VCU Massey Cancer Center researcher finds prostate cancer and its treatment can affect employment status

By Andrea Butler
Massey Cancer Center

A study led by a researcher from the Virginia Commonwealth University Massey Cancer Center is the first of its kind to examine the impact of prostate cancer on the employment status of men, shedding new light on how the physical effects of cancer and its treatment may affect their livelihoods.

The study, published in the July 6 Journal of the National Cancer Institute, found that men with prostate cancer were 10 percent less likely to be working six months after their cancer diagnosis than men without the disease, but that after 12 months, the gap in employment status closed.

However, about two-thirds of the patients who were still working said that they continued to work out of fear of losing health insurance coverage.

“The fear of losing health insurance may have encouraged some patients who otherwise would have quit or retired to keep working,” said Cathy J. Bradley, Ph.D., a health economist for the VCU Massey Cancer Center. “We saw an unemployment disparity among older, less-educated men.”  

Additionally, those still working decreased their weekly work hours by about four hours, and 43 percent of them said they were not able to work at their former capacity due to cancer treatment-related symptoms.

The study also found that men who underwent surgery were more likely to be among the unemployed six months after the diagnosis than men receiving other treatments. However, men electing hormone therapy were more likely to remain working.

“When patients and physicians make prostate cancer treatment decisions, we suggest they consider the impact on employment in addition to the clinical and quality-of-life assessments that normally factor in those decisions,” Bradley said.

As earlier-age prostate cancer screening becomes more prevalent, the profile of prostate cancer patients is likely to shift from men over age 65 to younger men who are more likely to still be in the work force. Treatments for prostate cancer can involve a number of complications, including incontinence, fatigue, or sexual dysfunction, many of which may interfere with work productivity. 

Prostate cancer treatments vary from removing the prostate by surgery, to hormone therapy, to chemotherapy—each of which may be effective but may differ in terms of side effects and medical complications. 

For the study, Bradley and colleagues tracked 267 men with prostate cancer who were employed at the start of the study. They asked the patients about their employment situation three months prior to receiving their diagnosis of cancer, and at six and 12 months after the diagnosis. They compared the results with those from two control groups of men without prostate cancer selected from U.S. Census population surveys. 

The researchers note certain limitations of the study, including the fact that all men surveyed were from the Detroit metropolitan area, which may not represent other geographic areas. The study also did not take into account treatment dosages or intensity, or use of rehabilitation services among the cancer patients—all of which could affect their ability to work.