Results from a prospective longitudinal survey of employment and work outcomes in newly diagnosed cancer patients during and after curative‐intent chemotherapy: A Wisconsin Oncology Network study

• Published in: Cancer Vol. 127; no. 5; pp. 801 - 808
• Main Authors: Tevaarwerk, Amye J., Kwekkeboom, Kris, Buhr, Kevin A., Dennee, Alexandra, Conkright, William, Onitilo, Adedayo A., Robinson, Emily, Ahuja, Harish, Kwong, Roger W., Nanad, Ranveer, Wiegmann, Douglas A., Chen, Karen, LoConte, Noelle K., Wisinski, Kari B., Sesto, Mary E.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-03-2021
• Subjects: Adult; Breast cancer; Cancer; cancer survivorship; Cancer therapies; cancer work limitations; Chemotherapy; Correlation analysis; Diagnosis; Employment; Female; Humans; Longitudinal Studies; Male; Middle Aged; Neoplasms - drug therapy; Oncology; Polls & surveys; Prospective Studies; return to work; Statistical analysis; Surveys and Questionnaires; Toxicity; Work Capacity Evaluation; working during cancer treatment; working during cancer treatment; cancer work limitations; cancer survivorship; return to work
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.33311

Background
Postcancer work limitations may affect a substantial proportion of patients and contribute to the “financial toxicity” of cancer treatment. The degree and nature of work limitations and employment outcomes are poorly understood for cancer patients, particularly in the immediate period of transition after active treatment. We prospectively examined employment, work ability, and work limitations during and after treatment.
Methods
A total of 120 patients receiving curative therapy who were employed prior to their cancer diagnosis and who intended to work during or after end of treatment (EOT) completed surveys at baseline (pretreatment), EOT, and 3, 6, and 12 months after EOT. Surveys included measures of employment, work ability, and work limitations. Descriptive statistics (frequencies, percentages, means with standard deviations) were calculated.
Results
A total of 111 participants completed the baseline survey. On average, participants were 48 years of age and were mostly white (95%) and female (82%) with a diagnosis of breast cancer (69%). Full‐time employment decreased during therapy (from 88% to 50%) and returned to near prediagnosis levels by 12‐month follow‐up (78%). Work‐related productivity loss due to health was high during treatment.
Conclusions
This study is the first to report the effects of curative intent cancer therapy on employment, work ability, and work limitations both during and after treatment. Perceived work ability was generally high overall 12 months after EOT, although a minority reported persistent difficulty. A prospective analysis of factors (eg, job type, education, symptoms) most associated with work limitations is underway to assist in identifying at‐risk patients.
Adjuvant therapy for cancer can have a negative effect on a patient's ability to work, but the degree of work limitation due to cancer treatment has not been captured prospectively in a longitudinal fashion. This prospective study of patients with cancer receiving adjuvant chemotherapy who worked during cancer treatment reveals that most patients eventually returned to the same level of work that they had performed before treatment.