Friday, October 31, 2014

Impact on workplace status 3 years after radical prostatectomy

Work Status 3 years after RP
Long-term impact on workplace status after radical prostatectomy | THE "NEW" PROSTATE CANCER INFOLINK

it would be interesting to know how many men had been clearly advised about this particular issue prior to their treatment. Like all of the other things that can go wrong during treatment or become problematic post-treatment, most of us would presumably like to be clearly informed about the risks before one has surgery so that one was fully aware of the possibilities (as opposed to just learning to deal with them afterwards, with no warning that there were such possibilities). To quote the recent article by Anne Katz, a patient counselor in Canada:
… I always end our discussion with these words: “In six months time, when you are fully recovered from whatever treatment you choose, I would rather you come to my door and tell me that I scared you with my frankness, and that none of what I said ‘could happen,’ did happen, than you come to my door and ask me why I didn’t tell you about something, because if I had, your decision would have been different.”
It would also be interesting to know whether workplace-related issues were more problematic post-surgery in a country like America, where dismissal of  “underperforming” employees is relatively easy, as compared to European nations like Norway, in which it is a good deal harder to dismiss employees because of issues related to treatment for health issues.
Dahl S, Loge JH, Berge V, Dahl AA, Cvancarova M, Fosså SD (2014)
Influence of radical prostatectomy for prostate cancer on work status and working life 3 years after surgery
J Cancer Surviv (in press)
PubMed 25216609

Purpose

The purpose of this study is to study the influence of radical prostatectomy (RP) for prostate cancer on work status and working life in men 3 years after surgery.

Methods

In a prospective, questionnaire-based study on adverse effects after RP, 330 prostate cancer (PCa) patients who had been active in the workforce before RP described their
work status 3 years after having surgery. We dichotomized their postoperative work status into “unchanged or increased” versus “reduced.” The participants also reported whether their working life was influenced by the PCa trajectory to no, some, or a great extent. Univariate and multiple logistic regression models were established with sociodemographic and clinical characteristics as independent variables and “work status” or “influence of PCa trajectory on working life” as dependent variables.

Results

Twenty-five percent of the participants had retired. Of the remaining participants,
approximately 20 % had a reduced work status, which in the multivariate analyses was significantly associated with increasing age. One third of the men still active in the workforce considered the PCa to negatively influence their working life. This was independently associated with bother related to urinary leakage, fatigue, and having
undergone additional oncological therapy (pelvic radiotherapy and/or hormone treatment).

Conclusion

Though RP does not affect work status in most men, approximately one third of
them experience problems in their working life due to adverse effects related to RP and/or additional post-RP anti-cancer therapy.

Implications for Cancer Survivors

Most PCa survivors can expect to remain in the workforce for at least 3 years after RP, but for some, persistent adverse effects after RP and /or additional anti-cancer treatment negatively affect their working life. Pre-RP counseling of men within the workforce should cover possible post-RP changes concerning work status and working life.

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