Survivors’ Dilemma: Young Adult Cancer Survivors’ Perspectives of Work-Related Goals

Abstract

Background: Young adult cancer survivors have significant work-related challenges, including interruptions to education and employment milestones, which may affect work-related goals (WRGs). The study purpose was to explore posttreatment perspectives of WRGs in a sample of young adult hematologic cancer survivors. Methods: This qualitative descriptive study used social media to recruit eligible cancer survivors (young adults working or in school at the time of cancer diagnosis). Data were collected through telephone semi-structured interviews and analyzed using directed content analysis, followed by thematic content analysis to identify themes. Findings: The sample ( N = 40) were mostly female (63.5%), White (75%), and diagnosed with Hodgkin lymphoma (57.5%); most worked in professional (40%) or health care (23%) roles. The overarching theme, “Survivors’ Dilemma,” highlights a changed perspective on work-related fulfillment and financial obligations, capturing survivors’ decision-making process regarding work. Three subthemes illustrated questions that participants contemplated as they examined how their WRGs had changed: (a) Self-identity: Do I want to do this work? (b) Perceived health and work ability: Can I do this work? and (c) Financial toxicity: Can I afford to/not to do this work? Conclusions/Application to Practice: Participants experienced a state of dilemma around their WRGs, weighing areas around self-identity, perceived health and work ability, and financial toxicity. Findings suggest occupational health nurses should be aware of challenges surrounding WRGs, including how goals may change following a cancer diagnosis and treatment, and the potential stressors involved in the Survivors’ Dilemma. Occupational health nurses should assess for these issues and refer young survivors to employee and financial assistance programs, as necessary.

“Now Everybody Is Thinking About Things Like That.” Young Adult Cancer Survivors Reimagining Work During the COVID-19 Pandemic

“…The study was approved by the New York University Institutional Review Board (2020-4281). Eligibility, recruitment, and data collection methods of the parent study are described in detail elsewhere (Ghazal, Merriman, et al, 2021). Briefly, participants included YA leukemia and lymphoma survivors who had completed active treatment within 5 years of diagnosis.…”

“…Understanding perceptions of work and describing work-related outcomes among the cancer survivorship continuum is critical; work is one of the greatest issues affecting quality of life (QOL) among cancer survivors (Peteet, 2000). We previously reported that hematologic YACS experienced “survivors’ dilemma” when reflecting on their work-related goals (Ghazal, Merriman, et al, 2021). Survivors continuously balanced factors related to changed self-identity, perceived work ability, and new or worse worry about money and difficulty paying for basics, which affected their QOL.…”

Work Placement and Job Satisfaction in Long-Term Childhood Cancer Survivors: The Impact of Late Effects

“…Monitoring and understanding the long-term consequences that CCS can develop through their life is relevant for public health [ 1 ]. Besides the possible onset of physical late effects induced by cancer treatments, CCS are at risk of developing psychological and socioeconomic vulnerability [ 2 , 3 , 4 , 5 ].…”

“…Key developmental tasks such as educational achievements, employment, financial independence, and job satisfaction are crucial factors for a good quality of life (QoL), for CCS as well as for their healthy peers [ 4 , 6 , 7 ]. However, due to their previous cancer, CCS may have greater difficulty coping with challenges that entering adulthood implies.…”

“…Although many CCS have an overall good QoL, others refer a lower satisfaction particularly among socioeconomic areas [ 3 , 4 , 6 , 7 ]. As a consequence, monitoring the subjective perception of satisfaction among educational and occupational progress should be included in their routine follow-up.…”