In 2012, the National Cancer Institute estimates that 226,870 women will be diagnosed with breast cancer. Data from 2005 to 2009 revealed that the average age of women diagnosed with breast cancer was 61 years. In Kentucky, nearly 3,500 women were estimated to be diagnosed with breast cancer in 2011.
As advancements in cancer screening and treatment evolve, many cancers are easier to detect, which increases long-term survival. As a leading cause of cancer in women, a breast cancer diagnosis can be extremely emotional. Breast cancer surgery, particularly a full mastectomy, is an invasive procedure resulting in short-term physical limitations and body changes. Moreover, the chemotherapy drugs used to treat breast cancer may result in hair loss, neuropathy, nausea, vomiting and residual cognitive decline, which can last up to two years post-treatment; and radiation treatment can cause skin changes, tenderness and swelling. Many women are also required to take daily medication for up to five years to help prevent a recurrence. Lastly, there are decisions about whether to undergo breast reconstruction surgery.
For many women undergoing breast cancer treatment, extreme fatigue, memory loss, anxiety, depression and physical weaknesses are common reasons for a delay in return to work. Nonetheless, with numerous women diagnosed each year who are well under the average age of retirement, it is not unusual for cancer patients to continue to work following diagnosis or to return to work post-treatment.
While previous research has generally focused on cancer survivorship and employment, there are limited studies on cancer survivorship and employment among low-wage hourly workers in particular. Employment circumstances are significantly different for lower-wage hourly workers than they are for higher-wage salaried workers. For instance, low-wage workers are less likely to have access to the employer benefits that aid employed cancer survivors. Some of these benefits include employer-sponsored health insurance, paid leave and flexible work hours. Studies have shown that women in low-wage occupations would rather miss treatment cycles than take time off from their employment or explore opportunities elsewhere for employment.
Furthermore, the cost of cancer could have a major impact on this population. Research indicates that 45 percent of working poor survivors — compared to only 6 percent of middle-income participants — suffered a financial burden from their medical costs (i.e., their medical costs amounted to more than 20 percent of their income). In addition, research has found that less than 60 percent of low-wage workers returned to work three years post-diagnosis of breast cancer. These findings differ greatly with previous studies that indicate approximately 80 percent of middle- and high-income breast cancer survivors return to work one to three years post-diagnosis.
These studies indicate that not only are low-income women vulnerable to financial burdens due to breast cancer diagnosis, but they also experience delays in return to work. Given the nature of low-wage employment, it is important to explore the experiences among low-wage women diagnosed with breast cancer.
With the growing number of breast-cancer survivors working during treatment or returning to work post-treatment, both health-care professionals and employers should recognize the work-cancer relationship and how it may affect patients’ quality of life in both the short and long term. For example, knowledge regarding the physical limitations, mental limitations and overall fatigue experienced by women following cancer treatments should be a well-understood side effect of the treatments. It is also important for employers to offer accommodations when available to help ease the employee back into the workplace. Workplace policies such as flexible schedules and employment accommodations allow the employee to return to work at a pace best for them so they are able to be as productive as possible. Additionally, women should be empowered with information about their rights as an employee.
In an attempt to expand and build upon the current literature regarding breast-cancer survivorship and employment, a research project is being conducted by Dr. Jennifer Swanberg, University of Kentucky Colleges of Social Work and Public Health and Dr. Robin Vanderpool, University of Kentucky College of Public Health. This project is working to understand the barriers that women in low-wage positions face within the workplace after a diagnosis of breast cancer. In addition, it will be instrumental in identifying and addressing solutions to share with employers throughout Kentucky.
To learn more about this study or to participate in the study, please call (859) 323-0586 and a study researcher will assist you. Participant eligibility includes: 1) women aged 18 to 65 years who were newly diagnosed with breast cancer within the last three years, 2) employed in an hourly position for at least 30 hours a week at the time of diagnosis, and earning $15 per hour or less at the time of diagnosis. Eligible participants will be asked to complete an hour-long telephone interview with a research assistant and will be compensated for their time.
Mary K. Webster is a graduate research assistant for the University of Kentucky’s Institute for Workplace Innovation. She is currently working towards her master’s degree at the UK College of Public Health, Epidemiology Department.