Hot flashes, fatigue, treatment exposures and work productivity in breast cancer survivors
While fatigue has been associated with work limitations the combined influence of specific diagnosis and treatment exposures based on medical records on work limitations in breast cancer survivors is currently unknown. Since symptom burden and perceived health can interfere with work, the present study investigated the relationship among these variables and work outcomes.
Medical chart abstraction, demographic measures, SF 36, the Work Limitations Questionnaire (WLQ) and measures of symptom burden, including hot flushes were obtained in 83 breast cancer survivors a mean of three years post treatment. OLS and poisson regression were used to determine the relationship of these factors to work productivity and work absences.
Breast cancer survivors reported a mean reduction in productivity of 3.1% below the healthy worker norm. This amounts to a loss of 2.48 hours of work over two weeks of full time employment. Stages 1 and 2 were related to work limitations. After controlling for stage, fatigue and hot flashes were each associated with work performance losses of 1.6% (p = 0.05) and 2.2% (p < 0.001), respectively. Protective factors included marriage and greater personal earned income.
Fatigue and hot flashes are important factors related to work productivity in breast cancer survivors even at three years post treatment.
Implications for survivors
Therapy for hot flashes should be given serious consideration in breast cancer survivors who are experiencing work limitations.
KeywordsBreast Employment Productivity Fatigue Hot flashes Cancer
- 1.American Cancer Society. Breast cancer facts and figures, 2007–2008. Atlanta: American Cancer Society, Inc.Google Scholar
- 11.Mar Fan HG, Houede-Tchen N, Yi QL, Chemerynsky I, Fownie FP, Sabate K, et al. Fatigue, menopausal symptoms, and cognitive function in women after adjuvant chemotherapy for breast cancer: 1 and 2-year follow-up of a prospective controlled study. J Clin Oncol 2005; 23:8025–32.Google Scholar
- 12.Schagen SB, van Dam FS, Muller MJ, Boogerd W, Lindeboom J, Bruning PF. Cognitive deficits after postoperative adjuvant chemotherapy for breast carcinoma. Cancer 1999;85:640–50. doi:10.1002/(SICI)1097-0142(19990201)85:3<640:AID-CNCR14>3.0.CO;2-G.PubMedCrossRefGoogle Scholar
- 16.Bonadonna G, Hortobagyi GN, Gianni AM. Textbook of breast cancer: a clinical guide to therapy. London: Martin Dunitz; 2001.Google Scholar
- 28.Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 health survey: manual and interpretation guide. Boston: The Health Institute; 1993.Google Scholar
- 32.US Census Bureau.American Community Survey. 2006 Table for the Rochester, New York Metropolitan Area. Last accessed online on August 28, 2008 at: http://factfinder.census.gov.
- 34.US Food and Drug Administration Alert. January 31, 2008. Suicidality and Antiepileptic Drugs. Last accessed on-line on June 27, 2008 at: http://www.fda.gov/cder/drig/infopage/antiepileptics/default.htm.