Cancer survivorship and work: Symptoms, supervisor response, co-worker disclosure and work adjustment

Introduction: Recent improvements in cancer treatment have not only increased cancer survivorship but also peoples' ability to work during and following treatment. However, the impact that both diagnosis and treatment has on cancer survivors' ability to fully engage in paid work is not yet entirely understood. This study aims to explore the role of symptoms, work adjustments and cancer disclosure to supervisors and co-workers on working during primary cancer treatment and return to work following treatment. Method: 328 cancer survivors responded to a 33 item questionnaire that assessed cancer-specific variables e.g. type and treatment, symptoms experienced during and following treatment, disclosure of cancer and adjustments and supports available at work. Multivariate logistic regressions were run to determine the association of symptoms, disclosure and work adjustments and working during treatment and returning to work following treatment. Results: The findings indicate that opportunities to work flexibly (OR=2.43, CI 1.21-4.02), disclosure to colleagues (OR=3.03, CI 1.28-8.19), difficulties managing fatigue (OR=2.08, CI 1.22-3.85), and paid time off to attend all medical appointments (OR=.4, CI .30-.87) were associated with continuing to work during treatment. Correlates of return to work included difficulties managing fatigue (OR=1.49, CI 1.42-6.18), managing the stress of cancer (OR=2.80, 1.05-5.34), managing physical changes associated with cancer (OR=.46, CI .13-.95), received advice from their doctor about work (OR=1.47, CI 1.09-2.84) and return to work meeting with employer (OR 1.99, 1.2-5.09). Conclusions: This study highlights the importance of symptom management in cancer survivors who work and the potential impact of workplace adjustments on the ability of cancer survivors to navigate in the world of work.