Assessment of late treatment-related symptoms using patient-reported outcomes and various factors affecting return to work in survivors of breast cancer

Rai, Rajeshwari; Malik, Monica; Valiyaveettil, Deepthi; Ahmed, Syed Fayaz; Basalatullah, Mohammed

doi:10.3332/ecancer.2023.1533

ecancer

2023

DOI: 10.3332/ecancer.2023.1533

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Assessment of late treatment-related symptoms using patient-reported outcomes and various factors affecting return to work in survivors of breast cancer

Rajeshwari Rai¹,

Monica Malik²,

Deepthi Valiyaveettil³

et al.

Abstract: Introduction: Breast cancer is the most common cancer in women worldwide. Survival in these patients has increased because of early diagnosis and multimodality treatment methods. Return to premorbid functional status after treatment is essential for rehabilitation and good quality of life. Many patients suffer from late treatment-related symptoms which affect their return to premorbid status. Various health-related and work-related variables also affect the return to premorbid status. Materials and methods:Thi… Show more

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2024

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Cited by 5 publications

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Cognition and Return to Work Status 2 Years After Breast Cancer Diagnosis

Lange,

Lequesne,

Dumas

et al. 2024

JAMA Netw Open

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ImportanceReturn to work after breast cancer (BC) treatment depends on several factors, including treatment-related adverse effects. While cancer-related cognitive impairment is frequently reported by patients with BC, to date, no longitudinal studies have assessed its association with return to work.ObjectiveTo examine whether cognition, assessed using objective and subjective scores, was associated with return to work 2 years after BC diagnosis.Design, Setting, and ParticipantsIn a case series of the French Cancer Toxicities (CANTO) cohort, a study of patients with stage I to III BC investigated cognition from April 2014 to December 2018 (2 years’ follow-up). Participants included women aged 58 years or younger at BC diagnosis who were employed or looking for a job.Main Outcomes and MeasuresThe outcome was return to work assessed 2 years after BC diagnosis. Objective cognitive functioning (tests), cognitive symptoms, anxiety, depression, and fatigue were prospectively assessed at diagnosis (baseline), 1 year after treatment completion, and 2 years after diagnosis. Multivariable logistic regression models were used to explain return to work status at year 2 according to each cognitive measure separately, adjusted for age, occupational class, stage at diagnosis, and chemotherapy.ResultsThe final sample included 178 women with BC (median age: 48.7 [range, 28-58] years), including 37 (20.8%) who did not return to work at year 2. Patients who returned to work had a higher (ie, professional) occupational class and were less likely to have had a mastectomy (24.1% vs 54.1%; P &lt; .001). Return to work at year 2 was associated with lower overall cognitive impairment (1-point unit of increased odds ratio [1-pt OR], 0.32; 95% CI, 0.13-0.79; P = .01), higher working memory (1-pt OR, 2.06; 95% CI, 1.23-3.59; P = .008), higher processing speed (1-pt OR, 1.97; 95% CI, 1.20-3.36; P = .01) and higher attention performance (1-pt OR, 1.63; 95% CI, 1.04-2.64; P = .04), higher perceived cognitive abilities (1-pt OR, 1.12; 95% CI, 1.03-1.21; P = .007), and lower depression (1-pt OR, 0.83; 95% CI, 0.74-0.93; P = .001) at year 2 assessment. Return to work at year 2 was associated with several measures assessed at baseline and year 1: higher processing speed (1-pt OR, 2.38; 95% CI, 1.37-4.31; P = .003 and 1.95; 95% CI, 1.14-3.50; P = .02), higher executive performance (1-pt OR, 2.61; 95% CI, 1.28-5.75; P = .01, and 2.88; 95% CI, 1.36-6.28; P = .006), and lower physical fatigue (10-pt OR, 0.81; 95% CI, 0.69-0.95; P = .009 and 0.84; 95% CI, 0.71-0.98; P = .02).Conclusions and RelevanceIn this case series study of patients with BC, return to work 2 years after diagnosis was associated with higher cognitive speed performance before and after BC treatment. Cognitive difficulties should be assessed before return to work to propose suitable management.

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Cognition and Return to Work Status 2 Years After Breast Cancer Diagnosis

Lange,

Lequesne,

Dumas

et al. 2024

JAMA Netw Open

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Measures of Work-life Balance and Interventions of Reasonable Accommodations for the Return to Work of Cancer Survivors: A Scoping Review

Buresti,

Rondinone,

Valenti

et al. 2024

Safety and Health at Work

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Impact of fatigue on work productivity and health-related job loss

Macfarlane,

D’Angelo,

Ntani

et al. 2024

Occupational Medicine

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Background Fatigue is commonly reported in population surveys and has been identified in patients with health conditions as a key co-morbidity which makes remaining in work challenging. Such patients, however, rarely have access to programmes to help them manage their fatigue. Aims To quantify the relationship between fatigue, work impairment and health-related job loss. Methods We use data from the Health and Employment After Fifty study, a longitudinal study of people aged 50–64 years when recruited through general practices in England in 2013–14. During follow-up, fatigue was measured using the Fatigue Assessment Scale, work impairment was assessed using the Work Productivity and Activity Impairment scale, and changes in employment status were recorded. Results A total of 2743 participants were eligible for the current analysis; 23% satisfied criteria for being fatigued. People who were fatigued were less likely to have a partner, university degree, be physically active and were more likely to be obese. Their job was more likely to involve shifts, be perceived as insecure, have reported difficulties coping with job demands, and be unsatisfying. After adjustment for socio-economic, lifestyle and work-related factors, they were almost twice as likely to report both work impairment (relative risk 1.8; 95% confidence interval [CI] 1.6, 2.1) and future health-related job loss, although the latter effect was only in those with other morbidities (incidence rate ratio 1.96; 95% CI 1.03–3.72). Conclusions Providing evidence-based support for workers with health conditions who experience fatigue may have an important impact at a population level in terms of extending working lives.

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Assessment of late treatment-related symptoms using patient-reported outcomes and various factors affecting return to work in survivors of breast cancer

Cited by 5 publications

References 18 publications

Cognition and Return to Work Status 2 Years After Breast Cancer Diagnosis

Cognition and Return to Work Status 2 Years After Breast Cancer Diagnosis

Measures of Work-life Balance and Interventions of Reasonable Accommodations for the Return to Work of Cancer Survivors: A Scoping Review

Impact of fatigue on work productivity and health-related job loss

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