Type of cancer treatment and cognitive symptoms in working cancer survivors: an 18-month follow-up study

Johanna K Ehrenstein,Saskia F A Duijts,Boukje A C Van Dijk,Heleen F Dorland,Sander K R Van Zon,Ute Bültmann,Sanne B Schagen

doi:10.1007/s11764-019-00839-w

Abstract

PurposeCognitive symptoms are reported to affect cancer survivors’ functioning at work. However, little is known about the type of cancer treatment and cognitive symptoms in working cancer survivors. We examined the longitudinal association between type of cancer treatment and cognitive symptoms in cancer survivors post return to work, and whether the course of cognitive symptoms over 18 months differed per type of cancer treatment.MethodsData from the Dutch longitudinal “Work-Life after Cancer” study were used. The study population consisted of 330 working cancer survivors who completed questionnaires at baseline, and 6, 12, and 18 months follow-up. Cognitive symptoms were assessed with the cognitive symptom checklist-work and linked with cancer treatment data from the Netherlands Cancer Registry. Data were analyzed using generalized estimating equations.ResultsCancer survivors who received chemotherapy reported comparable memory symptom levels (b: − 2.3; 95% CI = − 7.1, 2.5) to those receiving locoregional treatment. Executive function symptom levels (b: − 4.1; 95% CI = − 7.8, − 0.4) were significantly lower for cancer survivors who received chemotherapy, compared with those receiving locoregional treatment. In cancer survivors who received other systemic therapy, memory (b: 0.4; 95% CI = 0.1, 0.7) and executive function symptom levels (b: 0.4; 95% CI = 0.0, 0.7) increased over time. In cancer survivors who received chemotherapy and locoregional treatment, memory and executive function symptom scores were persistent during the first 18 months after return to work.ConclusionsThe contradictory finding that cancer patients receiving chemotherapy report fewer cognitive symptoms warrants further research.Implications for Cancer SurvivorsWorking cancer survivors may have cognitive symptom management needs irrespective of the type of cancer treatment they received.

Highlights

Worldwide, 40–50% of all newly diagnosed cancer survivors are of working age and potentially part of the labor force [1, 2]
In the current study, we aimed to assess: [1] the longitudinal associations between type of cancer treatment and selfreported cognitive symptoms in working cancer survivors, and [2] to assess whether the course of cognitive symptoms over 18 months post return to work differed per treatment group
Fourteen different types of cancer were identified in the participating survivors (Table 2)

Summary

Introduction

40–50% of all newly diagnosed cancer survivors are of working age and potentially part of the labor force [1, 2]. Despite advances in early detection and cancer treatment for cancer survivors of working age, cancer and its treatment can still result in a wide range of long-term physical and psychological problems, including fatigue, depression, and cognitive symptoms [4, 5]. The findings of an integrative review suggest that cognitive symptoms are an essential factor for work ability, return to work, and work performance [6]. A recent cross-sectional study demonstrated that cognitive symptoms at work were associated with lower levels of quality, quantity, and timeliness of completed work among breast cancer survivors [7]. The cognitive domains most likely to be negatively impacted are working memory and executive function [10]. Optimal cognitive functioning is required in many nonmanual (e.g., office work), and in manual (e.g., construction work) occupations [12]

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Results

Conclusion