by Kristine Nally, B.S., Microbiology
Whether or not to continue working can be an important concern for individuals preparing for chemotherapy. However, there is very little published research regarding work patterns, factors that affect the decision to work and support from employers during active cancer treatment. The decision and indeed the ability to continue working is highly individual and may be affected by physical and mental health, type and stage of cancer, age, type of work and finances.
For many people, working is an integral part of feeling “normal” and can have a positive psychological impact during a difficult time. In addition, the increased length of cancer treatments means that some people will need to work for financial reasons. Luckily, there have been great advances in the treatment of chemotherapy related side effects and some people that want to work, find that they can.
Rehabilitation services, now recognized as a critical component of cancer care1, can also help patients feel well enough to work. Physical and occupational therapists, trained in medically sound cancer rehabilitation practices, can help prevent loss of strength, mobility and function throughout chemotherapy and beyond.
Despite adequate medical and rehabilitation care, some patients may not have the strength and ability to continue working and some may simply choose not to work for personal reasons. Those not working should also receive appropriate support services. For example, an oncology social worker can help individuals to navigate the bureaucracy of insurance and disability coverage.
A small, yet well-designed study, recently published in the European Journal of Cancer Care2, provides some insight into work patterns during chemotherapy as well as factors that contribute to the decision of whether or not to continue working. A semi-structured survey, validated by experts in the field and tested on a small pilot group, was administered by nurses during the participant’s final chemotherapy session.
Fifty-five participants, aged 27 to 79 years (mean 57 years) were recruited across three sites in south-east England. Among the respondents 72%, 26% and 4% had undergone chemotherapy for breast cancer, colorectal cancer and lymphoma, respectively. The analysis focused on 35 respondents (64%) that were working at the time of diagnosis.
Of these 35 respondents:
- Fifty-four percent (19/35) were working when chemotherapy began with 12 of these 19 reporting a change of work schedule (e.g. fewer days or fewer hours per day).
- Twenty-nine percent (10/35) were working at the end of chemotherapy.
One significant correlation was found between demographic data and work patterns; respondents over the age of 58 were more likely to stop working. A trend towards not working as income increased was seen, but it was not statistically significant.
Seventy-seven percent rated “needed to concentrate on myself” as the top consideration when deciding whether or not to work or alter work patterns. It was not stated, and would be interesting to know, how many of the 12 respondents that changed their work schedules were also in the group still working at the end of treatment. In other words, did altering their work schedules help them to continue working?
In regards to attitudes at work:
- One hundred percent (17/17) of those working (not self-employed) felt supported by their employer when chemotherapy started. This number fell to 71% as treatment progressed.
- Forty-one percent (7/17) felt that there had been added pressure on their co-workers.
Although the sample size of this study is small, it provides some insight into work patterns and attitudes at work for patients undergoing chemotherapy. In addition, the survey reveals how the ability to work and attitudes about work changed over time. As described by the authors, “work is a dynamic issue that needs to be addressed throughout treatment.”
Few respondents reported receiving information from healthcare providers regarding work. As the number of people living with cancer and the length of treatment increases, the importance of this issue will increase as well. Additional research that includes larger sample sizes and tracks work patterns throughout all phases of cancer treatment will help clinicians to better address the often heard question, “Can I continue working during cancer treatment?”
1. American College of Surgeons. Cancer program accreditation. Available at www.facs.org/cancerprogram/index.html. Accessed November 28, 2011.
Kristine Nally, B.S., Microbiology, is a freelance writer residing in Phoenix, Arizona. She specializes in science, medicine and health and is an active member of the American Medical Writers Association. She has a strong background in cancer biology and has worked hands-on in several research laboratories including the Max-Planck Institute for Molecular Genetics and the Southwest Biomedical Research Institute. More recently, Kristine worked as a Program Coordinator for research that focused on cancer fatigue, a project joint funded by Scottsdale Healthcare and the University of Arizona. Additional information can be found at www.kristinenally.com.