C 2005) Journal of Occupational Rehabilitation, Vol. 15, No. 1, March 2005 ( DOI: 10.1007/s10926-005-0868-x
Cancer Survivorship and Work Michael Feuerstein1
This brief paper emphasizes that much of the knowledge and skills in the area of musculoskeletal disorders and work disability can be brought to bear on understanding and then intervening in the area cancer survivorship and work. KEY WORDS: cancer survivorship; work disability; multidisciplinary; research; secondary prevention.
As early detection and more effective intervention approaches emerge, the prevalence of cancer survivors continues to increase (1). In the US alone this number is expected to double by the year 2050 (2). While this is evidence that the health care community is positively impacting many types of cancers, functional problems then can become more apparent. A recent population-based investigation in the US reported that as compared to healthy controls matched on age, educational attainment and gender cancer, survivors had poorer outcomes across all measures of burden including work (3). This was found across tumor sites and across time since diagnosis. Of particular interest to readers of the Journal, are the findings of higher levels of lost productivity and higher levels of fair or poor health in the cancer survivors. Not unlike those workers with musculoskeletal pain, which has been the primary but not exclusive focus of this Journal, cancer survivors are experiencing problems getting back to work and achieving a level of productivity similar to their healthy counterparts. While there have been a few exemplary research efforts to attempt to find the factors affecting these outcomes (4,5) research in this area is relatively sparse. Although a relatively new area, several clinical researchers (6) and clinicians working this area for years have noted the challenges that cancer patients have had retuning and staying at work (7). Many of the challenges these survivors face have been attributed to both the disease and the various treatments such as chemotherapy and radiation (8,9). While these treatments very often effectively interrupt tumor growth they are not without their impact on other system (10). As researchers and clinicians focused on the prevention, evaluation and rehabilitation of work disability we are very well equipped with the theories, approaches and perspectives that can help identify the etiology, and develop and evaluate innovative prevention and rehabilitation approaches. 1 Correspondence
should be directed to Michael Feuerstein, PhD, MPH, Departments of Medical and Clinical Psychology and Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, Maryland 20814-4799; e-mail:
[email protected]. 1 C 2005 Springer Science+Business Media, Inc. 1053-0487/05/0300-0001/0
2
Feuerstein
As founding editor of the Journal of Occupational Rehabilitation, I wish to formally announce that this venue will be seeking research papers that address the problem of cancer and return to work, a problem that has been recognized for some time however long ignored in terms of its study. This problem can be investigated by the multidisciplinary group of physicians, nurses, psychologists, physical and occupational therapists, exercise physiologists, ergonomists, engineers, health systems researchers, policy analysts and policy makers who regularly read and submit papers to JOR. It is not a far jump. With new avenues for research funding it is possible to impact this work related problem as well. I hope you will take on this challenge. As you continue to work in the area of musculoskeletal health and the workplace consider extending your programs of research, clinical work and/or policy efforts to the problem of cancer and work. Let’s learn more about this problem and work toward developing innovative approaches to addressing it. It is a growing public health concern (http://www.cdc.gov/cancer/survivorship/#plan) (11). You can join a marathon and “race for a cure” but perhaps more importantly, given your expertise, you can race toward helping cancer survivors improve the quality of their work life.
REFERENCES 1. American Cancer Society. Cancer facts & figures 2003. Atlanta (GA) American Cancer Society, 2003, pp. 1–32. 2. Edwards BK, Howe HL, Ries, LA, Thun MJ, Rosenberg, HM, Yancik R, et al. Annual report to the nation on the status of cancer 1973–1999. Cancer 2002; 94: 2766–2792. 3. Yabroff KR, Lawrence WF, Clauser S, Davis WW, Brown ML. Burden of illness in cancer survivors: Finding from a population-based national sample. J Nat Cancer Inst 2004; 96(17): 1322–1330. 4. Spelten ER, Sprangers MAG, Verbeek JHAM. Factors reported to influence the return to work of cancer survivors: A literature review. Psycho-Oncology 2002; 11: 124–131. 5. Spelten ER, Verbeek JHAM, Uitterhoeve ALJ, Ansink AC, van der Lelie J, de Reijke RM, Kammeifer M, de Haes JCJM, Sprangers MAG. Cancer, fatigue and return to work—A prospective cohort study. Eur J Cancer 2003; 39: 1562–1567. 6. Meyers CA, Scheibel RS. Early detection and diagnosis of neuro-behavioral disorders associated with cancer and its treatment. Oncology 1990; 4(7): 115–122. 7. Dow KH, Ferrel BR, Leigh S, Ly J, Gulasekaram P. An evaluation of the quality of life among long-term survivors of breast cancer. Breast Cancer Res Treat 1996; 39: 261–273. 8. Saykin AJ, Ahles TA, McDonald BC. Mechanisms of chemotherapy-induced cognitive disorders: Neuropsychological, pathophysiological, and neuroimaging perspectives. Semin Clin Neuropsychiatry 2003; 8(4): 201–216. 9. Wefel JS, Lenzi R, Theriault R, Buzdar AU, Cruickshank S, Meyers CA. ‘Chemobrain’ in breast carcinoma? Cancer 2004 (early online view, 29 June 2004). 10. Tchen N, Juffs HG, Downie FP, Yi Q, Hu H, Chemerynsky I, Clemons M, Crump M, Goss PE, Warr D, Tweedale ME, Tannock IF. Cognitive function, fatigue, and menopausal symptoms in women receiving adjuvant chemotherapy for breast cancer. J Clin Oncol 2003; 21(22): 4175–4183. 11. Centers for Disease Control. A national action plan for cancer survivorship: Advancing public health strategies http://www.cdc.gov/cancer/survivorship/#plan 2004.
