A cancer diagnosis often disrupts the stasis of one’s work-life balance, challenging the ability to work in traditional schedules and setups, and calling into question many aspects of the personal worlds of people with cancer. Amidst a global pandemic taking a toll on national employment, the relationship between work and cancer becomes all the more tenuous, underlined by a variety of existing disparities in health and economic security. Supportive professionals in the oncology field, many of whom have been deemed essential and have maintained employment throughout the pandemic, must acknowledge that their patients face a distinctly different reality. They must become advocates for their patients and seek resources to bolster support for those they work for, financially and emotionally.

In understanding the intersections of cancer, the coronavirus disease 2019 (COVID-19) pandemic, and work, the distinction between the varied ways that patients with cancer may experience work interruptions is important. Some patients may have already been unable to work as a result of their diagnosis or treatment; some may have lost jobs or hours as a result of the pandemic; others may have had to give up work opportunities due to the health risk of working with a compromised immune system; others, still, may have transitioned to partial or completely remote work to ensure safety. The emotional journey of navigating work while undergoing treatment for cancer is, at baseline, draining and stressful and is only complicated by the weight of uncertainty that the COVID-19 pandemic carries. The intersection of cancer and COVID-19 concerns creates an array of emotional and practical consequences that impact one’s ability to work.

The pandemic has restructured many aspects of daily life. For many people, various elements of life have been collapsed into a single space, as homes become the site of work, education, medical appointments, recreation, digital socialization, and more. As people with cancer are more vulnerable to COVID-19, they are often required to be highly isolated from others, posing additional concern and difficulty pertaining to work. Socioeconomic variables that impact the types of jobs people with cancer have access to also affect their ability to continue working, maintain relationships, and experience positive growth throughout the pandemic.

For communities of color, this impact is compounded as available data shows that COVID-19 is disproportionately affecting people who are Black, Indigenous, Latinx, and other people of color.1 Early study data presented at the 2020 American Association for Cancer Research (AACR) Virtual Annual Meeting I, suggests that people with cancer and COVID-19 who identify as Black and Hispanic experience higher rates of mortality than those from other racial or ethnic groups.2 As it pertains to work, people of color may be more likely to work in essential jobs and less likely to be afforded the possibility of remote work, which naturally increases the risk of exposure to the coronavirus.3 In concert with the possibility of employment changes and job loss, comes a fluctuation in insurance coverage.3 When coupled with well-established data and research about how racial disparities in health care inform differences in cancer diagnosis, treatment variables, and outcomes,4 the COVID-19 pandemic has clearly magnified the pervasive economic, occupational, and health inequalities woven into the fabric of the US landscape.


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Oncology support professionals are well-situated to advocate for patients and connect them to key services to address their needs. Although many nonprofits have had to close their doors or refine their offerings during the pandemic, some have bolstered resources to meet the higher degree of need. Case management services, such as those provided by CancerCare and The Patient Advocate Foundation, can help people with cancer find local and national resources for additional support. Organizations such as Triage Cancer and Cancer and Careers provide critical information about workplace protections including FMLA, state family leave laws, and reasonable accommodations under the ADA.

Avenues of support, innovative service models, and job programs need to be further developed for those living within the experience of cancer treatment during the COVID-19 pandemic. Nurses, social workers, doctors, and others in the field must join in efforts to establish pathways to needs assessment and resource management within their institutions and organizations, generating work that speaks to the experiences of those people with cancer who have been the most marginalized, both historically and within the present context of the COVID-19 pandemic.


A.J. Cincotta-Eichenfield is an oncology social worker at CancerCare.


References

1. Godoy M, Wood D. What do coronavirus racial disparities look like state by state? NPR. Published May 30, 2020. Accessed September 22, 2020. https://www.npr.org/sections/health-shots/2020/05/30/865413079/what-do-coronavirus-racial-disparities-look-like-state-by-state

2. Blevins-Primeau AS. Racial and ethnic disparities among patients with cancer and COVID-19. Cancer Therapy Advisor. Published online April 28, 2020.

3. Balogun OD, Bea VJ, Phillips E. Disparities in cancer outcomes due to COVID-19 — a tale of 2 cities. JAMA Oncology. Published online August 13, 2020. doi:10.1001/jamaoncol.2020.3327

4. Cancer disparities. National Cancer Institute. Updated March 11, 2019. Accessed September 22, 2020. https://www.cancer.gov/about-cancer/understanding/disparities