Summary and future directions

Unemployed cancer survivors experience more challenges managing the cancer–work interface than cancer survivors who RTW and remain employed as survivors. Our findings suggest that these challenges increase the risk of unemployment. Specifically, both work-related psychological distress and work-related changes were significantly associated with odds of being unemployed during the 5 years following cancer diagnosis after controlling for social and demographic factors. Taken together, our findings highlight a number of important themes regarding supports that cancer survivors may need in order to return to and maintain employment as survivors. Psychosocial supports (on and off the job) may be needed to allow cancer survivors to discuss and exchange information about how adverse treatment effects may influence work tasks. This information is essential for survivors’ ability to develop strategies for managing work life and optimize long-term employment. Periodic meetings with an oncology social worker or counselor post-treatment could provide added supports for employed cancer survivors, especially among survivors with functional limitations.

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Likewise, workplace supports are needed for both cancer survivors and their employers. There is growing recognition among employers that supervisors and managers need education and strategies for how to support cancer survivors during treatment and upon RTW following treatment.21,22Employers are in significant need of approaches that can be used to support the employee long after treatment is over, especially among cancer survivors who may have residual functional limitations. Cancer survivors may benefit, long-term, from work place supports that allow them to reduce work hours, alter work tasks, and/or offer greater flexibility in order to accommodate adverse effects of treatment and associated changes in functional ability.

Cancer care teams could also play an important role in reducing the risk of unemployment among cancer survivors. Although successful RTW or the ability to work during treatment or enhancing chances for long-term employment post treatment may seem beyond the scope of the cancer care team, the clinical care team is in a unique position to assess, advise, and assist cancer survivors in managing employment issues during and after treatment. Cancer survivorship care plans may be a useful tool in facilitating discussion of this important topic between patients and providers and may serve a valuable function in connecting patients with information, strategies, and resources to successfully navigate the cancer–work interface, meaningful employment, and by extension, quality of life.

Future research should examine the impact of managing the cancer–work interface on cancer treatment decision making, treatment outcomes, and patients’ quality of life. Furthermore, effort should be made to develop provider, employment, and policy strategies to minimize unemployment and to address occupational contributors to cancer disparities.


The authors report no conflicts of interest in this work.

J. Kathleen Tracy,1,2 Derek Falk,1,3 Rebecca J. Thompson,4 Lily Scheindlin,1 Fiyinfolu Adetunji,1 Jennifer E. Swanberg1–3,51Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA; 2University of Maryland Greenebaum Comprehensive Cancer Center, University of Maryland Medical Center, Baltimore, MD, USA; 3University of Maryland School of Social Work, Baltimore, MD, USA; 4Management Department, Gettysburg College, Gettysburg, PA, USA; 5Department of Health Policy and Management, School of Professional Studies, Providence College, Providence, RI, USA 


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Source: Cancer Management and Research.
Originally published November 28, 2018.