Careers of Young Survivors Can be Disrupted by Late-Emerging Side Effects of Cancer Treatment

Side effects that arise months or years after adolescents and young adults (AYAs) have completed cancer treatment — known as late effects — can significantly affect both careers and quality of life in this population, according to two studies presented at the 2017 European Society for Medical Oncology Congress in Madrid, Spain, on Sept. 9.

The NOR-CAYAS study examined the work capacity of patients who had been diagnosed between the ages of 19 and 39. The study followed 1,198 patients after their treatment for melanoma, colorectal cancer, breast cancer, non-Hodgkin lymphoma or leukemia. The median age of participants at the time of the survey was 49, and the median amount of years since treatment was 13.

Sixty percent of survivors questioned held a full-time job. Authors found that those less likely to have full-time jobs were women with a low level of education, lymphedema, fatigue, depression and/or reduced physical quality of life or self-reported health.

“We found that psychological and physical late effects of cancer and other conditions were significantly associated with reduced work ability,” said lead author Cecilie Kiserud, M.D., Ph.D., chair of the National Advisory Unit for Late Effects After Cancer Treatment at Oslo University Hospital, in Oslo, Norway. “In comparison, treatment intensity and cancer type, apart from non-Hodgkin lymphoma, were not significantly related to work ability.”

Kiserud went on to emphasize that more awareness is needed regarding the fact that people in this population may be less able to work after cancer treatment due to late effects.

But the late effects of cancer treatment did not only affect AYA survivors in the workplace.

Another study presented at ESMO found that, in Europe, 67 percent of 266 health care professionals who were treating AYA patients did not have access to a center specializing in the needs of people in this age group to manage their late effects. Further, 69 percent reported that they were not aware of any research being conducted in their countries that focused on the AYA population.

Thirty-eight percent of health care professionals surveyed said that their patients did not have access to fertility specialists, and within Eastern Europe, that number jumped to 76 percent.

One important aspect to note, though, was that most of the physicians involved were able to refer their AYA patients for psychosocial support.

“These patients have specific needs that are not covered by pediatric or general oncology centers or classical medical oncology centers, and this survey shows that most do not have access to the recommended special care. Countries without these services can look at existing examples — such as in the U.K. and France — to build teams equipped to improve survival and survivorship for adolescents and young adults with cancer,” said lead author Emmanouil Saloustros, M.D., a consultant medical oncologist at the General Hospital of Heraklion “Venizelio,” in Heraklion, Crete, Greece.