Investigation on the working status and inhibiting factors during cancer treatment in advanced NSCLC patients

Abstract

Abstract Introduction Development of cancer treatment such as targeted drugs and anti-PD-1 inhibitors resulted in the prolongation of survival time in advanced NSCLC, although the prognosis of advanced NSCLC is not enough. Therefore, working during cancer treatment can be important for not only reducing financial burden, but also maintaining the quality of life in advanced NSCLC. Patients and Methods We performed questionnaire survey about patients characteristics, performance status (PS), physical symptoms, working status, and income, and reason of resignation in 100 advanced NSCLC patients at Aichi Cancer Center hospital, and received the answer from 66 patients. Results Median age of patients was 57 (range: 20-77). Fifty-seven (86%) patients were male, and 9 (14%) female. Twenty patients (30%) were PS0, 41 (62%) PS1, and 3 (5%) PS3 and 2 not evaluable. As job status, 39 (59%) patients were regular employee, 16 (24%) self-employed and 11 (17%) others. At the time of survey, 33 (50%) patients were working, 14 (21%) absent, and 14 (21%) resigned. After the initiation of cancer treatment, income decreased in 38 (58%) patients, and did not change in 20 (30%) patients. Regarding physical symptoms, 55 (83%) patients had fatigue, 44 (66%) dyspnea. Physical symptons and cancer treatment prevented 51 (78%) patients from working. Patients who were absent or resigned from work (resignation group: RG) were significantly poorer PS (≥1) with those who were working (working group: WG) (PS: p = 0.002). In RG, the resignation time was at the time diagnosis in 36 (55%) % of patients. The reasons of resignation was the expectation of physical burden after cancer treatment such as chemotherapy in 43% (65%) of patients. In contrast, 48 (74%) of patients wished to continue working during cancer treatment. Conclusion Patients who were absent and resigned from working were associated with PS and physical symptoms in advanced NSCLC.