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Factors that affect the ability to work in people with metastatic cancer


This research is relevant for:

Unhecked Breast cancer survivors

Checked Women under 45

Checked Women over 45

Unhecked Men with breast cancer

Checked Metastatic breast cancer

Unhecked Triple negative breast cancer

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Checked Special populations: people living with metastatic prostate, colon, or lung cancer

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Some patients who live with metastatic cancer either want or need to continue working while coping with symptoms of their disease and treatment. A recent study that looked at over 600 people with metastatic breast, prostate, colon, or lung cancer found that about one-third of them continue working full or part time. People most likely to continue working were those undergoing hormonal treatment and those with less severe symptoms or side effects from treatment. (4/12/16)


STUDY AT A GLANCE

This study is about:

Factors that affect employment for patients with metastatic cancer.

Why is this study important?  

Patients living with metastatic cancer often need or want to continue working. According to the study authors, “a better understanding of how metastatic cancer affects employment is a necessary step toward the development of tools for assisting survivors in this important realm.”

Study findings: 

  1. 35% (236 of 668) metastatic cancer patients were working full-time or part-time.
  2. 45% (302 of 668) metastatic cancer patients stopped working because of their illness.
  3. 20% (130 of 668) metastatic cancer patients were not employed for other reasons.
  4. Factors that were associated with a higher likelihood of working were: receiving hormonal treatment (if that was an option), and minimizing symptoms such as fatigue, pain, and memory loss.

What does this mean for me?

This research indicates that some patients with metastatic cancer continue working; however, whether this is because they feel like they need to work or because they want to work is unknown. Researchers suggest that patients who need to or wish to continue working talk to their health care provider about how they can reduce the severity of their symptoms.

Questions to ask your health care provider:

  • I want to go back to work but I have symptoms from my treatment or my cancer. What options/treatments can improve my symptoms? 
  • What can I do to improve my symptoms enough so that I’m able to work more comfortably?
  • I do not want to go back to work, but feel like I need to. How should I handle this?

IN DEPTH REVIEW OF RESEARCH

Study background:

Some metastatic cancer patients live for many years with their disease. As more people find themselves in this situation, they need to discuss employment and related topics with their health care provider. Cancer and cancer treatment affects employment, so these issues need to be addressed because “research suggests that cancer patients are more likely to return to work if information about managing problematic work activities is provided.” Unfortunately, very little information is available about patients living with metastatic disease.  

Through the Symptom Outcomes and Practice Patterns (SOAPP) study, Amye Tevaarwerk and her colleagues from the University of Wisconsin-Madison and other institutions published an article in the February 2016 issue of Cancer that looked at how many metastatic cancer patients continue working, and what factors are associated with employment.

Researchers of this study wanted to know:

How metastatic cancer affects employment.

Population(s) looked at in the study:

This study included both male and female patients who:

  • had breast, prostate, colon, or lung cancer.
  • had metastatic disease.
  • were 65 years old or younger.

Study findings: 

  1. 35% (236 of 668) of metastatic cancer patients were working full-time or part-time.
  2. 45% (302 of 668) metastatic cancer patients stopped working because of their illness.
  3. 20% (130 of 668) metastatic cancer patients were not employed for other reasons
  4. Factors that were associated with a higher likelihood of working were:
    • receiving hormonal treatment, if that was an option.
    • minimizing symptoms such as fatigue, pain, and memory loss.
    • being of non-Hispanic white ethnicity/race.
    • a better performance score on the ECOG (Eastern Cooperative Oncology Group) survey, which “describes a patient’s level of functioning in terms of their ability to care for themselves, daily activity, and physical ability.”
  5. Factors that were NOT associated with the ability to continue working were:
    • disease type.
    • interval since metastatic diagnosis.
    • number of metastatic sites.
    • location of metastatic disease.
    • treatment status.

Limitations:

This was a retrospective study, meaning that the researchers retrieved all their data from previously documented records of past patients, rather than collecting patient data specifically for this particular study. Other factors that were not directly studied or known to these researchers may have affected employment in this setting. Additionally, the researchers acknowledged that the study may have attracted certain types of patients. For example, patients with metastatic cancer and severe symptoms may not have wanted to participate in the study about employment, and/or patients with relatively mild symptoms who were able to work full-time may not have visited the clinic as often where the study was recruiting participants, and missed the opportunity to participate. 

Conclusions:

While more work needs to be done to understand employment for patients with metastatic disease, this study suggests that about one-third of people with metastatic cancer are currently employed either full-time or part-time. If continuing employment is something of interest, metastatic cancer survivors should discuss with their health care team what steps they can take to make their employment as comfortable as possible.

Posted 4/12/16

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References

ECOG-ACRIN cancer research group. “ECOG Performance Status.” 

Tevaarwerk AJ, Lee J, Terhaar A, et al. “Working After a Metastatic Cancer Diagnosis: Factors Affecting Employment in the Metastatic Setting from ECOG-ACRIN’s Symptom Outcomes and Practice Patterns Study.” Cancer. 2016 Feb. 1; 122(3): 438-46.  

 

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