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Working with Advanced Cancer

Posted 1/5/2016

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  A new study from the University of Wisconsin suggests that a third of people with advanced/metastatic cancer are continuing to work. This does not surprise me at all, and I actually would have guessed that the numbers would be a little higher. 

  There is no single model of someone with Stage IV cancer. There are many kinds of cancer and many kinds of treatment, and quality of life really boils down to symptom management and overall well-being. For example, there are many women with metastatic breast cancer who are being treated with hormonal therapies; this means that they take a pill daily and often have few side effects. If there are side effects from these treatments, they are joint/muscle aches and only rarely something more dire. On the other end of the curve, there are people who are receiving chemotherapy infusions of drugs with major side effects, and some of these people are already feeling poorly from the disease itself. 

  Over the years, I have known many people who chose to keep working, sometimes on a reduced schedule, after a diagnosis of metastatic cancer. There are lots of reasons for this: needing/wanting the income, trying to maintain a sense of routine and normalcy, enjoying one's work and feeling gratification from the job and the social contacts, a version of healthy denial that allows reality in when necessary, but keeps it at bay otherwise.

  Thinking of people with whom I have talked over the last several weeks, there probably are eight or ten who have metastatic disease, but are still working. Most of them are physically well enough that they don't even have to mention their situation to anyone beyond an immediate manager (that is usually necessary because there are medical appointments). Some are experiencing treatment side effects, such as hair loss, that are visible, but don't need to share details beyond: "I am back on treatment." Some are clearly more ill, but are determined to keep up with their lives and their worlds.

  Making a decision to stop working, to go out on Disability, is really tough. It makes one's health situation very clear, and is experienced as a big loss by almost everyone. There are also the hard decisions about priorities, spending time that is more limited than anticipated, values and relationships. Certainly this is not a decision that can be generalized to everyone.

  Here is the start of a report of this study from

MADISON, Wis., Dec. 21 (UPI) -- Regardless of what kind of cancer patients have or how it is treated,
management of symptoms significantly influenced metastatic cancer patients' decision to continue
Researchers in a study at the University of Wisconsin found more than one-third of people with metastatic
cancer continued to work. They said a focus on controlling symptoms could help continue to improve the
number of people who keep living their normal lives while battling cancer, based on the study.
"For patients with metastatic cancer, a great deal of attention is focused on the events surrounding initial
diagnosis of disease and the issues surrounding the end-of-life," said Dr. Amye Tevaarwerk, a researcher
at the University of Wisconsin-Madison, in a press release. "Between cancer recurrence and the end- ,
these patients are living their lives day-to-day and there are a number of unique survivorship issues
during this time that have been overlooked by researchers,"
The researchers surveyed 668 working-age metastatic cancer patients, finding 35 percent worked full- or
part-time and 45 percent stopped working due to cancer. Overall, 58 percent said their illness had caused
some change in employment.

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