It is ironic that at the time when cancer patients face the challenge of exuberant treatment costs, they are often at their most vulnerable in regards to their ability to generate income.
Cancer diagnosis and treatment are more than likely accompanied by physical, psychological and existential issues and this can have profound impact on the ability to continue employment.
In addition, symptoms like depression, fatigue, loss of memory and concentration and numbness and pain from nerve damage may adversely affect the ability to undertake work, especially in situations where there is little flexibility in the workplace to accommodate temporary reduced capacity. The impact of cancer on work ability is not just on the quantity but also quality of work.
It is also the non-financial benefits of employment that are affected, including sense of normality, purpose, social connection and meaning, all very valuable when recovering from cancer treatment.
Approximately half of cancer patients are younger than 65 - a time in life when employment is essential. Even as a survivor, they will have reduced ability to maintain employment and experience reduced quality of employment.
As a result, unemployment and reduced employment after a cancer diagnosis is associated with reduced financial reserves, impaired quality of life and possibly reduced survival.
The potential loss of work after cancer treatment impacts greatly those already most vulnerable: low income employees and the very young. And the high costs of cancer treatment are increasingly recognised as a significant challenge for all cancer patients and survivors.
Research needs to focus on quantifying and predicting the impact of reduced work participation on quality and quantity of survival and development of interventions to assist with meaningful work participation for cancer survivors. This would require fundamental change in how we see wellness of cancer patients and survivors and the role of the health profession in ensuring wellness.
Research and practice in this area requires collaboration with partners not traditionally engaged with healthcare professionals, such as employers and insurers. The design of future cancer clinical trials needs to take into account the impact of unemployment and financial vulnerability on quality and quantity of survival.
Currently, Australia does not have established cancer rehabilitation programs with a focus on vocational rehabilitation as these require further evidence of effectiveness and cost-effectiveness to provide justification for funding.
Referenced from CANCER FORUM, Volume 41, Number 2, July 2017. Unemployment after cancer - a hidden driver of financial toxicity. Bogda Koczwara Department of Medical Oncology, Flinders Medical Centre, Flinders Centre for Innovation in Cancer, South Australia
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