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

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. Importantly, this study only included people 65 years or older, so it is unknown if the same factors affect younger people diagnosed with metastatic cancers.

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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