Despite legislation in Canada and other countries to protect workers from discrimination based on disability or health state, some cancer survivors have reported problems in the workplace after cancer. These problems have included job loss, demotion, decreased wages, difficulty in obtaining a new job, and problems with supervisors and colleagues. However, few quantitative studies have addressed the work experiences of cancer survivors.
To assess breast cancer survivors' work experience, Elizabeth Maunsell, of the Université Laval in Quebec City, and colleagues conducted a population-based retrospective cohort study in Quebec, Canada, of a series of breast cancer patients who were age 60 and younger at diagnosis. The work experiences of 646 of these women over the 3 years after their diagnosis were compared with the experiences during the same time period of a group comprised of 890 women who were similar to the survivors except that they had never been diagnosed with cancer.
Slightly more breast cancer survivors than women in the comparison group (21% versus 15%) were unemployed at the end of the 3-year period. However, most women who were not working (84% of unemployed survivors and 76% of unemployed women in the comparison group) said that the decision to stop working was their own. Among women still employed 3 years later, no deterioration in working conditions was observed in either group. In addition, negative events, such as firings, were rare in both groups.
"[W]e recognize that individual women may find the return to work after breast cancer difficult and may attribute work problems or the personal decision to reduce work effort to the fact of having had breast cancer," the authors write. "On a population basis, however, we found little evidence to support the idea of involuntary changes in work situation because of breast cancer in Quebec. Thus, we believe that these results should provide some reassurance for working women who have just been diagnosed with breast cancer, especially women who are part of health and social systems similar to those in Canada."
In an editorial, Leslie R. Schover, Ph.D., of the University of Texas M. D. Anderson Cancer Center in Houston, discusses how most stereotypes of breast cancer survivorship have proven to be untrue. For example, breast cancer does not lead to higher divorce rates, and the type of breast surgery plays little role in a woman's sexual function or satisfaction. "We should, however, not grow complacent about, nor should we trivialize, the emotional and physical pain of acute cancer treatment," she writes. "However, future research on breast cancer survivorship should focus on those women who may be at increased risk for poor psychosocial outcomes: those who belong to underserved minority groups, are less well educated, are younger at diagnosis, have conflicted relationships, and are made prematurely menopausal by adjuvant chemotherapy."
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JNCI Journal of the National Cancer Institute