Work status changes and associated factors in a nationwide sample of Norwegian long-term breast cancer survivors

Bøhn, Synne-Kristin Hoffart; Vandraas, Kathrine F.; Kiserud, Cecilie E.; Dahl, Alv A.; Thorsen, Lene; Ewertz, Marianne; Lie, Hanne C.; Falk, Ragnhild Sørum; Reinertsen, Kristin V.

doi:10.1007/s11764-022-01202-2

Cited by 13 publications

(12 citation statements)

References 45 publications

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“…An interruption to full-time work can be expected for patients to undergo treatment [35], with some treatment regimens requiring greater time away from work. Receipt of chemotherapy is associated with reduced likelihood of RTW [8,9,35], likely due to the negative side effects, including fatigue and decreased cognitive function (e.g., "chemo brain") [36,37]. Additionally, some treatments, such as hormone replacement therapies, can be active for long periods of time [35], extending beyond typical allotments for sick leave and prolonging side effects.…”

Section: Return To Work Challenges Amplified By Treatmentmentioning

confidence: 99%

“…This may be amplified for those with occupations in which physical function, including arm function, is vital to job performance, and survivors may not be able to return to the same level of productivity they had before breast cancer treatment. Demographic disparities, such as income, number of dependents in the household, and living in a rural location, may also impact recovery and RTW [8][9][10]. Disparities can compound treatment outcomes, and their consideration in the treatment pathway is needed to fully understand the RTW landscape for breast cancer survivors.…”

Section: Introductionmentioning

confidence: 99%

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The role of physical arm function and demographic disparities in breast cancer survivors’ ability to return to work

Vidt

Heitzenrater

Dodge

et al. 2022

Support Care Cancer

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Purpose Ability to return to work (RTW) is an important aspect of breast cancer that is limited for many survivors. With 90% survivorship in the USA, it is imperative that focus shifts toward the improvement of physical arm function to improve survivors' ability to RTW. This narrative review discusses the role of physical arm function and demographic disparities in breast cancer survivor RTW. Methods Literature on physical function, arm function, and demographic disparities following breast cancer treatment and their implications for RTW is discussed. ResultsThe ability to RTW is a key component of recovery for breast cancer survivors, but challenges and inequalities persist. Treatment effects can induce and prolong functional disability, affecting survivors' ability to RTW. These effects may be compounded for survivors whose occupation requires physical arm function. The RTW landscape, including the occupations survivors have, the physical function required for job tasks, and availability of workplace accommodations, is also unclear. Additional demographic disparities (e.g., income, live in rural area) exist, but the extent to which these factors influence RTW is not well understood. More work is needed to understand the compounded impact of treatment effects, demographic disparities, and occupational factors on RTW. Multidisciplinary rehabilitation that includes occupational counseling and exercise is a promising approach, but widespread adoption in the US healthcare model presents an ongoing challenge. Areas for further research are highlighted. Conclusion There is an incomplete understanding of the effects of treatment on physical arm function and the role of demographic disparities on breast cancer survivor RTW.

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Section: Return To Work Challenges Amplified By Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The role of physical arm function and demographic disparities in breast cancer survivors’ ability to return to work

Vidt

Heitzenrater

Dodge

et al. 2022

Support Care Cancer

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“…5 However, the challenge goes beyond return to work (RTW) and sustainable RTW (SRTW) is an issue for many BCS who often have several sick leaves or struggle to retain their jobs after RTW. [6][7][8][9][10] Employment after cancer can be affected by different factors. Evidence from studies including survivors from all cancer sites found that clinical factors, sociodemographic factors, including older age, low socio-economic status, workplace environment (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…A recent meta‐analysis found that 70% of BCS return to work after the end of treatment, which was not significantly different from all cancer survivors 5 . However, the challenge goes beyond return to work (RTW) and sustainable RTW (SRTW) is an issue for many BCS who often have several sick leaves or struggle to retain their jobs after RTW 6–10 …”

Section: Introductionmentioning

confidence: 99%

Sustainable return to work among breast cancer survivors

Ruiz de Azua,

Kousignian,

Vaz‐Luis

et al. 2023

Cancer Medicine

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PurposeThis study assessed sustainable return to work (SRTW) of breast cancer survivors (BCS).MethodsWe used data from the prospective French cohort, CANTO. We included 1811 stage I–III BCS who were <57 years old and employed at the moment of diagnosis and working 2 years after diagnosis. Using logistic regression, we investigated the role of clinical, health and socio‐economic factors, and the work environment on SRTW 3 years after diagnosis. We compared having any sick leave with having worked continuously and being unemployed to having worked continuously between 2 and 3 years after diagnosis.ResultsOverall, 77% (n = 1395) worked continuously after return to work (RTW). Out of the other 416 BCS, 66% had any sick leave period, 33% had been unemployed, 4% had an early retirement, 2% a disability and 1% another status (multiple situations possible). Being on sick leave was associated with age > 50 (OR = 0.59; 95%CI = 0.43–0.82), stage III (2.56; 1.70–3.85), tumour subtype HR+/HER2+ (0.61; 0.39–0.95), severe fatigue (1.45; 1.06–1.98), workplace accommodations (1.63; 1.14–2.33) and life priorities (0.71; 0.53–0.95). Unemployment was associated with age > 50 (0.45; 0.29–0.72), working in the public sector (0.31; 0.19–0.51), for a small company (3.00; 1.74–5.20) and having a fixed‐term contract (7.50; 4.74–11.86).ConclusionsA high number of BCS have periods of sick leave or unemployment after RTW. The determinants differ between sick leave and unemployment.Implications for cancer survivorsBCS need to be supported even after RTW, which should be regarded as a process.

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“…A Norwegian study from 2017 [10] reported that up to 35% of cancer survivors experience chronic fatigue. Regardless of when they occur, late and long-term effects can significantly impair physical, psychological, or social functioning, and thus reduce cancer survivors' quality of life [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of late and long-term effects of cancer (treatment) and use of complementary and alternative medicine in Norway

Kristoffersen

Wider

Nilsen

et al. 2022

BMC Complement Med Ther

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Background The increasing number of patients surviving cancer leads to more people experiencing late and long term-effects from the disease and its treatment. Fatigue, sleep disorders, early menopause, pain, and nerve damage are commonly reported. Methods helping people to recover after cancer treatment are therefore essential. The aims of this study were threefold; (1) to determine the level of cancer patients suffering from late and long-term effects of cancer diagnosis and treatment in Norway, (2) explore complementary and alternative medicine (CAM) modalities used for managing these adversities, and (3) describe self-perceived benefits and harms of the CAM interventions. Methods The study was conducted in cooperation with the Norwegian Cancer Society (NCS) and consisted of an online cross-sectional study among members of the NCS user panel with present or previous cancer (n = 706). The study was carried out in September/October 2021 using a modified cancer-specific version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). A total of 315 women and 153 men agreed to participate, resulting in a response rate of 67%. Results Most of the participants (83%) suffered from late and long-term effects of cancer treatment; mostly fatigue (59.2%), sleep disorder (41.5%), hot flashes (39.2%), nerve damage (polyneuropathy, 38.0%), and pain (36.6%) with a mean number of 5.1 different late and long-term effects. Late and long-term effects were positively associated with younger age and college/university education. Nearly half of the participants experiencing late and long-term effects (43%) reported having used CAM to treat these complaints. Most frequently used were self-help practices (26%) such as relaxation therapy (19%), yoga (14%) and meditation (13%), but also visits to CAM providers were reported by 22%. Herbal- and other natural remedies to treat late and long-term effects were used by 13%. A high percentage of CAM users reported self-perceived improvements of their symptoms (86% for self-help practices, 90% for visits to CAM providers). Few experienced adverse effects of the CAM treatment. Conclusion A large proportion of cancer patients suffered from a wide range of late and long-term effects of cancer diagnosis and treatment, and they use CAM to treat these complaints to a rather high degree. Relaxation therapy, yoga, meditation, massage, and acupuncture were the most frequently used therapies regardless of complaint. The therapies used are generally considered to be both safe and beneficial for the respective complaint, indicating that the participants seem to be well informed about the choices they make.

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Work status changes and associated factors in a nationwide sample of Norwegian long-term breast cancer survivors

Cited by 13 publications

References 45 publications

The role of physical arm function and demographic disparities in breast cancer survivors’ ability to return to work

The role of physical arm function and demographic disparities in breast cancer survivors’ ability to return to work

Sustainable return to work among breast cancer survivors

Prevalence of late and long-term effects of cancer (treatment) and use of complementary and alternative medicine in Norway

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