Employment After Therapy for Localized Prostate Cancer: Widening the Perspective

Health Care Professionals and the Employment-Related Needs of Cancer Survivors

Introduction Individuals diagnosed with cancer look to health care professionals as primary sources of information. This positions staff in oncology settings in an ideal role to inform patients, who continue workforce participation in increasing numbers, about resources that might help them to handle work-related issues related to their oncological symptoms. This article reports on findings from a survey of staff that provide nonmedical services to cancer patients in two Houston area hospital systems. The impetus for this survey was two-fold: the trend in recent years for increasing numbers of cancer survivors to stay in the workforce after or even during treatment, and low levels of awareness that these employees are eligible for protection under the Americans with Disabilities Act of 1990 and its 2008 amendments (ADA Amendments Act of 2008, Pub. L. 110-325, 122 Stat. 3553, 2008; Americans with Disabilities Act, 42 U.S.C. § 12111-17, 2006). The survey assesses perceptions of the effects of cancer on patients' employment status, levels of knowledge about supports to address these employment-related needs, and respondents' preferred modes for information receipt. The latter topic serves the purpose of tailoring training activities to the respondents' informational needs and learning preferences. Methods Data were collected via an online survey administered in two Houston-area hospital systems. This article reports on the findings from 86 respondents. Results Tenure as measured by years in oncology is related positively to level of knowledge about disability-related benefits, legislation and programs (r = .32, P < .01). Respondents with more years in their profession worked with patients whom they reported had a higher number of cancer side effects that "created work difficulties for patients" (r = .24, P < .05). The number of side effects was in turn positively associated with negative effects of the diagnosis at work (r = .27, P < .05). A higher score of negative effects of the cancer diagnosis at work in turn correlated with unwanted consequences of disclosing the cancer at work (r = .36, P < .01). No statistically significant correlations were observed among the variables measuring respondents' reported knowledge of disability-related benefits, laws and programs, their perception of patients' level of understanding of these topics, and reports of patients' receipt of reasonable accommodation. Conclusions Health care professionals who treat cancer patients could benefit from training resources about how survivors might address their employment-related needs, including how to convey that knowledge to their patients. Mentoring programs might also have positive outcomes, since respondents with greater tenure in oncology-related settings reported higher levels of knowledge about disability-related topics.

Transitions in work participation after a diagnosis of colorectal cancer

BACKGROUND

How cancer adversely affects an individual's work role is an understudied survivorship issue. There are no Australian studies quantifying work participation after cancer or the potential barriers to work continuance. Using a large, population-based cohort of working adults with colorectal cancer, we assessed changes in work participation separately for men (n=621) and women (n=354).

METHODS

Telephone survey methods collected data on colorectal cancer survivors identified through the Queensland Cancer Registry. Status at baseline and one-year post-diagnosis were described, and logistic regression models assessed correlates of work cessation.

RESULTS

Among working adults who were diagnosed with colorectal cancer, 33% of men and 40% of women were not working at one-year post-diagnosis. Radiation therapy among men (OR=2.55, 95%CI: 1.35-4.83) and chemotherapy among women (OR=2.49, 95% Cl: 1.23-5.04) were associated with a higher prevalence of work cessation. Having private health insurance was linked with resuming work for both men and women.

CONCLUSION

A large proportion of working men and women leave the workforce by 12 months following a diagnosis of colorectal cancer. Factors correlated with work cessation after colorectal cancer appear different for men and women.

IMPLICATIONS

A better understanding of how cancer affects working adults and contributes to unwanted work cessation is required to identify individuals who may benefit from occupational rehabilitation programs.

Employment and cancer: findings from a longitudinal study of breast and prostate cancer survivors

We discuss how cancer affected the employment of almost 800 employed patients who participated in a longitudinal study. The greatest reduction in patients' labor supply (defined as employment and weekly hours worked) was observed 6 months following diagnosis. At 12 and 18 months following diagnosis, many patients returned to work. Based on these and other findings related to patients' employment situations, we suggest 4 areas for future research: 1) collection of employment information in cancer studies; 2) research into racial and ethnic minority patients and employment outcomes; 3) interventions to reduce the effects of cancer and its treatment on employment; and 4) investigations into the influence of employment-contingent health insurance on cancer treatment and recovery.

Absenteeism from work: the experience of employed breast and prostate cancer patients in the months following diagnosis

BACKGROUND

A better understanding of how cancer treatments affect patient's employment may help patients and physicians make more informed choices between treatment alternatives. This study examined the number of days employed patients undergoing treatment for either breast or prostate cancer were absent from their jobs.

METHOD

Using the Detroit Surveillance, Epidemiology, End-Results registry, all potentially eligible women diagnosed with breast cancer and men diagnosed with prostate cancer were selected. Subjects who were employed full-time were included in this analysis.

RESULTS

Women treated for breast cancer missed an average of 44.5 days from work; the median days missed was 22. The median days missed by women treated with surgery and chemotherapy was 40. Men diagnosed with prostate cancer missed an average of 27 days (median days = 20) from work. The median days missed for men treated surgically without hormone or radiation therapy was 25. In multivariable analyses, taking a leave of absence and greater elapsed time from diagnosis to interview were associated with the greatest number of days absent from work for all patients. Men treated with hormone and/or radiation therapy or who were not treated missed fewer days from work relative to men undergoing surgery.

CONCLUSION

Research and interventions are needed to minimize work loss for cancer patients. Vocational rehabilitation programs may minimize the impact of treatment on work. Information on how treatments may infringe the ability for patients to earn a living may influence treatment decisions.