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One in Three Cancer Survivors on Unemployment Line
Date:2/17/2009

Lingering physical effects of cancer a likely cause, finds study,,,,

TUESDAY, Feb. 17 (HealthDay News) -- As if fighting cancer wasn't hard enough, a new Dutch study concludes that one in three people who survive the ordeal won't be able to find a job.

The meta-analysis of more than 20,000 cancer survivors found that 33.8 percent of those who'd battled cancer were out of work vs. 15.2 percent of healthy people.

"Cancer survivorship is associated with unemployment," said lead researcher Angela de Boer, an assistant professor at the Coronel Institute of Occupation Health at the Academic Medical Center in Amsterdam. "Unemployment was higher in survivors of breast cancer, gastrointestinal cancer and cancers of the female reproductive organs, but unemployment rates were not higher for survivors of blood cancers, prostate cancers or testis cancers compared to controls," she added.

Results of the study were published in the Feb. 18 issue of the Journal of the American Medical Association.

Advances in cancer treatment mean that the number of people who survive a cancer diagnosis is on the rise, according to the study. And, de Boer said, nearly half of those who survive cancer are under age 65. However, many who survive cancer are left with physical, emotional and social problems. Such problems may include fatigue, pain, cognitive deficits, anxiety and depression.

Many people who've survived cancer treatment want to go back to work, viewing the return to work as evidence of a complete recovery, yet de Boer said little research has been done on the association between cancer survivorship and employment.

To get a better picture of what happens work-wise after cancer treatment, de Boer and her colleagues pooled data from 36 studies. Sixteen studies were from the United States, 15 were from Europe and five were from other areas. The studies included 20,366 people who'd survived cancer and 157,603 healthy people.

"Overall, cancer survivors were 1.4 times more likely to be unemployed than healthy controls," said de Boer.

"We think that the mechanism behind the higher unemployment rate among cancer survivors is partly a higher disability, which leads to a more vulnerable position in the labor market," said de Boer. What's more, she noted, "cancer survivors are even more at risk to become unemployed in the present economic climate with the rising unemployment rate."

As to why some cancers -- breast, gastrointestinal and female reproductive cancers -- had even higher unemployment rates, de Boer said there may be higher disability rates for those types of cancers due to more extensive and rigorous treatments.

"This is an important study that brings to light the fact that there is a fairly significant number of patients who, after they've survived cancer, are unemployed," said Dr. Smita Bhatia, director of cancer survivorship at City of Hope in Duarte, Calif.

"We need to be more proactive and identify who these vulnerable patients are. People undergoing cancer treatment need to be aware of the fact that this can possibly happen," said Bhatia, who also pointed out, "After treatment, you might want to rethink your employment situation."

De Boer said that a patient's working life should be taken into account during diagnosis and treatment. "Employment outcomes can be improved with clinical and supportive services aimed at better management of symptoms," she said. Also, she noted that paid sick leave needs to be increased in many countries to help ease some of the economic burden faced by those fighting cancer.

Just last week, a study presented at the conference on Science of Health Care Disparities found that many cancer survivors forgo necessary medical care because they can't afford it.

More information

To learn more about life after cancer treatment, visit the National Cancer Institute.



SOURCES: Angela de Boer, Ph.D., assistant professor, the Coronel Institute of Occupation Health at the Academic Medical Center, Amsterdam, the Netherlands; Smita Bhatia, M.D., M.P.H., director, Center for Cancer Survivorship, City of Hope, Duarte, Calif.; Feb. 18, 2009, Journal of the American Medical Association


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