Employment Concerns and Associated Impairments of Women Living With Advanced Breast Cancer

Abstract

Objective To describe the clinical and personal factors associated with work status, distress regarding work status, and the desire to resume employment and receive help to address work challenges reported by women living with advanced breast cancer. Design Descriptive statistics and univariate and multivariate logistic regression were used to explore factors related to employment challenges in this secondary analysis of an existing dataset. Setting Participants were recruited from an outpatient oncology clinic specializing in breast cancer at a free-standing comprehensive cancer center. Participants English-speaking women older than 18 years living with metastatic breast cancer with intact mental status and Karnofsky Performance Scale scores between 40 and 90 (N=163). Intervention Not applicable. Main Outcome Measures Dependent variables included (1) continued employment if working at the time of cancer diagnosis; (2) interest in resuming employment if working at the time of cancer diagnosis and now no longer working; (3) distress regarding vocational limitations; and (4) interest in receiving help to resume work. Results Seventy percent of the sample was working before their cancer diagnosis (n = 114), yet only 21% (n = 35) was working when surveyed. Lower functional status and higher symptom burden were strongly and consistently associated with lack of work retention, distress related to vocational role limitations, and desire for help in addressing limitations (all P values<.01). Conclusions With more people living longer with metastatic cancer, there is a need to assess and support survivors’ desire and capacity to maintain employment. Participants’ reduced employment was strongly associated with potentially actionable clinical targets (ie, higher symptom burden and lower functional status) that fall within cancer rehabilitation’s mission.

Quality of working life can protect against cognitive and emotional vulnerability in women living with metastatic breast cancer: a cross-sectional study

“…Collectively our findings indicate that greater quality of working life may play an influential role in enhancing workability by increasing perceived cognitive function in working women with MBC. Reduced workability and work productivity are common amongst women with MBC [ 22 , 24 , 25 ]. We recommend that subsequent research be conducted to investigate the moderating role of quality of working life in the relationship between perceived cognitive function and workability.…”

“…Women also attend regular oncology appointments and treatment sessions that can adversely impact their work presenteeism. In a recent study by Lyons et al [25], it was shown that more than two-thirds of women with MBC report being restricted in work and require a series of work-based adaptions indicating social support and understanding in the workplace are essential. It has been shown that greater social support, as well as lower job stress and fatigue, predicts a better quality of working life in cancer survivors [30,31].…”

“…Factors such as pain, nausea, fatigue, sadness, drowsiness, memory difficulties and numbness/ tingling have been associated with poor sustainment of work in individuals with metastatic cancer [23]. Similarly, to women with earlier-stage breast cancer, women with MBC have been shown to experience reduced workability and productivity [22,24,25]. In women with earlier-stage cancer, employer and co-worker support and flexibility have been linked to better workability, confidence, retention of work and an earlier return to work [26][27][28].…”

“…In women with earlier-stage cancer, employer and co-worker support and flexibility have been linked to better workability, confidence, retention of work and an earlier return to work [26][27][28]. Lyons et al [25] delineated that over two-thirds of women living with advanced breast cancer reported that they were restricted in the types of work they can perform (68%), had to reduce their work (71%) or needed to take frequent rest breaks at work to manage their adverse side effects (71%). These figures indicate that women with MBC require a high level of employer understanding, support and flexibility.…”

Quality of working life and career engagement of cancer survivors: the mediating role of effect of disease and treatment

“…Despite more attention being directed towards various matters related to cancer survivors, the role of work and career issues remains generally understudied (Hamood et al , 2019). Nevertheless, studies that have been carried out reveal that a lower functional status, and a higher symptom burden are strongly and consistently associated with a lack of work retention, distress related to vocational role limitations and the desire for help in addressing such limitations (Lyons et al , 2019). According to Strauser et al (2015), young adult cancer survivors frequently lack appropriate career development skills.…”