Impact of cancer on employment: A qualitative study exploring employment changes and financial coping strategies following breast cancer

Abstract

Background: Few studies have examined the impact of cancer diagnosis on employment among breast cancer patients. We aim to gain an in-depth understanding on the employment issues faced by breast cancer patients as well as their financial coping strategies in a multi-ethnic Asian setting. Methods: Six focus group discussions (FGDs) were carried out with breast cancer patients, representing various ethnicities and socioeconomic backgrounds, who were recruited from Hospital Kuala Lumpur, a public hospital, and University Malaya Medical Centre, a public academic hospital. All FGDs were audio recorded and transcribed verbatim. Thematic content analysis was carried out using the NVivo software. Results: Majority of breast cancer patients quitted their jobs upon diagnosis of breast cancer, with many describing that their bosses were not understanding in terms of their cancer diagnosis. Those who were self-employed meanwhile reported less productivity. Patterns of financial coping strategies due to employment changes were diverse. Some patients chose to do light weight part time jobs, while others described the important role of husbands and relatives in coping with income loss. There were mixed responses regarding return to work, in which money was the major reason to return to work, while stress was cited as a barrier to not return to work. However, many reported barriers in finding a job after cancer due to discrimination against their cancer and their age. Conclusion: It is evident that a breast cancer diagnosis brings about adverse impact on employment. Multidisciplinary interventions are urgently required in Malaysia to improve the employment status of our cancer survivors including legislative reforms to prevent discrimination. This study was funded by AIA Bhd. NMRR ID: NMRR-16-2054-32802