Working after cancer: in-depth perspectives from a setting with limited employment protection policies

Abstract

Purpose

A considerable proportion of individuals who are diagnosed with cancer are at a working age. We aimed to gain an in-depth understanding of the challenges, and arising needs related to working after cancer in a setting with limited employment protection policies.

Methods

Focus group discussions were conducted with cancer patients who were diagnosed at least 1 year prior to recruitment, and either had paid work, were self-employed, currently unemployed, or currently retired (N = 66).

Results

Three main themes were identified: (1) loss of income: While some participants were entitled for a 1-year cancer-specific sick leave, many other participants recounted having insufficient paid sick leave, forcing them to take prolonged unpaid leave to complete treatment; (2) dealing with side effects of cancer and its treatment: The need for workplace accommodations was highlighted including flexible working hours, lighter workloads, and dedicated rest areas to enable patients to cope better; (3) Discrimination and stigma at workplace: Some participants mentioned being passed over on a promotion, getting demoted, or being forced to resign once their cancer diagnosis was disclosed, highlighting an urgent need to destigmatize cancer in the workplace.

Conclusion

In settings with limited employment protection policies, a cancer diagnosis severely impacts the working experiences of patients, leading to financial loss. Urgent interventions and legislative reforms are needed in these settings to address the unmet employment needs of cancer survivors.

Implications for Cancer Survivors

This study may facilitate planning of local solutions to fulfill the unmet employment needs following cancer, such as return-to-work navigation services.

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Funding

This study was supported through an unrestricted educational grant from PhAMA (Pharmaceutical Association of Malaysia).

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Affiliations

Authors

Contributions

Yek-Ching Kong: conceptualization, data curation, formal analysis, data interpretation, and writing—review and editing. Negina Rauf: formal analysis, data interpretation, and writing—review and editing. Shridevi Subramaniam: data curation and writing—review and editing. Ros Suzanna Bustamam: data curation and writing—review and editing. Li-Ping Wong: formal analysis, data interpretation, and writing—review and editing. Gwo-Fuang Ho: data curation and writing—review and editing. Hafizah Zaharah: data curation and writing—review and editing. Matin Mellor: data curation and writing—review and editing. Cheng-Har Yip: data curation and writing—review and editing. Nirmala Bhoo-Pathy: conceptualization, funding acquisition, formal analysis, data interpretation, and writing—review and editing.

Corresponding author

Correspondence to Nirmala Bhoo-Pathy.

Ethics declarations

Ethical approvals were obtained from the Medical Research and Ethics Committee (NMRR-16-2054-32802), University Malaya Medical Centre Medical Ethics Committee (2016105-4324), and Subang Jaya Medical Centre (201711.2).

Conflict of interest

The authors declare that they have no conflicts of interest.

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The funder had no role in the design of the study, data collection and analysis, preparation of the manuscript, or decision to publish.

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Kong, YC., Rauf, N., Subramaniam, S. et al. Working after cancer: in-depth perspectives from a setting with limited employment protection policies. J Cancer Surviv (2020). https://doi.org/10.1007/s11764-020-00962-z

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Keywords

  • Cancer
  • Survivorship
  • Supportive care
  • Return to work
  • Employment