Work may be an important issue for some palliative care patients. Additional research is needed to facilitate ongoing employment for those who wish or need to continue working.
35 Background: Early integration of palliative care (PC) with oncologic care means return to work (RTW) issues will apply to some patients. There is an extensive literature on RTW after completing definitive treatment but much less is known about RTW in patients with active disease and on treatment. Methods: Cross-sectional survey of patients in two Pain & Palliative Care (PC) clinics at a comprehensive cancer center. Respondents were aged 25-65 and had been in paid employment prior to or during their treatment. The survey consisted of 37 items covering three domains: clinical details and demographics; work status, occupation, and work ability; importance of work and factors interfering with work. Results: 105 surveys were completed. 54% respondents were females, median age 53. 79% had been working at the time diagnosis. The commonest primaries were breast, colorectal, lung, GYN, and melanoma/sarcoma. 80% reported having active disease, median 2 years since diagnosis, and 73% were currently on treatment. In patients with active disease (n=86), 47% were currently working, 63% of them full time, typically RTW after taking < 6 months off. Work was important to 80% them, making 83% "feel normal", and 58% feel like they are “beating the cancer”. 35% would have liked to work more hours. Fatigue interfered with work in 49%, pain in 38%, and side effects of pain medicines in 31%. Almost ¼ were anxious or depressed about their work situation. More than 20% experienced discrimination in the work place, although usually minor. Conclusions: It is not uncommon for patients with advanced cancer to RTW even when they are on treatment and are sick enough to need to be followed in a PC clinic. Work is important to them and many would like to work more. Symptoms and side effects may interfere with their work ability. Some may be experiencing discrimination in the work place. Interventions to overcome these problems should be part of comprehensive, interdisciplinary PC.
e20677 Background: There is an extensive literature on patients who return to work (RTW) after completing definitive cancer treatment. Much less is known about patients who work while on treatment. At a time of economic uncertainty as cancer becomes more of a chronic disease and palliative care is seen as offering much more than comfort care, issues affecting the working cancer patient needed to be explored. Methods: Cross sectional, anonymous survey completed once in two pain and palliative care clinics at a comprehensive cancer center by patients aged 25-65 who had been in paid employment prior to or during their treatment. Survey covered 37 items in three areas: cancer details (diagnosis, date of diagnosis, prior treatments, current disease status); occupation, work status and work ability; importance of work and factors interfering with work. Results: 97 surveys have been completed but up to 20% items missing responses. Cancer details: 54% females, median age 53, 79% working at diagnosis. Common primaries: Breast 26; CRC 14; lung 6; pancreas 4; prostate 2. 80% (67/84) reported having active disease, median 2 years since diagnosis, and 80% of them on treatment currently.Work status and attitudes of the 67 patients with active disease: 42% (29/68) are currently working, mostly full time, and typically will RTW after < 6 months off. 39% would like to work more hours. Work is important to 73% them, making 78% "feel normal", and 53% that they are “beating the cancer”. Fatigue interfered with work in 49%, pain in 38%, and side effects of pain medicines in 31%. Almost ¼ were anxious or depressed about their work situation. More than 20% experienced discrimination in the work place, but usually minor. Conclusions: Many of these patients with advanced cancer were trying to remain in the work force, even when they are on treatment and are sick enough to need to be followed in a Pain & Palliative Care clinic. Work is important to them and almost half would like to work more. Symptoms and side effects are interfering with their work ability. Some are experiencing discrimination in the work place. Interventions need to be developed to overcome some of these problems.
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