Most cancer survivors able to stay on the job

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Most working-age cancer survivors fare well enough to remain at their jobs in the first few years after treatment, according to a new study.

In particular, researchers found, survivors of certain cancers that can be detected early, including breast and prostate tumors and melanomas, had the lowest risk of having to quit work for ongoing problems related to their disease.

On the other hand, men and women who had been treated for tumors of the central nervous system, head and neck, blood or lymph system had the highest rates of work disability and unemployment in the four years following therapy.

The findings suggest there are some cancer patients who need more help in facing potential problems in getting back to work, the study authors note.

Employment after cancer is another way of measuring how well people fare after treatment for the disease, according to Dr. Pamela Farley Short of Pennsylvania State University in University Park, the study’s lead author.

Being able to work, she told Reuters Health, is important not only financially, but also in terms of social relationships and a person’s sense of identity.

The new findings, Short said, can be viewed as largely “good” news, but they also highlight the fact that some cancer survivors—about 20 percent in this study—have ongoing problems that affect their ability to work.

Short and her colleagues report the findings in the current issue of the journal Cancer.

The study is based on data from more than 1,400 cancer survivors treated at four medical centers between 1997 and 1999. Overall, the researchers estimate, 13 percent of patients who had jobs at the time of their diagnosis had to quit working for cancer-related reasons within four years of their diagnosis.

About 40 percent of patients stopped working during their treatment, but 84 percent returned to their jobs—usually in the first year after diagnosis. Overall, 20 percent of the men and women reported some type of work disability, though half continued to work despite their limitations.

Patients treated for cancers of the breast, prostate, thyroid, uterus and skin (melanoma) were the least likely to suffer from a work disability or to leave their jobs after treatment.

Survivors of some other cancers did not fare as well. Those treated for tumors of the brain or spinal cord, for example, had the highest rates of work disability and one of the highest resignation rates. Men and women with late-stage lymphoma, blood cancers such as leukemia, or head and neck cancers, such as tumors of the mouth, throat or nasal cavity, were also at greater risk of work disability and unemployment.

Short speculated that the reasons for the disparities among survivors of different cancers has to do with the stage at which various tumors are typically diagnosed, as well as the physical effects of the specific cancer and its treatment.

“For example,” she said, “the success of public health efforts to increase the percentage of women who get mammograms means that more women are diagnosed earlier, when they don’t have to be treated as aggressively and the treatment is more likely to be successful.”

In contrast to solid tumors confined to an organ, a blood cancer like leukemia must be treated with chemotherapy, which affects the whole body, Short noted. In addition, she explained, some cancers can also cause damage that hinders a person’s ability to work—as in the case of brain cancer, where survivors may have lasting problems in perception, thinking and movement.

According to Short and her colleagues, the “challenge” for cancer specialists is to identify and try to help cancer survivors with employment problems.

As an example, Short said doctors can let patients know they have legal protections against job discrimination, and that they can go to several organizations, such as the American Cancer Society, for information about their rights.

“Also,” she added, “as a group, doctors and healthcare providers can help to reassure employers that most cancer survivors are going to live a long time and will be just as productive as anyone else.”

SOURCE: Cancer, March 15, 2005.

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