Melissa A Carlson1,2, Elizabeth A Fradgley1,3,2,4, Paula Bridge1,2,4, Jo Taylor1,2,4, Sarah Morris1, Emily Coutts1, Christine Paul5,6,7,8. 1. School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia. 2. Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia. 3. Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia. 4. Priority Research Centre for Health Behavior, University of Newcastle, Callaghan, Australia. 5. School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia. Chris.paul@newcastle.edu.au. 6. Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia. Chris.paul@newcastle.edu.au. 7. Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia. Chris.paul@newcastle.edu.au. 8. Priority Research Centre for Health Behavior, University of Newcastle, Callaghan, Australia. Chris.paul@newcastle.edu.au.
Abstract
BACKGROUND: People with a cancer diagnosis experience physical and emotional impacts that may affect employment. Alongside cancer care costs, reduced ability to generate an income is a key contributor to financial toxicity which is associated with poor emotional wellbeing, quality of life, treatment adherence and survival. This study aimed to explore people's experiences of changes to employment and their suggestions for how cancer survivors can be better supported. METHODS: Semi-structured telephone interviews were conducted with a purposive sample of 21 cancer survivors identified as part of a larger study of emotional distress. Purposive sampling was used to include a diverse group of people across age, gender, tumour type, self-reported financial difficulties and employment status. Interviews were inductively and iteratively coded by two independent coders and analysed using thematic analysis. RESULTS: There is a dynamic relationship between a person's cancer treatment and their employment. For some, employment was disrupted due to physical or emotional impacts of cancer, or workplace stigma and discrimination. Others continued to work at the detriment of their health. Participants wished they had been made aware earlier how cancer might impact their capacity to work, their finances and their health. There was a lack of knowledge on the financial supports that may be available to them. CONCLUSIONS: Healthcare professionals may have a role in minimising the financial impact of a cancer diagnosis through early assessment, communication of patients' potential work capacity and appropriate referrals to occupational therapy to aid return to work or financial planning. A robust government social support system specifically for households experiencing cancer is urgently required.
BACKGROUND: People with a cancer diagnosis experience physical and emotional impacts that may affect employment. Alongside cancer care costs, reduced ability to generate an income is a key contributor to financial toxicity which is associated with poor emotional wellbeing, quality of life, treatment adherence and survival. This study aimed to explore people's experiences of changes to employment and their suggestions for how cancer survivors can be better supported. METHODS: Semi-structured telephone interviews were conducted with a purposive sample of 21 cancer survivors identified as part of a larger study of emotional distress. Purposive sampling was used to include a diverse group of people across age, gender, tumour type, self-reported financial difficulties and employment status. Interviews were inductively and iteratively coded by two independent coders and analysed using thematic analysis. RESULTS: There is a dynamic relationship between a person's cancer treatment and their employment. For some, employment was disrupted due to physical or emotional impacts of cancer, or workplace stigma and discrimination. Others continued to work at the detriment of their health. Participants wished they had been made aware earlier how cancer might impact their capacity to work, their finances and their health. There was a lack of knowledge on the financial supports that may be available to them. CONCLUSIONS: Healthcare professionals may have a role in minimising the financial impact of a cancer diagnosis through early assessment, communication of patients' potential work capacity and appropriate referrals to occupational therapy to aid return to work or financial planning. A robust government social support system specifically for households experiencing cancer is urgently required.
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