impact of race/ethnicity on the development of bone marrow suppression in AYA BC survivors. PATIENTS AND METHODS Female patients ages 15-39 years diagnosed with BC (2006-2018) and surviving ≥ 2 years were identified from the California Cancer Registry and linked to statewide hospitalization data. We estimated the cumulative incidence of developing late effects of bone marrow suppression, such as leukopenia, anemia, thrombocytopenia, bleeding, and infection/sepsis, during hospital discharge diagnoses present ≥ 2 years after diagnosis. We examined the impact of sociodemographic and clinical factors on late effects using multivariate Cox proportional hazards regression. RESULTS Of 11,293 patients, 42.8% were non-Hispanic (nH) White, 28.8% Hispanic, 19.5% nH Asian/Pacific Islander, and 7.5% nH Black. In multivariable analyses, nH Blacks had the highest risk (versus nH Whites) of anemia [hazard ratio (HR) 1.72, 95% confidence interval (CI) 1.47-2.02], leukopenia (HR 1.56, CI 1.14-2.13), thrombocytopenia (HR 1.46, CI 1.08-1.99), major infection/sepsis (HR 1.64, CI 1.4-1.92), and bleeding (HR 1.89, CI 1.39-2.58). Hispanics had a higher risk of developing anemia (HR 1.17, CI 1.04-1.32), bleeding (HR 1.4, CI 1.12-1.76), and major infections/sepsis (HR 1.36, CI 1.21-1.52). Asian/Pacific Islanders had only a higher risk of developing bleeding (HR 1.33, CI 1.03-1.72). Patients from a low neighborhood socioeconomic status had a 20% higher risk of infection/sepsis (HR 1.21, CI 1.1-1.34), but there were no associations for the other late effects. CONCLUSIONS We identified that AYAs of nH Black, Hispanic, and Asian/Pacific Islander race/ethnicity are at an increased risk of several late effects after adjuvant therapy compared with nH White patients. From these data, providers can implement early/frequent screening of hematologic late effects in these high-risk survivors.
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Affiliation(s)
- A Bellini
- Comprehensive Cancer Center, University of California Davis, Sacramento, CA, USA
- Department of Surgery, University of California Davis School of Medicine, Sacramento, CA, USA
| | - T H M Keegan
- Comprehensive Cancer Center, University of California Davis, Sacramento, CA, USA
- Center for Oncology Hematology Outcomes Research and Training (COHORT) and Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Q Li
- Center for Oncology Hematology Outcomes Research and Training (COHORT) and Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, CA, USA
| | - F B Maguire
- California Cancer Reporting and Epidemiologic Surveillance Program, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA
| | - V Lyo
- Department of Surgery, University of California Davis School of Medicine, Sacramento, CA, USA
- Center for Alimentary and Metabolic Science, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Candice Sauder
- Comprehensive Cancer Center, University of California Davis, Sacramento, CA, USA.
- Department of Surgery, University of California Davis School of Medicine, Sacramento, CA, USA.
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Boelhouwer IG, van Vuuren T. The association of fatigue and cognitive complaints with work-related outcomes and cancer-related anxiety among employees 2-10 years after cancer diagnosis. J Health Psychol 2024:13591053241234748. [PMID: 38433650 DOI: 10.1177/13591053241234748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
This study investigated the association of fatigue and cognitive complaints among employees post-cancer diagnosis, with work-related outcomes, and moderation by cancer-related anxiety. A survey was carried out among workers 2-10 years after cancer diagnosis. Employees without cancer recurrence or metastases were selected (N = 566). Self-reported fatigue and cognitive complaints were classified into three groups. ANOVA's and regression analyses were used, controlling for age. Group 1 (cognitive complaints, n = 25, 4.4%), group 2 (fatigue, n = 205, 36.2%), and group 3 (cognitive complaints and fatigue, n = 211, 37.3%) were associated with higher burnout complaints and lower work engagement, and group 2 and 3 with lower work ability. Cancer-related anxiety positively moderated the association of group 3 with higher burnout complaints. Employees with both fatigue and cognitive complaints report less favorable work functioning. Cancer-related anxiety needs attention in the context of burnout complaints.
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Affiliation(s)
| | - Tinka van Vuuren
- Open Universiteit, the Netherlands
- Loyalis Knowledge & Consult, the Netherlands
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Holme IK, Hollund HA, Vandraas K, Kiserud CE, Reinertsen KV, Loge JH, Lie HC. Sexual Problems as Late Effects: Awareness and Information Needs Among 1870 Long-term Norwegian Childhood, Adolescent, and Young Adult Cancer Survivors (The NOR-CAYACS Study). J Adolesc Young Adult Oncol 2024; 13:203-212. [PMID: 37579257 DOI: 10.1089/jayao.2023.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Abstract
Purpose: Treatment-related sexual problems are common, but understudied, among survivors of Childhood, Adolescent, and Young Adult Cancer Survivors (CAYACS). We investigated awareness of, and information needs regarding, sexual problems as late effects in a nation-wide sample of long-term CAYACS. Methods: Five-year survivors were identified by the Cancer Registry of Norway, diagnosed between 1985 and 2009 with any childhood cancer (0-18 years of age, excluding central nervous system tumors), leukemia, colorectal cancer, breast cancer, non-Hodgkin lymphoma, or malignant melanoma (19-39 years of age). Malignant melanoma survivors treated with local surgery only served as an unmatched reference group. Survivors were mailed a survey, including items on awareness and information needs. Descriptive statistics and logistic regression analyses were used for data analyses. Results: Of 5361 CAYACS invited, 2104 responded (39%), of which 1870 were eligible for inclusion. In all, 62% were aware of sexual problems as late effects (46% aware only, 16% experienced it) and 31% reported information needs. Of all groups, childhood cancer survivors reported the lowest level of awareness (43% aware, 7% experienced it) and the highest information needs (38%). In multivariable models, awareness was associated with higher education, shorter time since treatment, more intense treatments, and experiencing hormonal changes and reduced fertility. Information needs were associated with having experienced sexual problems, female gender, higher treatment intensity, chronic fatigue, and increased depressive symptoms. Conclusions: A substantial proportion of long-term CAYACS report being unaware of, and have information needs regarding sexual problems as late effects decades beyond treatment. Addressing such issues during follow-up care is important.
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Affiliation(s)
- Ida K Holme
- Department of Behavioral Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Henrikke A Hollund
- Department of Behavioral Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kathrine Vandraas
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - Cecilie E Kiserud
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - Kristin V Reinertsen
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - Jon Håvard Loge
- Department of Behavioral Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Hanne Cathrine Lie
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
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Husson O, Janssen SHM, Reeve BB, Sodergren SC, Cheung CK, McCabe MG, Salsman JM, van der Graaf WTA, Darlington AS. Protocol for the development of a Core Outcome Set (COS) for Adolescents and Young Adults (AYAs) with cancer. BMC Cancer 2024; 24:126. [PMID: 38267900 PMCID: PMC10809623 DOI: 10.1186/s12885-023-11716-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/04/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Adolescents and young adults (AYAs) with cancer, defined as individuals aged 15-39 years at initial cancer diagnosis, form a unique population; they face age-specific issues as they transition to adulthood. This paper presents the protocol for the development of a core outcome set (COS) for AYAs with cancer. METHODS The methodological standards from the Core Outcome Measures in Effectiveness Trials (COMET) and the International Consortium for Health Outcomes Measurement (ICHOM) for COS development will guide the development of the COS for AYAs with cancer. The project will consist of the following phases: (1) define the scope of the COS; (2) establish the need for a COS in this field (3) assemble an international, multi-stakeholder working group; (4) develop a detailed protocol; (5) determine "what to measure" (i.e., outcomes); (6) determine "how to measure" (i.e., measures); and (7) determine "case-mix" variables. CONCLUSIONS The development of a COS for AYAs with cancer will facilitate the implementation of efficient and relevant standards for data collection, both for clinical trials and in routine healthcare, thereby increasing the usefulness of these data to improve the value of the care given to these underserved young cancer patients.
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Affiliation(s)
- Olga Husson
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Silvie H M Janssen
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Bryce B Reeve
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Cancer Institute, Durham, NC, USA
| | | | | | - Martin G McCabe
- Division of Cancer Sciences, University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - John M Salsman
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Winston Salem, NC, USA
| | - Winette T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
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Powis M, Hack S, Fazelzad R, Hodgson D, Kukreti V. Survivorship care for patients curatively treated for Hodgkin's and non-Hodgkin's lymphoma: a scoping review. J Cancer Surviv 2023:10.1007/s11764-023-01500-3. [PMID: 38048010 DOI: 10.1007/s11764-023-01500-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/13/2023] [Indexed: 12/05/2023]
Abstract
PURPOSE We undertook a scoping review of the literature to synthesize what is known about lymphoma survivorship and develop a comprehensive set of lymphoma-specific survivorship recommendations. METHODS We searched the peer-reviewed literature from January 1995 to April 2022, focused on topics relevant to survivorship care in patients ≥ 18 years of age, treated curatively for non-Hodgkin's and Hodgkin's lymphoma, and in remission for at least 2 years. RESULTS We retained 92 articles; themes included late effects of treatment (53.3%, 49/92), particularly fatigue and sleep disturbances, and fertility, as well as psychosocial considerations of survivors (27.2%; 25/92), screening for secondary malignancies (22.8%; 21/92), outcomes of interventions to improve survivorship care (10.9%; 10/92), and best practices and elements for survivorship plans (8.7%; 8/92). While there were published guidelines for screening for recurrence and secondary malignancies, despite the considerable number of articles on the psychosocial aspects of survivorship care, there remains limited guidance on screening frequency and management strategies for anxiety and depression, sleep disturbances, and treatment-related fatigue within the lymphoma population. CONCLUSION We have developed a comprehensive set of lymphoma-survivorship recommendations; however, work is needed to adapt them to local healthcare contexts. IMPLICATIONS FOR SURVIVORS While there is a focus in the literature on the long-term psychosocial impacts of cancer and its treatment on lymphoma survivors, there remains no concrete recommendations on effective screening and management of detriments to quality of life such as anxiety, depression, fatigue, and distress, and availability of local resources vary widely.
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Affiliation(s)
- Melanie Powis
- Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre- University Health Network, Toronto, ON, Canada
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 700 University Ave, Suite 6-223, Toronto, ON, M5G 1X6, Canada
| | - Saidah Hack
- Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre- University Health Network, Toronto, ON, Canada
| | - Rouhi Fazelzad
- Library and Information Services, University Health Network, Toronto, ON, Canada
| | - David Hodgson
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Radiation Medicine Program, Princess Margaret Cancer Centre- University Health Network, Toronto, ON, Canada
| | - Vishal Kukreti
- Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre- University Health Network, Toronto, ON, Canada.
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 700 University Ave, Suite 6-223, Toronto, ON, M5G 1X6, Canada.
- Department of Medicine, University of Toronto, Toronto, ON, Canada.
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Phillips T, Liu N, Bloudek B, Migliaccio-Walle K, Reynolds J, Burke JM. Estimated impact of ECHELON-1 overall survival on productivity costs in stage III/IV classical Hodgkin lymphoma in the United States. J Manag Care Spec Pharm 2023; 29:1312-1320. [PMID: 37921077 PMCID: PMC10701259 DOI: 10.18553/jmcp.2023.23101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
BACKGROUND A 2010 study on the impact of cancer mortality on productivity costs found Hodgkin lymphoma to have the second largest productivity cost lost per death in the United States. The ECHELON-1 trial demonstrated that frontline brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine (A+AVD) improves overall survival (OS) vs doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in stage III/IV classical Hodgkin lymphoma (cHL), reducing the risk of death to 41% (hazard ratio = 0.59; 95% CI = 0.40-0.88; P = 0.009). OBJECTIVES To assess the estimated impact of frontline treatment choice on mortality and productivity using an oncology simulation model informed by ECHELON-1 data. METHODS Individual productivity was estimated using the human capital approach and reported via present value lifetime earnings (PVLE) estimates. Deaths avoided and lifeyears saved without and with A+AVD were calculated using a model informed by realworld treatment use, treatment-specific OS, and expert clinicians' opinions. A+AVD use in the base case was 27% (range: 0%-80%). Stage III/IV cHL prevalence over a 10-year period was estimated; downstream lifetime productivity costs were projected without and with A+AVD. RESULTS In 2031, 3,645 patients were estimated to be newly diagnosed with stage III/IV cHL. Over 10 years with 27% A+AVD vs no A+AVD use, estimates predicted 14% fewer deaths (2,290 vs 2,650) and 14% less total PVLE losses ($1.438 vs $1.664 billion). Results from scenario analyses (40%-80% vs no A+AVD use) showed 20% to 32% decreases in PVLE losses ($1.331-$1.137 billion vs $1.664 billion), saving up to $527 million over 10 years. CONCLUSIONS Productivity cost losses due to mortality in stage III/IV cHL are high. Increasing A+AVD use for patients with stage III/IV cHL would reduce productivity cost losses as deaths are avoided, based on ECHELON-1 OS results.
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Affiliation(s)
- Tycel Phillips
- Department of Hematology, City of Hope Medical Center, Duarte, CA
| | | | | | | | | | - John M. Burke
- US Oncology Hematology Research Program, Rocky Mountain Cancer Centers, Aurora, CO
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Rosenthal A, Duvall A, Kahn J, Khan N. Disparities in care and outcomes for adolescent and young adult lymphoma patients. EJHAEM 2023; 4:934-939. [PMID: 38024615 PMCID: PMC10660400 DOI: 10.1002/jha2.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 12/01/2023]
Abstract
Though survival outcomes among adolescents and young adults (AYAs) with lymphoma have improved over the last three decades, socially vulnerable populations including non-White, low-income, and publicly insured groups continue to trail behind on survival curves. These disparities, while likely the result of both biological and non-biological factors, can be largely attributed to inequities in care over the full cancer continuum. Nationally representative studies have demonstrated that from diagnosis through therapy and into long-term survivorship, socially vulnerable AYAs with lymphoma face barriers to care that impact their short and long-term survival. Thus, improving outcomes for all AYAs with lymphoma requires dedicated study to understand, and then address the unique challenges faced by non-White and low-income lymphoma populations within this age group.
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Affiliation(s)
- Allison Rosenthal
- Mayo Clinic Arizona Division of Hematology Medical OncologyPhoenixArizonaUSA
| | - Adam Duvall
- Department of MedicineSection of Hematology/OncologyUniversity of ChicagoChicagoIllinoisUSA
| | - Justine Kahn
- Department of PediatricsDivision of Pediatric Hematology/Oncology/Stem Cell TransplantationColumbia University Medical CenterNew YorkNew YorkUSA
| | - Niloufer Khan
- Department of Hematology and Hematopoietic Cell Transplantation DuarteCity of HopeDuarteCanada
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Altherr A, Bolliger C, Kaufmann M, Dyntar D, Scheinemann K, Michel G, Mader L, Roser K. Education, Employment, and Financial Outcomes in Adolescent and Young Adult Cancer Survivors-A Systematic Review. Curr Oncol 2023; 30:8720-8762. [PMID: 37887531 PMCID: PMC10604989 DOI: 10.3390/curroncol30100631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/11/2023] [Accepted: 09/02/2023] [Indexed: 10/28/2023] Open
Abstract
Adolescents and young adults (AYAs) with cancer face unique challenges. We aimed to describe (i) education, employment, and financial outcomes and (ii) determinants for adverse outcomes in AYA cancer survivors. We performed a systematic literature search. We included original research articles on AYA (15-39 years of age) cancer survivors (≥2 years after diagnosis) and our outcomes of interest. We narratively synthesized the results of the included articles. We included 35 articles (24 quantitative and 11 qualitative studies). Patients in education had to interrupt their education during cancer treatment, and re-entry after treatment was challenging. After treatment, most survivors were employed but started their employment at an older age than the general population. Overall, no disadvantages in income were found. Survivors reported more absent workdays than comparisons. We identified chemotherapy, radiotherapy, late effects or health problems, female sex, migration background, and lower education associated with adverse outcomes. Although most AYA cancer survivors were able to re-enter education and employment, they reported difficulties with re-entry and delays in their employment pathway. To facilitate successful re-entry, age-tailored support services should be developed and implemented.
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Affiliation(s)
- Aurelia Altherr
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Céline Bolliger
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Michaela Kaufmann
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Daniela Dyntar
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
- Cancer Registry of Central Switzerland, 6000 Lucerne, Switzerland
| | - Katrin Scheinemann
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
- Division of Hematology & Oncology, Children’s Hospital of Eastern Switzerland, 9006 St. Gallen, Switzerland
- Department of Pediatrics, McMaster Children’s Hospital and McMaster University, Hamilton, ON L8N 3Z5, Canada
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Luzius Mader
- Institute of Social and Preventive Medicine, University of Bern, 3012 Bern, Switzerland;
- Cancer Registry Bern-Solothurn, University of Bern, 3008 Bern, Switzerland
| | - Katharina Roser
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
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Mersin S, Gülük F, Gülcan E, Eşkazan AE. Current and emerging tyrosine kinase inhibitors for the treatment of chronic myeloid leukemia in young adults. Expert Opin Pharmacother 2023; 24:1703-1713. [PMID: 37482425 DOI: 10.1080/14656566.2023.2240702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 07/04/2023] [Accepted: 07/21/2023] [Indexed: 07/25/2023]
Abstract
INTRODUCTION Chronic myeloid leukemia (CML) is more common in older adults, but nearly 15-20% of the patients is between 15 and 39 years of age. In this age group, patients may seek clinical care a much later period of the disease and they may have a heavier burden of disease. In addition, young patients with CML may face unique challenges related to their age, such as concerns about health care, fertility, or careers. The current standard of care for CML is the use of tyrosine kinase inhibitors (TKIs), which induce remission in most young patients and can achieve long-term disease control. AREAS COVERED This review summarizes age-specific treatment-related conditions, as well as the effectiveness of TKI therapy in this age group. PubMed, Google Scholar, clinicaltrials.gov and other abstract databases were used while preparing this review. The period of 2001-2023 was chosen as the search window. EXPERT OPINION Although we do not have sufficient data, young adult population has a special importance for TKI treatment. Clinical features, efficacy of treatments, and specific conditions in this age group should attract more attention of clinicians and more intensive studies should be conducted in the future.
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Affiliation(s)
- Sinan Mersin
- Department of Hematology, Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - Fatih Gülük
- Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Emirhan Gülcan
- Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Ahmet Emre Eşkazan
- Division of Hematology, Department of Internal Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Sharma S, Brunet J. Young Adults' Lived Experiences with Cancer-Related Cognitive Impairment: An Exploratory Qualitative Study. Curr Oncol 2023; 30:5593-5614. [PMID: 37366905 DOI: 10.3390/curroncol30060422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023] Open
Abstract
Cancer-related cognitive impairment (CRCI; e.g., disrupted memory, executive functioning, and information processing) affects many young adults, causing significant distress, reducing quality of life (QoL), and thwarting their ability to engage in professional, recreational, and social experiences. The purpose of this exploratory qualitative study was to investigate young adults' lived experiences with CRCI, and any strategies (including physical activity) they use to self-manage this burdensome side effect. Sixteen young adults (Mage = 30.8 ± 6.0 years; 87.5% female; Myears since diagnosis = 3.2 ± 3) who reported clinically meaningful CRCI whilst completing an online survey were interviewed virtually. Four themes comprising 13 sub-themes were identified through an inductive thematic analysis: (1) descriptions and interpretations of the CRCI phenomenon, (2) effects of CRCI on day-to-day and QoL, (3) cognitive-behavioural self-management strategies, and (4) recommendations for improving care. Findings suggest CRCI is detrimental to young adults' QoL and must be addressed more systematically in practice. Results also illuminate the promise of PA in coping with CRCI, but research is needed to confirm this association, test how and why this may occur, and determine optimal PA prescriptions for young adults to self-manage their CRCI.
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Affiliation(s)
- Sitara Sharma
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Jennifer Brunet
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Cancer Therapeutic Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
- Institut du Savoir Montfort, Hôpital Montfort, Ottawa, ON K1N 6N5, Canada
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Ghazal LV, Merriman JD, Santacroce SJ, Fletcher J, Wright F, Dickson VV. Profiles of Work and Quality of Life among Young Adult Cancer Survivors. West J Nurs Res 2023; 45:293-305. [PMID: 36529990 DOI: 10.1177/01939459221120742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Work ability, or the perception of one's ability to work presently and in the future, may impact quality of life (QOL) among young adult (YA) cancer survivors. Through a convergent mixed methods design, we explored work ability, work-related goals, and QOL among YA hematologic cancer survivors within five years of diagnosis. We described associations at the individual- and microsystem (work)- levels; and compared factors across low and high work ability groups. Participants (N = 40) completed a survey and interview via digital platforms. Qualitative analysis revealed self-assessed declines in work ability led to questioning work-related goals and influenced QOL. Integrated analysis led to the development of four profiles, growing our understanding of work's influence on QOL for YA cancer survivors, and identifying components YAs considered when contemplating work-related goals after a cancer diagnosis. Larger studies are needed to elucidate these profiles and identify modifiable factors to inform targeted interventions to improve QOL.
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Affiliation(s)
- Lauren V Ghazal
- School of Nursing, University of Michigan, Ann Arbor, MI, USA.,Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - John D Merriman
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | | | - Jason Fletcher
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Fay Wright
- Rory Meyers College of Nursing, New York University, New York, NY, USA
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13
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Di Giuseppe G, Pagalan L, Jetha A, Pechlivanoglou P, Pole JD. Financial toxicity among adolescent and young adult cancer survivors: A systematic review of educational attainment, employment, and income. Crit Rev Oncol Hematol 2023; 183:103914. [PMID: 36706969 DOI: 10.1016/j.critrevonc.2023.103914] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/17/2022] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
PURPOSE To identify, evaluate and summarize the evidence on educational attainment, employment status and income of AYAs surviving cancer. METHODS A search of six databases for articles published between 01/01/2010 and 03/31/2022 was performed. Articles with an AYA survivorship population, quantitative design and a cancer-free comparator group were included. Data extraction was conducted, and quality appraisal was completed using ROBINS-I. Results were summarized using a narrative synthesis. RESULTS A total of 2801 articles were identified, of which 12 were included. Among the limited evidence, educational attainment did not differ from cancer-free peers. Survivors were more likely to be unemployed, have lower incomes and require social security for income supplementation. Evidence suggested that females, diagnosis of brain cancer and the presence of late-effects were among the risk factors for severe outcomes. CONCLUSIONS Limited socioeconomic evidence exists for AYAs surviving cancer. Long-lasting financial toxicities occur and highlights a need for further investigation.
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Affiliation(s)
- Giancarlo Di Giuseppe
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | - Lief Pagalan
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Arif Jetha
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Work & Health, Toronto, Ontario, Canada
| | | | - Jason D Pole
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Centre for Health Sciences Research, University of Queensland, Brisbane, Australia
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Parsons SK, Keegan THM, Kirchhoff AC, Parsons HM, Yabroff KR, Davies SJ. Cost of Cancer in Adolescents and Young Adults in the United States: Results of the 2021 Report by Deloitte Access Economics, Commissioned by Teen Cancer America. J Clin Oncol 2023:JCO2201985. [PMID: 36827624 DOI: 10.1200/jco.22.01985] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
PURPOSE The purpose of this report, commissioned by Teen Cancer America and performed by Deloitte Access Economics in 2021, was to estimate the total costs incurred by adolescent and young adults (AYAs) after cancer diagnosis in the United States (US) over their life course. METHODS The incidence of cancer in 2019 among AYAs age 15-39 years was estimated from the US Cancer Statistics Public Use Database, and relative survival was projected from the Surveillance, Epidemiology, and End Results Program. Cost domains included health system, productivity, and well-being costs. Components were estimated with published literature and pooled data from the Medical Expenditure Panel Survey from 2008 to 2012 and inflated to 2019 dollars. RESULTS The economic and human costs of cancer in AYAs are substantial-$23.5 billion overall, corresponding to $259,324 per person over the lifetime. The majority of costs are borne by AYA cancer survivors themselves in the form of lost productivity, loss of well-being, and loss of life. CONCLUSION These findings underscore the need to address the burden of cancer in AYAs through targeted programs for AYAs, such as financial navigation and health insurance literacy interventions, as well as local and national policy initiatives to address access to and enhanced coverage for clinical trials participation, fertility services, and survivorship care.
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Affiliation(s)
- Susan K Parsons
- Divisions of Hematology/Oncology and Clinical Care Research, Tufts Medical Center, Tufts University School of Medicine, Boston, MA.,Departments of Medicine and Pediatrics, Tufts University School of Medicine, Boston, MA
| | - Theresa H M Keegan
- Center for Oncology Hematology Outcomes Research and Training and Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, CA
| | - Anne C Kirchhoff
- Huntsman Cancer Institute and University of Utah, School of Medicine, Salt Lake City, UT
| | - Helen M Parsons
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN
| | - K Robin Yabroff
- Scientific Vice President, Health Services Research, American Cancer Society, Inc
| | - Simon J Davies
- Executive Director, Teen Cancer America, Los Angeles, CA
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15
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Kristoffersen AE, Wider B, Nilsen JV, Bjelland M, Mora DC, Nordberg JH, Broderstad AR, Nakandi K, Stub T. Prevalence of late and long-term effects of cancer (treatment) and use of complementary and alternative medicine in Norway. BMC Complement Med Ther 2022; 22:322. [PMID: 36471296 PMCID: PMC9721050 DOI: 10.1186/s12906-022-03790-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The increasing number of patients surviving cancer leads to more people experiencing late and long term-effects from the disease and its treatment. Fatigue, sleep disorders, early menopause, pain, and nerve damage are commonly reported. Methods helping people to recover after cancer treatment are therefore essential. The aims of this study were threefold; (1) to determine the level of cancer patients suffering from late and long-term effects of cancer diagnosis and treatment in Norway, (2) explore complementary and alternative medicine (CAM) modalities used for managing these adversities, and (3) describe self-perceived benefits and harms of the CAM interventions. METHODS The study was conducted in cooperation with the Norwegian Cancer Society (NCS) and consisted of an online cross-sectional study among members of the NCS user panel with present or previous cancer (n = 706). The study was carried out in September/October 2021 using a modified cancer-specific version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). A total of 315 women and 153 men agreed to participate, resulting in a response rate of 67%. RESULTS Most of the participants (83%) suffered from late and long-term effects of cancer treatment; mostly fatigue (59.2%), sleep disorder (41.5%), hot flashes (39.2%), nerve damage (polyneuropathy, 38.0%), and pain (36.6%) with a mean number of 5.1 different late and long-term effects. Late and long-term effects were positively associated with younger age and college/university education. Nearly half of the participants experiencing late and long-term effects (43%) reported having used CAM to treat these complaints. Most frequently used were self-help practices (26%) such as relaxation therapy (19%), yoga (14%) and meditation (13%), but also visits to CAM providers were reported by 22%. Herbal- and other natural remedies to treat late and long-term effects were used by 13%. A high percentage of CAM users reported self-perceived improvements of their symptoms (86% for self-help practices, 90% for visits to CAM providers). Few experienced adverse effects of the CAM treatment. CONCLUSION A large proportion of cancer patients suffered from a wide range of late and long-term effects of cancer diagnosis and treatment, and they use CAM to treat these complaints to a rather high degree. Relaxation therapy, yoga, meditation, massage, and acupuncture were the most frequently used therapies regardless of complaint. The therapies used are generally considered to be both safe and beneficial for the respective complaint, indicating that the participants seem to be well informed about the choices they make.
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Affiliation(s)
- Agnete E. Kristoffersen
- grid.10919.300000000122595234National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Barbara Wider
- grid.10919.300000000122595234National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Jorunn V. Nilsen
- grid.454853.b0000 0000 9990 0607The Norwegian Cancer Society, Oslo, Norway
| | - Mona Bjelland
- grid.454853.b0000 0000 9990 0607The Norwegian Cancer Society, Oslo, Norway
| | - Dana C. Mora
- grid.10919.300000000122595234National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Johanna Hök Nordberg
- Regional Cancer Center Stockholm Gotland, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Karolinska Institutet, Department of Neurobiology, Care Sciences & Society, Division of Nursing & Department of Physiology & Pharmacology, Stockholm, Sweden
| | - Ann Ragnhild Broderstad
- grid.10919.300000000122595234Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kiwumulo Nakandi
- grid.10919.300000000122595234National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Trine Stub
- grid.10919.300000000122595234National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Davis EL, Clarke KS, Patterson P, Cohen J. Using Intervention Mapping to Develop an Education and Career Support Service for Adolescents and Young Adults Diagnosed with Cancer: Identification of the Contextual Factors That Influence Participation in Education and Employment. Cancers (Basel) 2022; 14:cancers14194590. [PMID: 36230511 PMCID: PMC9561995 DOI: 10.3390/cancers14194590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 11/29/2022] Open
Abstract
Simple Summary Quality of life for adolescents and young adults (AYAs) is driven by their participation in education and employment. This participation is disrupted for AYAs diagnosed with cancer. There is limited available information on factors that impact participation in education and employment, as well as limited access to evidence-based services. This paper presents the results from the first step in developing an education and career support service for AYAs diagnosed with cancer using Intervention Mapping. Information was collected and combined from a literature review, survey of AYAs, and feedback from a planning group. Factors found to impact AYAs’ participation in education or employment were categorised under AYA behaviours, environmental conditions, health and demographic factors, and internal factors. This information will guide the development of an education and career support service for AYAs diagnosed with cancer, with the aim of improving quality of life. Abstract Adolescents and young adults (AYAs) diagnosed with cancer experience disrupted engagement in education and employment, which can have profound and long-term impacts on their quality of life. It is therefore vital to offer AYAs access to tailored, evidence-based services to help them to achieve their education and employment goals. However, few such services exist for this population. This paper presents the results from the first step in developing an education and career support service for AYAs diagnosed with cancer using Intervention Mapping. This first step involved developing a logic model that describes the influences of health and demographic factors, individual determinants, behaviours, and environmental conditions on AYA participation in education or employment. The logic model was developed by integrating data from an integrative literature review; cross-sectional survey of AYA clients of a community-based organisation; and feedback from a planning group of stakeholders. It is a valuable framework that will be used to direct the focus of the education and career support service for AYAs diagnosed with cancer. More broadly, the logic model has implications for guiding clinical, service, research, and policy improvements for AYA education, employment, and career support, with the aim of improving AYA quality of life.
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Affiliation(s)
| | | | - Pandora Patterson
- Canteen, Sydney, NSW 2042, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Correspondence: or
| | - Jennifer Cohen
- Canteen, Sydney, NSW 2042, Australia
- School of Clinical Medicine, UNSW Medicine & Health, University of NSW, Sydney, NSW 2031, Australia
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Short- and long-term impact of cancer on employment and financial outcomes of adolescents and young adults (AYAs): a large population-based case-control registry study in the Netherlands. ESMO Open 2022; 7:100521. [PMID: 35772237 PMCID: PMC9434129 DOI: 10.1016/j.esmoop.2022.100521] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/18/2022] [Accepted: 05/23/2022] [Indexed: 12/24/2022] Open
Abstract
Background Adolescent and young adult (AYA) cancer survivors, 18-39 years at initial cancer diagnosis, often self-report negative consequences of cancer (treatment) for their career. Less is known, however, about the objective impact of cancer on employment and financial outcomes. This study examines the employment and financial outcomes of AYA cancer survivors with nationwide population-based registry data and compares the outcomes of AYAs with cancer with an age- and sex-matched control population at year of diagnosis, 1 year later (short-term) and 5 years later (long-term). Patients and methods A total of 2527 AYAs, diagnosed in 2013 with any invasive tumor type and who survived for 5 years, were identified from the Netherlands Cancer Registry (clinical and demographic data) and linked to Statistics Netherlands (demographic, employment and financial data). AYAs were matched 1 : 4 with a control population based on age and sex (10 108 controls). Analyses included descriptive statistics, chi-square tests, independent samples t-tests, McNemar tests and logistic regression. Results AYA cancer survivors were significantly less often employed compared with their controls 1 year (76.1% versus 79.5%, P < 0.001) and 5 years (79.3% versus 83.5%, P < 0.001) after diagnosis, and received more often disability benefits (9.9% versus 3.1% 1 year after diagnosis, P < 0.001; 11.2% versus 3.8% 5 years after diagnosis, P < 0.001). Unemployed AYAs were more often diagnosed with higher disease stages (P < 0.001), treated with chemotherapy (P < 0.001), radiotherapy (P < 0.001) or hormone therapy (P < 0.05) and less often with local surgery (P < 0.05) compared with employed AYAs 1 and 5 years after diagnosis. Conclusion Based on objective, nationwide, population-based registry data, AYAs’ employment and financial outcomes are significantly affected compared with age- and sex-matched controls, both short and long-term after cancer diagnosis. Providing support regarding employment and financial outcomes from diagnosis onwards may help AYAs finding their way (back) into society. Based on objective data, AYAs’ employment and financial outcomes are significantly affected compared with matched controls. AYAs were significantly more often unemployed compared with their controls 1 and 5 years after diagnosis. AYAs received significantly more often disability benefits compared with their controls 1 and 5 years after diagnosis.
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18
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Boelhouwer IG, Vermeer W, van Vuuren T. Work ability among employees 2–10 years beyond breast cancer diagnosis: Late treatment effects and job resources - A longitudinal study. Work 2022; 74:1061-1076. [PMID: 35527613 DOI: 10.3233/wor-211288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: The number of workers who have previously undergone a cancer treatment is increasing, and possible late treatment effects (fatigue, physical and cognitive complaints) may affect work ability. OBJECTIVE: The aim of the study was to investigate the impact of late treatment effects and of job resources (autonomy, supportive leadership style, and colleagues’ social support) on the future work ability of employees living 2–10 years beyond a breast cancer diagnosis. METHODS: Data at T1 (baseline questionnaire) and at T2 (9 months later) were collected in 2018 and 2019 (N = 287) among Dutch-speaking workers with a breast cancer diagnosis 2–10 years ago. Longitudinal regression analyses, controlling for years since diagnosis, living with cancer (recurrence or metastasis), other chronic or severe diseases, and work ability at baseline were executed. RESULTS: Higher levels of fatigue and cognitive complaints at baseline predicted lower future work ability. The three job resources did not predict higher future work ability, but did relate cross-sectionally with higher work ability at baseline. Autonomy negatively moderated the association between physical complaints and future work ability. CONCLUSIONS: Fatigue and cognitive complaints among employees 2–10 years past breast cancer diagnosis need awareness and interventions to prevent lower future work ability. Among participants with average or high levels of physical complaints, there was no difference in future work ability between medium and high autonomy. However, future work ability was remarkably lower when autonomy was low.
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Affiliation(s)
- Ingrid G. Boelhouwer
- Department of Applied Psychology, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Willemijn Vermeer
- Department of Applied Psychology, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Tinka van Vuuren
- Department Organisation, Faculty of Management, Open Universiteit, Heerlen, The Netherlands
- Loyalis Knowledge & Consult, Heerlen, The Netherlands
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19
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Work ability 8 years after breast cancer: exploring the role of social support in a nation-wide survey. Breast Cancer Res Treat 2022; 193:685-694. [PMID: 35445949 PMCID: PMC9114073 DOI: 10.1007/s10549-022-06599-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/04/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION As the 5-year survival rate after breast cancer in Norway is 92%, the population of breast cancer survivors (BCSs) is increasing. Knowledge of work ability in this population is scarce. In a population-based cohort of BCSs, we explored work ability 8 years after diagnosis and the association between work ability and social support, and cancer-related variables including late effects and lifestyle factors. METHODS In 2019, all Norwegian women < 59 years when diagnosed with stage I-III breast cancer in 2011 or 2012, were identified by the Cancer Registry of Norway and invited to participate in a survey on work life experiences. Work ability was assessed using the Work Ability Index (scale 0-10). Factors associated with excellent work ability (score ≥ 9) were identified using univariate and multivariate logistic regression analyses, and adjusted for socioeconomic-, health- and cancer-related variables. RESULTS Of the 1951 eligible BCSs, 1007 (52.8%) responded. After excluding survivors with relapse (n = 1), missing information on work ability score (n = 49), or work status (n = 31), the final sample comprised 926 BCSs within working age at survey (< 67 years). Mean age at survey was 56 years and 8 years (SD 0.7) had passed since diagnosis. Work ability had been reduced from 8.9 (SD 2.3) at diagnosis to 6.3 (SD 3.1). One in three BCSs reported poor work ability (WAS ≤ 5), and seven out of ten reported that their physical work ability had been reduced due to cancer. Social support from colleagues during cancer therapy was associated with excellent work ability, which was not observed for social support provided by supervisors or the general practitioner. Cognitive impairment and fatigue were inversely associated with work ability. None of the cancer-related variables, including treatment, were associated with work ability 8 years after diagnosis. CONCLUSION In this population-based sample, one in three BCSs reported poor work ability 8 years after diagnosis. Collegial social support during cancer therapy appears to be a protective factor for sustained work ability, whilst survivors struggling with fatigue and cognitive impairments may represent a particularly vulnerable group for reduced work ability.
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20
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Chapman B, Derakshan N, Grunfeld EA. Exploring primary breast cancer survivors' self-management of sustained cancer-related cognitive impairment in the workplace. Psychooncology 2021; 31:606-613. [PMID: 34699652 DOI: 10.1002/pon.5844] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 10/19/2021] [Accepted: 10/19/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Work plays a central role in return to a more 'normal' life among women diagnosed with primary breast cancer. However, ongoing cancer-related cognitive impairment (CRCI) and cancer-related sequelae continue to detrimentally impact workability. Only a few studies have explored the long-term consequences of CRCI and self-management coping strategies applied in the workplace. This study explored women's experiences of sustained post-treatment CRCI and its impact on workability beyond the initial return-to-work (RTW), as well as experiences of self-management coping strategies. METHOD Forty employed women with a diagnosis of primary breast cancer who were between 6 and 60 months post-active treatment completed a semi-structured telephone interview. A 'framework' analysis approach was used. RESULTS Two superordinate themes were identified: 'Sustained consequences of CRCI' and 'Self-management coping strategies to support work-related performance'. We found that the impact of CRCI extends beyond the initial RTW. The adopted self-management coping strategies could provoke mixed emotions, including emotional distress. Reduced workability was experienced up to 5-years post-active-treatment. CONCLUSION Sustained CRCI induces negative emotions, fatigue and diminishes confidence reducing workability long into survivorship beyond RTW. The self-management coping strategies implemented to manage these sequelae generate mixed feelings, with some describing the strategies as problematic and of little benefit.
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Affiliation(s)
- Bethany Chapman
- Department of Psychological Sciences, Centre for Building Resilience in Breast Cancer, Birkbeck, University of London, London, UK
| | - Nazanin Derakshan
- Department of Psychological Sciences, Centre for Building Resilience in Breast Cancer, Birkbeck, University of London, London, UK
| | - Elizabeth A Grunfeld
- Department of Psychological Sciences, Centre for Building Resilience in Breast Cancer, Birkbeck, University of London, London, UK
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21
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Kim SY, Kissane DW, Richardson G, Senior J, Morgan J, Gregory P, Birks S, Ooi C, Lipton L, Antill Y, Vereker M, Michael N, Bobevski I. The role of depression and other psychological factors in work ability among breast cancer survivors in Australia. Psychooncology 2021; 31:167-175. [PMID: 34460129 DOI: 10.1002/pon.5802] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/30/2021] [Accepted: 08/16/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Identifying modifiable factors affecting work ability among cancer survivors is important. The primary aim of the present study was to examine the effects of depression and related psychological factors on work ability among breast cancer survivors in Australia. METHODS In this cross-sectional electronic and postal survey, Australian breast cancer survivors were investigated. Work status and conditions before and after cancer treatment were analysed. Work ability was measured using the Work Limitation Questionnaire©-Short Form (WLQ-SF) with its four domains (time management, physical tasks, mental-interpersonal tasks, and output tasks). Three psychological factors were investigated: depression, fear of cancer recurrence, and demoralisation. Sociodemographic and clinical data were also collected. Multivariate regression analysis was used to identify the associations of psychological factors with WLQ-SF. RESULTS Among eligible survivors, 310 (50%) responded to the survey and were analysed. Nearly one third reported their work conditions had changed after cancer treatment. The depressed group reported limited work ability in 35%-44% of the four domains of WLQ-SF, while the non-depressed group reported limited work ability in only 8%-13%. At-work productivity loss was approximately fourfold higher in the depressed group than in the non-depressed group. In multivariate analysis, at-work productivity loss was associated with depression, demoralisation, and past history of anxiety. CONCLUSIONS After breast cancer treatment, work conditions changed toward lower wages and working hours. Depression, demoralisation, and past history of anxiety were associated with lower work ability. Further evaluations of work rehabilitation in breast cancer survivors are warranted.
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Affiliation(s)
- Seon-Young Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea.,Mental Health Clinic, Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - David W Kissane
- Cabrini Health, Melbourne, Victoria, Australia.,School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.,School of Medicine, University of Notre Dame Australia and Cunningham Centre, Sydney, New South Wales, Australia
| | - Gary Richardson
- Cabrini Health, Melbourne, Victoria, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | | | | | | | - Sarah Birks
- Cabrini Health, Melbourne, Victoria, Australia
| | - Corinne Ooi
- Cabrini Health, Melbourne, Victoria, Australia
| | - Lara Lipton
- Cabrini Health, Melbourne, Victoria, Australia.,Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Yoland Antill
- Cabrini Health, Melbourne, Victoria, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | | | - Natasha Michael
- Cabrini Health, Melbourne, Victoria, Australia.,School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.,School of Medicine, University of Notre Dame Australia and Cunningham Centre, Sydney, New South Wales, Australia
| | - Irene Bobevski
- Cabrini Health, Melbourne, Victoria, Australia.,School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
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22
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Tan CJ, Yip SYC, Chan RJ, Chew L, Chan A. Investigating how cancer-related symptoms influence work outcomes among cancer survivors: a systematic review. J Cancer Surviv 2021; 16:1065-1078. [PMID: 34424498 PMCID: PMC9489549 DOI: 10.1007/s11764-021-01097-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/09/2021] [Indexed: 01/07/2023]
Abstract
Purpose The purpose of this study is to investigate how different cancer-related symptoms influence work outcomes among cancer survivors. Methods A literature search was performed in PubMed, EMBASE, CINAHL, PsycINFO, and Scopus to identify studies published between 1st January 1999 and 30th October 2020 that investigated the impact of specific cancer-related symptoms on work outcomes among cancer survivors who have completed primary antineoplastic treatment. Study findings were extracted and grouped by symptoms and work outcomes, allowing comparison of associations between these outcomes. Results Seventy-three articles representing 68 studies were eligible for inclusion. From these studies, 27 cancer-related symptoms, 9 work outcomes, and 68 unique associations between specific symptoms and work outcomes were identified. Work status (return to work and employment rates) was most commonly studied, and symptom burden was mainly measured from the patient’s perspective. Higher symptom burden was generally associated with trends of poorer work outcomes. Significant associations were reported in most studies evaluating body image issues and work status, oral dysfunction and work status, fatigue and work ability, and depression and work ability. Conclusion Several cancer-related symptoms were consistently associated with inferior work outcomes among cancer survivors. Body image issues and oral dysfunction were shown to be associated with poorer employment rates, while fatigue and depression were linked to lower levels of work performance. Implications for Cancer Survivors Failure to return to work and decreased productivity post-cancer treatment can have negative consequences for cancer survivors and society at large. Findings from this review will guide the development of work rehabilitation programs for cancer survivors. Protocol registration PROSPERO identifier CRD42020187754 Supplementary Information The online version contains supplementary material available at 10.1007/s11764-021-01097-5.
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Affiliation(s)
- Chia Jie Tan
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | | | - Raymond Javan Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Lita Chew
- Department of Pharmacy, National University of Singapore, Singapore, Singapore.,Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore
| | - Alexandre Chan
- Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore. .,Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, 101 Theory, Suite 100, Irvine, CA, 92612, USA.
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23
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Baloch AN, Hagberg M, Thomée S, Steineck G, Sandén H. Disability pension among gynaecological cancer survivors with or without radiation-induced survivorship syndromes. J Cancer Surviv 2021; 16:834-843. [PMID: 34414517 PMCID: PMC9300541 DOI: 10.1007/s11764-021-01077-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 06/23/2021] [Indexed: 11/24/2022]
Abstract
Purpose Gynaecological cancer patients treated with external radiation therapy to the pelvis may face long-lasting and long-term gastrointestinal syndromes. The aim of this study was to assess the association between such radiation-induced survivorship syndromes and disability pension among gynaecological cancer survivors treated with pelvic radiation therapy. Methods This prospective register study included gynaecological cancer survivors (n=247) treated during 1991–2003, alive at the time of the study, and <65 years of age. In 2006, they completed a postal questionnaire measuring patient-reported outcomes. The self-reported data were linked to the national register on disability pensions. Relative risks and risk differences with 95% confidence intervals (CIs) of being granted a disability pension were estimated using log-binomial regression. Results Gynaecological cancer survivors with gastrointestinal syndromes had a higher risk of disability pension than survivors without such syndromes. Survivors with blood discharge syndrome had a 2.0 (95% CI 1.3–3.2) times higher risk of disability pension than survivors without blood discharge syndrome. The relative risk among survivors with urgency syndrome was 1.9 (1.3–2.9) and for leakage syndrome, 2.1 (1.4–3.1). Adjusting for age did not affect our interpretation of the results. Conclusions Gynaecological cancer survivors with a specific radiation-induced survivorship syndrome have a higher risk of disability pension than survivors without that specific syndrome. Implications for Cancer Survivors The findings highlight the need for more awareness and knowledge regarding the potential role of radiation-induced survivorship syndromes for continuing work among gynaecological cancer survivors. Work-life-related parameters should be considered during radiotherapy and rehabilitation after treatment. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-021-01077-9.
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Affiliation(s)
- Adnan Noor Baloch
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine at University of Gothenburg, P.O. Box 463, 405 30, Gothenburg, Sweden.
| | - Mats Hagberg
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine at University of Gothenburg, P.O. Box 463, 405 30, Gothenburg, Sweden
| | - Sara Thomée
- Department of Psychology, University of Gothenburg, Box 500, 405 30, Gothenburg, Sweden
| | - Gunnar Steineck
- Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences at University of Gothenburg, 405 30, Gothenburg, Sweden
| | - Helena Sandén
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine at University of Gothenburg, P.O. Box 463, 405 30, Gothenburg, Sweden
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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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Brock H, Friedrich M, Sender A, Richter D, Geue K, Mehnert-Theuerkauf A, Leuteritz K. Work ability and cognitive impairments in young adult cancer patients: associated factors and changes over time-results from the AYA-Leipzig study. J Cancer Surviv 2021; 16:771-780. [PMID: 34118000 PMCID: PMC9300567 DOI: 10.1007/s11764-021-01071-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/03/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Although young adults represent a significant portion of the working population, little is known about the work ability and cognitive impairments in adolescent and young adult (AYA) cancer patients (including the long-term course) following cancer treatment. METHODS As part of the AYA-Leipzig study, we surveyed AYA cancer survivors (aged 18-39 years at diagnosis; time since diagnosis ≤ 4 years, including all cancer diagnoses) at two time points (t2 = 12 months after t1). Work ability (Work Ability Index, WAI-r) and cognitive impairments (Copenhagen Psychosocial Questionnaire, COPSOQ) were compared at both time points. We analysed predictors for work ability at, on average, 2 years post cancer diagnosis (t2) by using multivariate regression analyses. RESULTS A total of 502 patients (74.7% women) participated in both measurements. Mean work ability increased significantly from t1 (6.0; SD = 2.3) to t2 (6.8; SD = 2.2) (t = -9.3; p < 0.001). As many as 380 (76%) AYA cancer survivors reported reduced work ability at t1; 1 year later, this still applied to 287 (57%) of them. Decreased work ability (t2) was associated with more cognitive impairment, higher effort coping with the disease, comorbidities, sick leave > 6 months (since diagnosis), and having children (adj R2 = .48). Cognitive impairments occurred in approximately every fifth patient at both surveys. CONCLUSIONS Achieving maximum work ability is a major challenge for AYAs. Our results show the need for multimodal cancer survivorship and rehabilitation programmes with a special focus on improving cognitive and psychosocial functioning. IMPLICATIONS FOR CANCER SURVIVORS AYAs with cancer should receive targeted occupational counselling early in the course of the disease.
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Affiliation(s)
- Hannah Brock
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany.
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Annekathrin Sender
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Diana Richter
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Kristina Geue
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Katja Leuteritz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
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Hernæs KH, Smeland KB, Fagerli UM, Kiserud CE. Post-treatment work patterns amongst survivors of lymphoma treated with high-dose chemotherapy with autologous stem-cell transplantation. BMC Cancer 2021; 21:143. [PMID: 33557789 PMCID: PMC7871541 DOI: 10.1186/s12885-021-07836-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/26/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND This study describes post-treatment work patterns in lymphoma survivors treated with high-dose chemotherapy with autologous stem-cell transplantation (HDT-ASCT). It aims to identify determinants for labour force participation and exclusion after HDT-ASCT. METHODS All survivors treated with HDT-ASCT for lymphoma in Norway between 1995 and 2008, aged ≥18 years at HDT-ASCT and alive at survey in 2012-2013 were eligible. We divide survivors by current employment status (full-time, part-time and unemployed). Main outcomes are current employment status, work hours and work ability. Withdrawals are patients employed when diagnosed but not before HDT-ASCT. RESULTS Of the 274 who completed the survey, 82% (N = 225) were included in the final analyses. Mean age at survey was 52 years, 39% were female, 85% were employed when diagnosed, 77% before HDT-ASCT and 69% at survey. Employment before HDT-ASCT corresponds with a higher probability of employment at survey for a given symptom burden. In the most extensive statistical model, it increases with 37.3 percentage points. Work hours amongst withdrawals plummet after HDT-ASCT while work ability shows a rebound effect. The potential economic gain from their re-enter into the work force equals 70% of the average annual wage in Norway in 2012. CONCLUSIONS For a given symptom burden, staying employed throughout diagnosis and treatment is associated with a higher probability of future employment. These results favour policies for labour force inclusion past diagnosis and treatment increasing cancer survivors' probability of future employment. However, we need more research on withdrawal mechanisms, and on policy measures that promote inclusion.
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Affiliation(s)
- Kjersti Helene Hernæs
- Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway. .,Previous affiliation: Research Support Services, Oslo University Hospital, Sogn Arena, Klaus Torgårds vei 3, 3. Floor, 0372, Oslo, Norway.
| | - Knut B Smeland
- National Advisory Unit for Late Effects after Cancer Treatment, Oslo University Hospital, Radiumhospitalet, PO 4953, Nydalen, N-0424, Oslo, Norway
| | - Unn-Merete Fagerli
- Department of Oncology, St. Olavs hospital HF, Postboks 3250 Torgarden, 7006, Trondheim, Norway.,Institute for Clinical and Molecular Medicine (IKOM), The Norwegian University of Science and Technology (NTNU), Olav kyrres gate 9, 7006, Trondheim, Norway
| | - Cecilie E Kiserud
- National Advisory Unit for Late Effects after Cancer Treatment, Oslo University Hospital, Radiumhospitalet, PO 4953, Nydalen, N-0424, Oslo, Norway
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Jin Z, Griffith MA, Rosenthal AC. Identifying and Meeting the Needs of Adolescents and Young Adults with Cancer. Curr Oncol Rep 2021; 23:17. [PMID: 33449203 DOI: 10.1007/s11912-020-01011-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Adolescents and young adults (AYAs) with cancer are a vulnerable population with unique needs that are under-recognized and often overlooked by healthcare providers. This review focuses on identifying and meeting some of those needs including adherence to treatment, financial implications, impact on fertility and intimacy, issues with work/school, isolation, challenges with re-entry, and long-term side effects and survivorship. RECENT FINDINGS Survival rates have not improved in adolescents and young adults with cancer at the same rate as in children and older adults (the so called "AYA gap"). Restricted or delayed access to care and inconsistent cancer treatment and follow-up care contribute to this. Importantly, fertility preservation options have broadened and efforts to provide age appropriate counseling prior to treatment have improved. Additionally, AYAs face a variety of psychosocial issues while dealing with a cancer diagnosis during critical developmental years, and yet data pertaining to the successful identification and management of these issues is lacking. As a result, there has been recent increasing awareness that this patient population warrants strong advocates, additional research, and requires age group specific resources to be successful in navigating their cancer experience during treatment and into survivorship care. Members of the healthcare team should familiarize themselves with the unique needs of AYA cancer patients to provide optimal patient care. In order to build upon early progress, this group calls for additional study particularly when it comes to barriers to enrollment for AYA-specific research (including clinical trials), recognizing psychosocial needs (both during and after treatment), transition planning for returning to life after cancer, and managing long-term effects of treatment (including neuro cognitive changes). In addition, access to financial resources and appropriate mental health support needs to be improved.
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Affiliation(s)
- Zhaohui Jin
- Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Melody A Griffith
- Division of Hematology/Oncology, Mayo Clinic, Phoenix, AZ, 85054, USA
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Working cancer survivors' physical and mental characteristics compared to cancer-free workers in Japan: a nationwide general population-based study. J Cancer Surviv 2021; 15:912-921. [PMID: 33433855 PMCID: PMC8519890 DOI: 10.1007/s11764-020-00984-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/08/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE This study compared working cancer survivors' self-rated health status (SRHS), physical functional capacity, depressive symptoms, and happiness to those of cancer-free workers. METHODS A nationwide general population-based cross-sectional study on a sample of Japanese was conducted. Prevalence of deteriorated SRHS, restricted physical functional capacity, depressive symptoms, and perceived happiness were compared between working cancer survivors and cancer-free workers with multivariable logistic regression analysis adjusted for age and sociodemographic and health-related backgrounds. RESULTS Of the 28,311 male and 26,068 female workers, 977 (3.5%) and 1267 (4.9%) were cancer survivors, respectively. Working cancer survivors reported deteriorated SRHS more frequently than cancer-free workers: 21.3% vs. 13.8%, multivariable-adjusted odds ratio (95% confidence interval), 1.64 (1.39-1.95) for men, 23.8% vs. 17.5%, 1.34 (1.16-1.54) for women. Restricted physical functional capacity was reported more frequently in working cancer survivors than cancer-free workers: 6.8% vs. 2.6%, 1.76 (1.34-2.32) for men, 4.9% vs. 2.0%, 2.06 (1.56-2.71) for women. No significant difference was found for depressive symptoms: 21.6% vs. 22.9% in men, 30.0% vs. 28.5% in women. Working cancer survivors felt happiness more frequently than cancer-free survivors in men (77.3% vs. 71.7%, 1.21 (1.01-1.45)) but not in women (76.1% vs. 74.9%). CONCLUSIONS Working cancer survivors had worse SRHS and more restricted physical functional capacity than cancer-free workers. In men, working cancer survivors felt happiness more frequently than cancer-free workers. IMPLICATIONS FOR CANCER SURVIVORS Continuous support to improve cancer survivors' SRHS and physical functional capacity would be necessary even while they are working.
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Gingrich AA, Sauder CAM, Goldfarb M, Li Q, Wun T, Keegan THM. Disparities in the Occurrence of Late Effects following Treatment among Adolescent and Young Adult Melanoma Survivors. Cancer Epidemiol Biomarkers Prev 2020; 29:2195-2202. [PMID: 32856613 PMCID: PMC7641994 DOI: 10.1158/1055-9965.epi-20-0427] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/05/2020] [Accepted: 08/05/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Melanoma is the third most common cancer in the adolescent and young adult (AYA) population; however, no studies have addressed the occurrence of adverse health conditions following melanoma treatment in these survivors. METHODS Data for patients ages 15 to 39 years diagnosed with cutaneous melanoma from 1996 to 2012 and surviving ≥2 years were obtained from the California Cancer Registry and linked to statewide hospitalization data. The influence of age at diagnosis, sex, race/ethnicity, neighborhood socioeconomic status (SES), health insurance, and surgery on the development of adverse health conditions was evaluated using Cox proportional hazards regression models. RESULTS Of 8,259 patients, 35.3% were male, 83.3% were non-Hispanic White, 82.4% had private health insurance, and 60.5% were considered high SES. In Cox regression models, males had an increased risk of developing adverse health conditions across all systems, including cardiac [HR, 1.73, 95% confidence interval (CI), 1.47-2.03], lymphedema (HR, 1.56; 95% CI, 1.37-1.77), hematologic disorders (HR, 1.17; 95% CI, 1.03-1.33), major infection/sepsis (HR, 1.59; 95% CI, 1.39-1.82), and second cancers (HR, 1.51; 95% CI, 1.31-1.74). Patients with public/no insurance (vs. private) had a greater risk of developing all studied adverse health conditions, including subsequent cancers (HR, 2.34; 95% CI, 1.94-2.82). AYA patients residing in low SES neighborhoods had similar increased risk of developing adverse health conditions. CONCLUSIONS Of AYA melanoma survivors, males, those with public/no health insurance, and those living in low SES neighborhoods had a greater likelihood of developing adverse health conditions. IMPACT Strategies to improve surveillance and secondary prevention of these adverse health conditions are needed among AYA melanoma survivors, specifically for the at-risk populations identified.
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Affiliation(s)
- Alicia A Gingrich
- Department of Surgery, University of California, Davis, Sacramento, California.
| | - Candice A M Sauder
- Comprehensive Cancer Center, University of California, Davis, Sacramento, California
| | - Melanie Goldfarb
- Center for Endocrine Tumors and Disorders, John Wayne Cancer Institute, Santa Monica, California
| | - Qian Li
- Center for Oncology Hematology Outcomes Research and Training (COHORT) and Division of Hematology and Oncology, University of California, Davis School of Medicine, Sacramento, California
| | - Ted Wun
- Comprehensive Cancer Center, University of California, Davis, Sacramento, California
- Center for Oncology Hematology Outcomes Research and Training (COHORT) and Division of Hematology and Oncology, University of California, Davis School of Medicine, Sacramento, California
| | - Theresa H M Keegan
- Comprehensive Cancer Center, University of California, Davis, Sacramento, California
- Center for Oncology Hematology Outcomes Research and Training (COHORT) and Division of Hematology and Oncology, University of California, Davis School of Medicine, Sacramento, California
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Mellblom AV, Kiserud CE, Rueegg CS, Ruud E, Loge JH, Fosså SD, Lie HC. Self-reported late effects and long-term follow-up care among 1889 long-term Norwegian Childhood, Adolescent, and Young Adult Cancer Survivors (the NOR-CAYACS study). Support Care Cancer 2020; 29:2947-2957. [PMID: 33011832 PMCID: PMC8062364 DOI: 10.1007/s00520-020-05790-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/18/2020] [Indexed: 01/28/2023]
Abstract
Purpose The majority of childhood, adolescent, and young adult cancer survivors (CAYACS) are at risk of late effects but may not receive long-term follow-up care for these. Here, we investigated (1) self-reported late effects, (2) long-term follow-up care, and (3) factors associated with receiving follow-up care in a population-based sample of Norwegian long-term CAYACS. Methods Survivors were identified by the Cancer Registry of Norway. All > 5-year survivors diagnosed between 1985 and 2009 with childhood cancer (CCS, 0–18 years old, excluding CNS), breast cancer (BC, stages I–III), colorectal cancer (CRC), leukemias (LEUK), non-Hodgkin lymphoma (NHL), or malignant melanoma (MM) at age 19–39 years were mailed a questionnaire (NOR-CAYACS study). Descriptive statistics and logistic regression models were used to analyze occurrence of late effects, long-term follow-up care for these, and associated factors. Results Of 2104 responding survivors, 1889 were eligible for analyses. Of these, 68% were females, with a mean age of 43 years at survey, on average 17 years since diagnosis, and diagnosed with CCS (31%), BC (26%), CRC (8%), NHL (12%), LEUK (7%), and MM (16%). Overall, 61.5% reported the experience of at least one late effect, the most common being concentration/memory problems (28.1%) and fatigue (25.2%). Sixty-nine percent reported not having received long-term follow-up care focusing on late effects. Lower age at survey (p = 0.001), higher education (p = 0.012), and increasing number of late effects (p = < 0.001) were associated with increased likelihood of follow-up care in the multivariate model. Conclusions The majority of survivors reported at least one late effect, but not receiving specific follow-up care for these. This indicates a need for structured models of long-term follow-up to ensure adequate access to care. Electronic supplementary material The online version of this article (10.1007/s00520-020-05790-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- A V Mellblom
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.B. 1111, 0317, Oslo, Norway
| | - C E Kiserud
- National Resource Centre for Late Effects after Cancer Treatment, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - C S Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - E Ruud
- Department of Pediatric Haematology and Oncology, Division for Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - J H Loge
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.B. 1111, 0317, Oslo, Norway
| | - S D Fosså
- National Resource Centre for Late Effects after Cancer Treatment, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - Hanne C Lie
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.B. 1111, 0317, Oslo, Norway. .,National Resource Centre for Late Effects after Cancer Treatment, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.
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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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Ota A, Kawada K, Tsutsumi A, Yatsuya H. Cross-sectional association between working and depression prevalence in cancer survivors: a literature review. ENVIRONMENTAL AND OCCUPATIONAL HEALTH PRACTICE 2020. [DOI: 10.1539/eohp.2020-0006-ra] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Atsuhiko Ota
- Department of Public Health, Fujita Health University School of Medicine
| | - Kenji Kawada
- Department of Medical Oncology, Fujita Health University School of Medicine
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine
| | - Hiroshi Yatsuya
- Department of Public Health, Fujita Health University School of Medicine
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