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Kim K, Yoon H. Effectiveness of a mobile-based return to work program for decent return to work, fatigue, stress, and quality of working life among cancer survivors. J Cancer Surviv 2024:10.1007/s11764-024-01570-x. [PMID: 38769245 DOI: 10.1007/s11764-024-01570-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 03/13/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE This study aimed to develop a smartphone mobile application-based supportive return to work (RTW) program for cancer survivors and evaluate its effects on their RTW, fatigue, stress, and quality of working life. This program was developed through a comprehensive process involving literature review, interviews with cancer survivors, and consultations with experts. METHODS A non-equivalent control group pre- and post-test design was used, with 41 participants assigned to the experimental (n = 18) and control (n = 23) groups based on recruitment timing. The experimental group received a 6-week smartphone mobile application-based supportive RTW program comprising "Counseling and Education" and "Self-Management." Participants completed assessments of decent RTW, fatigue, stress, and quality of working life at baseline and 6 months later. The experimental group completed an additional post-program completion survey. RESULTS During the 6-week program, no experimental group participants dropped out. The program's impact on decent RTW remains unclear. Fatigue (F = 2.52, p = 0.095) and quality of working life (F = 0.86, p = 0.434) did not show statistically significant differences. However, there was a significant reduction in stress (F = 4.59, p = 0.017). CONCLUSION The smartphone application-based RTW program, focusing on self-management and counseling, effectively reduced participants' stress levels. To further evaluate the effectiveness of the program, a more diverse range of interventions and ongoing programs should be implemented. IMPLICATIONS FOR CANCER SURVIVORS This study underscores the importance of tailored digital interventions to support the RTW of cancer survivors. The use of mobile smartphone applications allows temporal and spatial flexibility in program participation. Interventions involving various activities should be implemented to ensure ongoing participation.
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Affiliation(s)
- Kisook Kim
- Department of Nursing, Chung-Ang University, 84, Heukseok-Ro, Dongjak-Gu, Seoul, 06974, Republic of Korea
| | - Hyohyeon Yoon
- Department of Nursing, Chung-Ang University, 84, Heukseok-Ro, Dongjak-Gu, Seoul, 06974, Republic of Korea.
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Nakamura K, Matsuoka H, Kubo K, Shirakawa S, Ida N, Haraga J, Ogawa C, Okamoto K, Nagao S, Masuyama H. Not taking sick leave for gynecologic cancer treatment is negatively associated with returning to the same workplace. Jpn J Clin Oncol 2024; 54:292-296. [PMID: 37995280 PMCID: PMC10925846 DOI: 10.1093/jjco/hyad159] [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: 06/26/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Gynecologic cancers are one of the most common types of malignancies in working-age women. We aimed to determine the factors that impede women from returning to the same workplace after treatment for such cancers. METHODS A questionnaire-based survey was conducted on 194 women who underwent treatment for gynecologic cancer at the Okayama University (≥1 year after cancer treatment and <65 years of age). We performed a logistic regression analysis to determine the relationship between returning to the same workplace and not taking sick leave. RESULTS The median age at diagnosis was 49.0 years, and the median time from cancer treatment to questionnaire completion was 3.8 years. Not returning to the same workplace was positively associated with not being regularly employed (P = 0.018), short work time per day (P = 0.023), low personal income (P = 0.004), not taking sick leave (P < 0.001), advanced cancer stage (P = 0.018) and long treatment time (P = 0.032). Interestingly, not taking sick leave was strongly associated with not returning to the same workplace in the multivariable analysis (P < 0.001). CONCLUSIONS Not taking sick leave likely was negatively associated with returning to the same workplace after the treatment for gynecologic cancer. Therefore, we suggest that steps be taken to formally introduce a sick leave system over and above the paid leave system in Japan.
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Affiliation(s)
- Keiichiro Nakamura
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hirofumi Matsuoka
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kotaro Kubo
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Shinsuke Shirakawa
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Naoyuki Ida
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Junko Haraga
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Chikako Ogawa
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazuhiro Okamoto
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Shoji Nagao
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hisashi Masuyama
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Xu J, Zhou Y, Li J, Tang J, Hu X, Chen Y, Guo Y. Cancer patients' return-to-work adaptation experience and coping resources: a grounded theory study. BMC Nurs 2023; 22:66. [PMID: 36899341 PMCID: PMC9999662 DOI: 10.1186/s12912-023-01219-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/22/2023] [Indexed: 03/12/2023] Open
Abstract
OBJECTIVE To explore the return-to-work adaptation experience and coping resources used by cancer patients. METHODS With the help of the Nantong Cancer Friends Association, from June 2019 to January 2020, this study recruited 30 cancer patients who had returned to work using purpose sampling, snowball sampling and theoretical sampling. The researchers analyzed the data using initial-, focusing-, and theoretical coding. RESULTS The adaptation of cancer patients to return-to-work is a rebuilding process by taking advantage of the available personal and external coping resources. The adaptation experience includes: focusing on rehabilitation, rebuilding self-efficacy, and adjusting plans. CONCLUSION Medical staff should help patients mobilize coping resources to adapt to return to work.
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Affiliation(s)
- Jiashuo Xu
- Medical College (school of nursing), Nantong University, Nantong, Jiangsu, China.,Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Xuzhou Medical University, Nanjing, Jiangsu, China
| | - Yuwen Zhou
- Medical College (school of nursing), Nantong University, Nantong, Jiangsu, China.,Nursing Department of Taizhou Second People's Hospital, Taizhou, Jiangsu, China
| | - Jiamei Li
- Medical College (school of nursing), Nantong University, Nantong, Jiangsu, China
| | - Jue Tang
- Medical College (school of nursing), Nantong University, Nantong, Jiangsu, China
| | - Xiaoyun Hu
- Pharmacy College, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yifan Chen
- Medical College (school of nursing), Nantong University, Nantong, Jiangsu, China
| | - Yujie Guo
- Medical College (school of nursing), Nantong University, Nantong, Jiangsu, China.
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Liang MI, Harrison R, Aviki EM, Esselen KM, Nitecki R, Meyer L. Financial toxicity: A practical review for gynecologic oncology teams to understand and address patient-level financial burdens. Gynecol Oncol 2023; 170:317-327. [PMID: 36758422 DOI: 10.1016/j.ygyno.2023.01.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/19/2023] [Accepted: 01/29/2023] [Indexed: 02/10/2023]
Abstract
Financial toxicity describes the adverse impact patients experience from the monetary and time costs of cancer care. The financial burden patients experience comes from substantially increased out-of-pocket spending that often occurs concurrent with reduced income due to sick leave from work. Financial toxicity is common affecting approximately half of patients with a gynecological cancer depending on the validated instrument used for measurement. Financial toxicity is experienced by patients in three domains: economic hardship affecting patients' material conditions (i.e., medical debt), psychological response (i.e., distress), and health-related coping behaviors that patients adopt (i.e., foregoing care due to costs). Higher financial toxicity among cancer patients has been associated with decreased quality of life, impaired adherence to recommended care, and worse overall survival. In this review, we describe the current literature on financial toxicity, including how it can be assessed with validated tools, the downstream impact on patients, risk factors, and employment concerns of survivors. Whenever possible, we highlight data from research featuring patients with gynecologic cancer specifically. We also review studies with interventions aimed to mitigate financial toxicity and offer the reader real world examples of interventions currently being used. Lastly, we provide an overview of health policy developments relevant to financial toxicity and advocate for innovation in the development and implementation of strategies to decrease the financial toxicity patients experience following a diagnosis of gynecologic cancer.
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Affiliation(s)
- Margaret I Liang
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Ross Harrison
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, OR, USA
| | - Emeline M Aviki
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Katharine M Esselen
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Roni Nitecki
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Larissa Meyer
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Motoi N, Ooshima A, Suzuki Y, Sasaki K. Research on Cancer Screening Promotion and Employment Support for Employees with Cancer at Business Establishments. Yonago Acta Med 2023; 66:129-145. [PMID: 36820284 PMCID: PMC9937971 DOI: 10.33160/yam.2023.02.015] [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: 12/22/2022] [Accepted: 01/13/2023] [Indexed: 02/16/2023]
Abstract
Background Increasing cancer screening rates among working-age populations and providing employment support for employees with cancer are issues that need to be addressed in Japan. Therefore, this study aimed to clarify the situation regarding cancer screening promotion and employment support for employees with cancer at business establishments and the support they seek from medical professionals regarding these issues. Methods This survey covered 1,058 business establishments and included the following items: attributes of the business establishments, cancer screening rate, support for employees to promote cancer screening, support sought by business establishments from medical professionals to promote cancer screening, presence of employees with cancer, support programs for employees with cancer, awareness of the resources available for employment support for employees with cancer, difficulties in supporting employees with cancer in the workplace, and support sought by business establishments from medical professionals in providing employment support for employees with cancer. Data analysis was primarily conducted using summary statistics. Results This study included 153 establishments. The median cancer screening rate ranged from 50.00 to 99.15. Employee support for promoting cancer screening ranged from approximately 30% to 40% for "ensuring time for screening" and from 20% to 30% for "providing full subsidies for cancer screening cost." The median screening rate for breast and cervical cancers was 50.00, and support for promoting screening was less than 30% for each. Business establishments sought support from medical professionals regarding cancer and study sessions on cancer prevention to promote cancer screening. Regarding support systems for employees with cancer, 49.7% of the establishments offered sickness benefits, and 42.5% offered paid leave on an hourly basis. Less than 10% were aware of the websites provided by public organizations regarding employment support for patients with cancer. Approximately 50% of the establishments reported difficulties regarding treatment policies and duration uncertainties. Conclusion Business establishments sought the provision of relevant knowledge and specific information to increase cancer screening rates and provide employment support for employees with cancer. Furthermore, this study suggests that employees with cancer need to manage the information they provide their establishments.
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Affiliation(s)
- Nozomi Motoi
- Graduate School of Medical Sciences Major in Health Sciences, Tottori University, Yonago 683-8503, Japan
| | - Asami Ooshima
- Department of Women’s & Children’s Family Nursing, School of Health Science Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Yasue Suzuki
- Department of Women’s & Children’s Family Nursing, School of Health Science Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Kumiko Sasaki
- Department of Women’s & Children’s Family Nursing, School of Health Science Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
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De Oliveira Santana E, Marcondes L, Aparecida Alves da Silva L, Okino Sawada N, Martins da Rosa L, Puchalski Kalinke L. Imagen guiada para la calidad de vida de mujeres con cáncer de cuello uterino: estudio cuasi-experimental. REVISTA CUIDARTE 2023. [DOI: 10.15649/cuidarte.2358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Introducción: Las terapias de mente y cuerpo, como la relajación de imágenes guiadas, que se encuentran entre las principales prácticas integradoras utilizadas por los pacientes con cáncer, son esenciales para mantener un equilibrio saludable entre la activación simpática y parasimpática en el cerebro. Objetivo: Evaluar el efecto de la relajación de imagen guiada, con el uso de realidad virtual, sobre la calidad de vida relacionada con la salud de mujeres con cáncer de cuello uterino en tratamiento concomitante con quimiorradioterapia. Materiales y Método: Estudio cuasi-experimental, realizado en un hospital de referencia de oncología en el sur de Brasil, de octubre de 2019 a enero de 2021. Participaron 52 mujeres, divididas en dos grupos, experimental (intervención de relajación guiada por imaginería con realidad virtual), y control (rutina por defecto). El instrumento funcional se utilizó para evaluar las puntuaciones de calidad de vida relacionada con la salud. Evaluación de Cáncer terapia cuello uterino cáncer, aplicado antes, 14 días después y al final del tratamiento, en aproximadamente 35 días. Los análisis se realizaron utilizando el modelo lineal generalizado mixto, con una matriz de covarianza autorregresiva de orden 1, y la significación fue confirmada por la prueba de Sidak. Resultados: hubo una diferencia estadísticamente significativa para el grupo experimental en la calidad de vida física (p = 0,02), funcional (p = 0,00), síntomas específicos del cáncer de cuello uterino y efectos del tratamiento (p = 0,03) y en general (p = 0,02).). Conclusión: La Relajación por Imagen Guiada contribuyó a mejorar la Calidad de Vida Relacionada con la Salud de las pacientes con cáncer de cuello uterino durante el tratamiento con quimiorradioterapia.
Como citar este artículo: Santana, Edenice de Oliveira; Marcondes, Larissa; Silva, Luana Aparecida Alves da; Sawada, Namie Okino; Rosa, Luciana Martins da; Kalinke, Luciana Puchalski. Imagem guiada para qualidade de vida de mulheres com câncer cervical: estudo quase experimental. Revista Cuidarte. 2023;14(1):e2358. http://dx.doi.org/10.15649/cuidarte.2358
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Kaku S, Miyata K, Tsuchiya M, Kusaka S, Koitabashi M, Moroi N, Shimizu R, Shimizu M, Arai M, Yabumoto M, Matsunaga N, Maeda R, Iwasa S, Horinouchi H, Satomi E. [Investigation the contents of employment consultation and support in a cancer center hospital]. SANGYO EISEIGAKU ZASSHI = JOURNAL OF OCCUPATIONAL HEALTH 2022; 64:337-344. [PMID: 34911877 DOI: 10.1539/sangyoeisei.2021-019-e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES This study aimed to analyze and categorize the actual situation of employment consultation and support according to consultation times or employment status at the Consultation Support Center of the National Cancer Center Hospital of Japan. METHODS We retrospectively analyzed the patient backgrounds, consultation contents, and the number of employment consultation cases conducted at the Consultation Support Center of the National Cancer Center Hospital during a 6-month period from May to December 2018. RESULTS During the study period, 117 patients (male: female = 46:71) visited the Consultation Support Center. The median age of patients was 48 years old. The most common primary cancer site was the breast in 28 patients followed by the lung in 16 patients, and then gynecologic cancer in 10 patients. The most common cancer treatment was chemotherapy in 53 patients (45.3%), and 12 patients (10.2%) were recurrent patients. Fifty-two patients were in regular employment, 24 were unemployed, 17 were of unknown employment status, 16 were in non-regular employment, and 8 were classified/categorized as other. In terms of working status, 40 were on leave, 35 were working, 15 were seeking work, 8 were unemployed, and 19 were categorized as other. The median number of consultations was 1 (1,11). The content of consultations was the social security system in 44 cases (37.6%) job seeking in 24 cases (20.5%), how to inform the workplace in 14 cases (12%), and workplace environment adjustment in 13 cases (11.1%). CONCLUSIONS We conducted a survey on the actual status of employment consultation in a cancer center hospital. The majority of consultations were completed in one session. In terms of the content of consultations, there was a high need for consultations on the social security system and job seeking. Further study is needed on the characteristics of employment consultations according to employment status and other attributes.
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Affiliation(s)
- Sawako Kaku
- Department of Regional Medical Liaison Office, National Cancer Center Hospital
- Department of Diagnostic Radiology, National Cancer Center Hospital
| | - Kayoko Miyata
- Department of Regional Medical Liaison Office, National Cancer Center Hospital
| | - Miyako Tsuchiya
- Division of Cancer Survivorship Research Center for Cancer Control and Information Services, National Cancer Center
| | - Sachiko Kusaka
- Department of Regional Medical Liaison Office, National Cancer Center Hospital
| | - Miho Koitabashi
- Department of Regional Medical Liaison Office, National Cancer Center Hospital
| | - Natsuko Moroi
- Department of Regional Medical Liaison Office, National Cancer Center Hospital
| | - Rieko Shimizu
- Department of Regional Medical Liaison Office, National Cancer Center Hospital
| | - Mariko Shimizu
- Department of Regional Medical Liaison Office, National Cancer Center Hospital
| | - Mari Arai
- Department of Regional Medical Liaison Office, National Cancer Center Hospital
| | - Masako Yabumoto
- Department of Regional Medical Liaison Office, National Cancer Center Hospital
| | - Naoko Matsunaga
- Department of Regional Medical Liaison Office, National Cancer Center Hospital
| | - Ryoko Maeda
- Department of Regional Medical Liaison Office, National Cancer Center Hospital
| | - Satoru Iwasa
- Department of Regional Medical Liaison Office, National Cancer Center Hospital
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital
| | - Hidehito Horinouchi
- Department of Regional Medical Liaison Office, National Cancer Center Hospital
- Department of Thoracic Oncology, National Cancer Center Hospital
| | - Eriko Satomi
- Department of Regional Medical Liaison Office, National Cancer Center Hospital
- Department of Palliative Medicine, National Cancer Center Hospital
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Nitecki R, Fu S, Jorgensen KA, Gray L, Lefkowits C, Smith BD, Meyer LA, Melamed A, Giordano SH, Ramirez PT, Rauh-Hain JA. Employment disruption among women with gynecologic cancers. Int J Gynecol Cancer 2022; 32:69-78. [PMID: 34785522 PMCID: PMC9035315 DOI: 10.1136/ijgc-2021-002949] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/28/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Adverse employment outcomes pose significant challenges for cancer patients, though data patients with gynecologic cancers are sparse. We evaluated the decrease in employment among patients in the year following the diagnosis of a gynecologic cancer compared with population-based controls. METHODS Patients aged 18 to 63 years old, who were diagnosed with cervical, ovarian, endometrial, or vulvar cancer between January 2009 and December 2017, were identified in Truven MarketScan, an insurance claims database of commercially insured patients in the USA. Patients working full- or part-time at diagnosis were matched to population-based controls in a 1:4 ratio via propensity score. Multivariable Cox proportional hazards models were used to evaluate the risk of employment disruption in patients versus controls. RESULTS We identified 7446 women with gynecologic cancers (191 vulvar, 941 cervical, 1839 ovarian, and 4475 endometrial). Although most continued working following diagnosis, 1579 (21.2%) changed from full- or part-time employment to long-term disability, retirement, or work cessation. In an adjusted model, older age, the presence of comorbidities, and treatment with surgery plus adjuvant therapy versus surgery alone were associated with an increased risk of employment disruption (p<0.0003, p=0.01, and p<0.0001, respectively) among patients with gynecologic cancer. In the propensity-matched cohort, patients with gynecologic cancers had over a threefold increased risk of employment disruption relative to controls (HR 3.67, 95% CI 3.44 to 3.95). CONCLUSION Approximately 21% of patients with gynecologic cancer experienced a decrease in employment in the year after diagnosis. These patients had over a threefold increased risk of employment disruption compared with controls.
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Affiliation(s)
- Roni Nitecki
- Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, Texas, USA
| | - Shuangshuang Fu
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kirsten A Jorgensen
- Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, Texas, USA
| | - Lauren Gray
- Baylor College of Medicine, Houston, Texas, USA
| | - Carolyn Lefkowits
- Department of Gynecologic Oncology, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
| | - Benjamin D Smith
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Larissa A Meyer
- Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, Texas, USA
| | - Alexander Melamed
- Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, Columbia University, New York Presbyterian Hospital, New York, New York, USA
| | - Sharon H Giordano
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Pedro T Ramirez
- Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, Texas, USA
| | - Jose Alejandro Rauh-Hain
- Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, Texas, USA
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Return to work in survivors of Primary Brain Tumours treated with Intensity Modulated Radiotherapy. Cancer Treat Res Commun 2021; 26:100302. [PMID: 33440331 DOI: 10.1016/j.ctarc.2021.100302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/29/2020] [Accepted: 01/04/2021] [Indexed: 12/09/2022]
Abstract
MINI: Primary Brain Tumour survivors usually have significant morbidity, especially cognitive and neurological dysfunction. Return to pre-diagnosis work can be an important QoL indicator and outcomes measure in these patients. We did a retrospective study to assess return to work amongst the patients who underwent radiotherapy at our centre. BACKGROUND Primary brain tumour (PBT) survivors have a high burden of morbidity. Return to work (RTW) is an important survivorship parameter and outcomes measure in these patients, especially in developing countries. This study was done to assess RTW after radiotherapy, reasons for no RTW, and relationship of RTW with treatment and patient factors. PATIENTS AND METHODS A single centre study was done amongst PBT patients. Baseline and treatment details, education, employment was assessed. RTW assessed as: time to RTW, full/ part-time, reasons for no RTW and RTW at 6 months post-therapy, and last follow up. RESULTS 67 PBT patients with a median age of 42 years were assessed. Most common diagnosis was low grade glioma. Over 66% patients were illiterate, and 62% had semi-skilled and unskilled jobs, mostly agriculture. About 64.4% patients returned to employment in a median time of 3 months. At 6 months post-treatment 58.2% had a job, with only 42% working full-time. 'Limb weakness' (21.4%), followed by 'loss of job/ no job' (16.7%), 'fatigue'/ 'tiredness' (14.3%), 'poor vision/ diminished vision' (11.9%) were the common reasons for no RTW. The factors found to be significantly associated with return to work were younger age (p = 0.042), male sex (0.013), the absence of complications during radiotherapy (p = 0.049), part time job prior to diagnosis (p = 0.047), and early return to work after RT (p < 0.001). CONCLUSION Studies are needed to identify the barriers in re- employment and steps to overcome them in cancer patients.
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Nitecki R, Fu S, Lefkowits C, Smith BD, Meyer LA, Melamed A, Giordano SH, Rauh-Hain JA. Employment disruption following the diagnosis of endometrial cancer. Gynecol Oncol 2021; 160:199-205. [PMID: 33183765 PMCID: PMC7779695 DOI: 10.1016/j.ygyno.2020.10.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/31/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Oncologic treatment has been associated with unemployment. As endometrial cancer is highly curable, it is important to assess whether patients experience employment disruption after treatment. We evaluated the frequency of employment change following endometrial cancer diagnosis and assessed factors associated with it. METHODS A cohort of patients 18-63 years-old who were diagnosed with endometrial cancer (January 2009-December 2017) were identified in the Truven MarketScan database, an insurance claims database of commercially insured patients in the United States. All patients who were working full- or part-time at diagnosis were included and all employment changes during the year following diagnosis were identified. Clinical information, including use of chemotherapy and radiation, were identified using Common Procedural Terminology codes, and International Statistical Classification of Diseases codes. Cox proportional hazards models incorporating measured covariates were used to evaluate the impact of treatment and demographic variables on change in employment status. RESULTS A total of 4381 women diagnosed with endometrial cancer who held a full-time or part-time job 12 months prior to diagnosis were identified. Median age at diagnosis was 55 and a minority of patients received adjuvant therapy; 7.9% received chemotherapy, 4.9% received external-beam radiation therapy, and 4.1% received chemoradiation. While most women continued to work following diagnosis, 21.7% (950) experienced a change in employment status. The majority (97.7%) of patients had a full-time job prior to diagnosis. In a multivariable analysis controlling for age, region of residence, comorbidities, insurance plan type and presence of adverse events, chemoradiation recipients were 34% more likely to experience an employment change (HR 1.34, 95% CI 1.01-1.78), compared to those who only underwent surgery. CONCLUSION Approximately 22% of women with employer-subsidized health insurance experienced a change in employment status following the diagnosis of endometrial cancer, an often-curable disease. Chemoradiation was an independent predictor of change in employment.
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Affiliation(s)
- Roni Nitecki
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Shuangshuang Fu
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Carolyn Lefkowits
- Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Department of Internal Medicine, Palliative Care, University of Colorado Denver, Aurora, CO, United States of America
| | - Benjamin D Smith
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, United States of America
| | - Larissa A Meyer
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Alexander Melamed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States of America
| | - Sharon H Giordano
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - J Alejandro Rauh-Hain
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
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11
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Ohara K, Suzuki M, Niigata N, Shirai C, Idoguti Y, Kawahira M. [Factors associated with unemployment or job change due to the treatment of designated intractable diseases]. SANGYŌ EISEIGAKU ZASSHI = JOURNAL OF OCCUPATIONAL HEALTH 2020; 63:143-153. [PMID: 33342960 DOI: 10.1539/sangyoeisei.2020-039-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Unemployment or job change due to treatment for a disease is affected by various factors such as disease type, degree of disability, and workplace patient support. This study aimed to clarify the factors affecting the unemployment/job-change rate among workers who had designated intractable diseases. METHODS A questionnaire survey was administered to 3210 designated patients with intractable diseases who underwent applications for renewal of medical care subsidies at the Hirakata City Public Health Center during fiscal year 2019 (July-December). Of these patients, 539 workers aged 20-59 years who were employed as regular workers, temporary contract worker/dispatched workers, and part-time workers when they became designated intractable diseases were subjects of the analysis. Unemployment/job-change due to the treatment for a designated intractable disease was treated as an event occurrence, while the absence of unemployment/job-change due to disease at the time of the survey were considered censored cases. The Kaplan-Meier method was used to determine the trend of the unemployment/job-change rate associated with the duration of work. The Cox proportional hazard model was used to examine the relationship between unemployment/job-change and factors such as gender, age at onset, disease groups, activities of daily living, types of employment, experienced workplace supports (e.g., reduced working hours and hourly paid leave), and existence of insoluble medical difficulties at the workplace. RESULTS The unemployment/job-change rate due to treatment for designated intractable disease was 19.4%. Significantly independent factors of unemployment/job-change were the following: 50s at onset (compared to those in their 30s, HR = 2.55, 95% CI (1.21-5.37)), requiring outing assistance (compared to going out alone, 2.31 (1.13-4.71)), being a temporary contract worker/dispatched worker (compared to a regular worker, 2.66 (1.20-5.89)), existence of insoluble medical difficulties at workplace (4.15 (2.43-7.09)). Experienced workplace support was not a significant factor in preventing unemployment/job-change. CONCLUSIONS Age at onset, degree of disability, form of employment, and existence of insoluble medical difficulties at the workplace were significantly associated with unemployment/job change due to treatment for designated intractable diseases. The relationship between workplace patient supports and unemployment/job-change was not clear, but to reduce medical difficulties in the workplace, workplace supports must be expanded. Given that workplace support is not an obligatory effort for employers, it is necessary to establish a system where employers can easily promote workplace support.
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Affiliation(s)
- Kenryo Ohara
- Occupational Health Section, Hirakata City Office
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12
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Oza S, Badillo SA, Breevoort S, Florendo J. Women’s Cancer Rehabilitation: a Review of Functional Impairments and Interventions Among Breast and Gynecologic Cancer Survivors. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2020. [DOI: 10.1007/s40141-020-00261-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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13
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Horsbøl TA, Dalton SO, Ammitzbøll G, Johansen C, Andersen EAW, Jensen PT, Frøding LP, Lajer H, Kjaer SK. Gynaecological cancer leads to long-term sick leave and permanently reduced working ability years after diagnosis. J Cancer Surviv 2020; 14:867-877. [PMID: 32564197 DOI: 10.1007/s11764-020-00899-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 05/29/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The aim of the study was to investigate overall patterns in labour market affiliation, risk for permanently reduced work ability and prevalence of long-term sickness absence among women diagnosed with gynaecological cancer. METHODS We followed 8451 women diagnosed with ovarian, endometrial or cervical cancer, and 72,311 women with no history of cancer in nationwide registers for up to 19 years (mean 7.5 years). We computed hazards ratios for permanently reduced working ability and annual proportions of long-term sick leave. RESULTS Patterns of labour market affiliation varied by cancer diagnosis and stage. The hazard of permanently reduced working ability was increased for survivors of all three cancers but most pronounced for women diagnosed with advanced ovarian cancer. The highest hazard ratios were found 2-5 years after diagnosis, and they persisted for years in all groups and throughout the follow-up period of 19 years in women diagnosed with advanced cervical cancer. In the subgroups of women who continued to be potentially active on the labour market, long-term sick leave was more prevalent among cancer survivors than women with no history of cancer up to 10 years after diagnosis. CONCLUSIONS Women diagnosed with localised as well as advanced gynaecological cancer are at prolonged risk for permanently reduced working ability and long-term sick leave. IMPLICATIONS FOR CANCER SURVIVORS Gynaecological cancer can have long-term as well as permanent consequences for working ability, and survivors who remain active on the labour market might have to take more sick leave even years after cancer diagnosis than other women at their age.
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Affiliation(s)
- Trine Allerslev Horsbøl
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.
| | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.,National Research Center for Equality in Cancer, Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Rådmandsengen 5, 4700, Næstved, Denmark
| | - Gunn Ammitzbøll
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.,National Research Center for Equality in Cancer, Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Rådmandsengen 5, 4700, Næstved, Denmark
| | - Christoffer Johansen
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.,Late Effect Research Unit CASTLE, Copenhagen University Hospital, Blegdamsvej 58, 2100, Copenhagen, Denmark
| | | | - Pernille Tine Jensen
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.,Faculty of Health, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus, Denmark
| | | | - Henrik Lajer
- Department of Gynaecology, Copenhagen University Hospital, Juliane Maries Vej 10, 2100, Copenhagen, Denmark
| | - Susanne K Kjaer
- Department of Gynaecology, Copenhagen University Hospital, Juliane Maries Vej 10, 2100, Copenhagen, Denmark.,Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
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14
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Mamguem Kamga A, Dumas A, Joly F, Simon J, Billa O, Poillot ML, Jolimoy G, Roignot P, Coutant C, Arveux P, Dabakuyo-Yonli TS. Socio-economic and occupational outcomes of long-term survivors of gynaecological cancer: A French population-based study. Eur J Cancer Care (Engl) 2020; 29:e13235. [PMID: 32215988 DOI: 10.1111/ecc.13235] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 02/18/2020] [Accepted: 02/18/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To describe socio-economic and professional outcomes in long-term survivors of cervical, endometrial or ovarian cancer, including return to work and problems related to obtaining loans and insurance. METHODS Women with cervical, endometrial or ovarian cancers diagnosed from 2006 to 2013 were selected through the French gynaecological cancer registry of Côte d'Or, in a cross-sectional survey. Using a questionnaire established with the help of sociologists and psychologists, social and cancer-related work issues were collected among women aged less than 60 years at the time of cancer diagnosis. The socio-economic status was also assessed, at the time of the survey using the EPICES questionnaire. RESULTS A total of 92 gynaecological cancer survivors (CS) participated in this survey. Gynaecological CS reported a decrease in income since cancer diagnosis, difficulties obtaining loans, and a decrease in ability to work, both in the short term after treatment and at the time of survey, on average 6 years after diagnosis. Fatigue, emotional and cognitive difficulties were the reasons cited to explain the decreased ability to work, both immediately after treatment and in the long term. CONCLUSIONS Gynaecological CS experienced many problems, such as decreased work capacity, decreased income and difficulty obtaining loans.
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Affiliation(s)
- Ariane Mamguem Kamga
- Breast and Gynaecologic Cancer Registry of Côte d'Or, Georges-François Leclerc Cancer Centre-UNICANCER, Dijon, France
| | - Agnès Dumas
- Centre for Research in Epidemiology and Population Health (CESP), INSERM U1018, Université Paris-Sud, University of Paris-Saclay, Villejuif, France.,Department of Clinical Research, Gustave Roussy, Villejuif, France
| | - Florence Joly
- Medical Oncology Department, François Baclesse Cancer Centre-UNICANCER, University Hospital Côte de Nacre, Caen, France
| | - Julien Simon
- Breast and Gynaecologic Cancer Registry of Côte d'Or, Georges-François Leclerc Cancer Centre-UNICANCER, Dijon, France
| | - Oumar Billa
- Breast and Gynaecologic Cancer Registry of Côte d'Or, Georges-François Leclerc Cancer Centre-UNICANCER, Dijon, France
| | - Marie-Laure Poillot
- Breast and Gynaecologic Cancer Registry of Côte d'Or, Georges-François Leclerc Cancer Centre-UNICANCER, Dijon, France
| | | | | | - Charles Coutant
- Medical Oncology, Georges-François Leclerc Cancer Centre-UNICANCER, Dijon, France.,Burgundy Franche-Comté University, Dijon, France
| | - Patrick Arveux
- Breast and Gynaecologic Cancer Registry of Côte d'Or, Georges-François Leclerc Cancer Centre-UNICANCER, Dijon, France
| | - Tienhan Sandrine Dabakuyo-Yonli
- Breast and Gynaecologic Cancer Registry of Côte d'Or, Georges-François Leclerc Cancer Centre-UNICANCER, Dijon, France.,National Quality of Life and Cancer Platform, Dijon, France
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Magalhães PAPD, Loyola EACD, Dupas G, Borges ML, Paterra TDSV, Panobianco MS. THE MEANING OF LABOR ACTIVITIES FOR YOUNG WOMEN WITH BREAST NEOPLASMS. TEXTO & CONTEXTO ENFERMAGEM 2020. [DOI: 10.1590/1980-265x-tce-2018-0422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to understand the meaning of work activities for young women with breast cancer. Method: a qualitative study that used as a theoretical framework the Symbolic Interactionism and, as the methodological framework, the Discourse of the Collective Subject. It was developed in a mastology outpatient clinic and a mastectomized rehabilitation center whose data collection took place between February 2014 and January 2015. Twelve women between 18 and 40 years old with up to one year of diagnosis of breast cancer participated, being excluded those with metastasis; interviewed from the guiding question: how is it for you to be young with breast cancer, in relation to work? Thematic content analysis was applied. Results: the following theoretical categories emerged: young women’s feelings about having to stop working due to breast cancer and its treatments; quitting work meant annoyance and discouragement; change in income and collection by herself raised concern about the financial contribution; physical changes changing work activities, meaning limitation and impairment; work as an opportunity to live a better life, as a meaning of freedom; lack of collaboration of colleagues in the work environment whose significance was difficulties in the work environment; solidarity and positivity at work and family support that provided them with encouragement to cope with the disease. Conclusion: it was difficult to experience and accept changes in work activities. The support of family, friends and coworkers was paramount to cope with this process, which should also be taken into account by the health team, especially nursing.
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Lives and Economic Loss in Brazil due to Lack of Radiotherapy Access in Cervical Cancer: A Cost-Effectiveness Analysis. Clin Oncol (R Coll Radiol) 2019; 31:e143-e148. [PMID: 31160129 DOI: 10.1016/j.clon.2019.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 03/26/2019] [Accepted: 04/12/2019] [Indexed: 11/20/2022]
Abstract
AIMS Among all malignancies, the use of radiotherapy incurs the highest survival benefit within cervical cancers. Radiotherapy, however, remains underutilised for cervical cancers within the Brazilian public health system (BPHS). The objective of this study was to estimate the potential health and monetary benefits for universal access to radiotherapy and chemoradiotherapy (CRT) for untreated cervical cancer patients in the BPHS. MATERIALS AND METHODS Using 2016 data on Brazilian cervical cancer incidence and availability of radiotherapy/CRT in the BPHS, the number of cancer deaths due to radiotherapy/CRT underutilisation was estimated. The incremental effectiveness was calculated by life-year gain. The indirect costs from mortality-related productivity loss (MRPL) were estimated based on life expectancy, wage and labour force participation rate. MRPL was compared with direct medical costs after being adjusted to 2016 US dollars. This study was conducted from the payer's perspective; both costs and effectiveness were discounted at a rate of 3%. The incremental cost-effectiveness ratio (ICER) was calculated to determine the cost-effectiveness of radiotherapy for cervical cancer in Brazil. One-way sensitivity analyses were carried out to assess the robustness of the model. RESULTS The total number of life-years lost due to lack of universal access to radiotherapy and CRT per year were 27 199 and 31 627, respectively. The annual cost to match the radiotherapy gap was $10.5 million, with an additional cost of $3 million to close the CRT gap. The mean years of potential life lost per death was 20.5. The cost per life saved was $7942 for radiotherapy alone (ICER $388/life-year) and $8774 for CRT (ICER $429/life-year). MRPL due to shortage of radiotherapy and CRT were $59 million and $69 million, respectively. CONCLUSION Providing universal access to radiotherapy/CRT for cervical cancer patients in the BPHS is highly cost-effective and should be prioritised as an impactful public health initiative.
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Income generated by women treated with magnetic resonance imaging-based brachytherapy: A simulation study evaluating the macroeconomic benefits of implementing a high-end technology in a public sector healthcare setting. Brachytherapy 2017; 16:981-987. [PMID: 28600140 DOI: 10.1016/j.brachy.2017.05.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 03/03/2017] [Accepted: 05/07/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To estimate the difference in income generated if all women presenting in our institute over a 5-year period were treated with MRI-based image-guided brachytherapy (MR-IGBT) instead of conventional radiograph-based brachytherapy (CR-BT). METHODS AND MATERIALS Outcome data from 463 patients (94 treated with MR-IGBT) treated in our institute was used to simulate cumulative women-days of work and cumulative income over 5 years for 5526 patients expected to be treated in this period. The average daily income for a woman was derived from the National Sample Survey Organization (NSSO) survey data. Outcomes from both unmatched and propensity score-matched data sets were simulated. RESULTS The cumulative income in 5 years ranged between Rs 101-168 million if all patients presenting at our institute underwent MR-IGBT. The simulated excess income ranged from Rs 4-45 million after 5 years, which represented 6-66% of the expenditure incurred for acquiring the required equipment and manpower for practicing exclusive MR-IGBT. CONCLUSIONS Using outcome data from a prospective cohort of patients treated with MR-IGBT in our institute, we demonstrated that significant economic gains may be realized if MR-IGBT was used instead of CR-BT.
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