Abstract
A significant proportion of individuals undergoing treatment for lymphoma are of working age and are in employment prior to diagnosis and during subsequent chemotherapy treatment.
This small-scale study seeks to explore the impact that chemotherapy treatments have on employment. Specifically, the reasons for the decision to continue to work or not, and any perceived benefits or disadvantages encountered as a result are explored.
Methods:
All individuals presenting with newly diagnosed lymphoma, over a 12 month period, were identified retrospectively. Individuals of official working age, and who were receiving out-patient chemotherapy (i.e. who had the ability to be working at the time) were invited to participate.
Participants were asked to complete a questionnaire that was designed to explore their experiences of employment during this time.
Results:
A total of 33 patients were invited to participate. A return rate of 70% was achieved.
Of those who responded, 5 (22%) had already retired prior to diagnosis.
A total of 12 patients (52%) continued to work during their chemotherapy treatment. Of these, 6 (50%) continued to work the same hours in the same conditions, whereas 6 (50%) worked an altered or flexible pattern.
6 patients (26%) stopped working for the duration of treatment, one of whom has not returned since.
There were no obvious differences in patients with Hodgkin’s Lymphoma as opposed to Non-Hodgkin’s Lymphoma.
The response rate was much higher in those who had received intravenous chemotherapy than oral preparations, preventing analysis of any potential variation in experiences.
The qualitative data obtained gives a clearer insight into the many issues faced by the patient when undergoing chemotherapy treatment.
Familiar themes were identified in many cases, and these were grouped into 5 main theme categories:
Diversion from the reality of diagnosis and treatment Psychological Issues Issues of retained normality Practical Issues Physical or medical issues.
Difficulty in coping with the side-effects of treatment, particularly fatigue, were commonly cited. Emotional effects such as stress and anxiety were also alluded to.
Despite this, those who continued to work reported benefit from retaining a normal lifestyle, gained support from co-workers and experienced a diversion of focus from treatment.
Several of those who continued to work cited financial reasons for this decision.
Feedback suggested that advice given by the health-care team was often lacking or inconsistent. This did not reflect our perception of current practice, so it may suggest that it is the way that information is given that is ineffective.
Conclusion:
The majority of patients continued to work during their treatment and there appear to be many benefits to this. Difficulties encountered related mainly to treatment side-effects, logistical and practical problems associated with undergoing chemotherapy.
It is envisaged that a greater understanding of the impact that lymphoma and its treatment has on employment may improve the level of support that can be offered by the multi-disciplinary team.
The curative nature of many Lymphomas demands that long-term complications of the disease and treatment are fully addressed at the time of diagnosis. Social, economic and employment welfare are integral aspects to be considered, especially in a group of individuals who are likely to be long-term survivors.
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