Working women who survive breast cancer are far more likely to lose their jobs


#1

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#2

i wonder what the numbers are like for men who have cancer


#3

Paragraph 1: "A new study shows that working women with breast cancer who receive chemotherapy and live for four or more years after treatment are 30% more likely to lose their jobs within those first four years of survival"

CBS Summary: "Researchers at the University of Michigan Health System found that 30 percent of women who had jobs when they began treatment for breast cancer were unemployed four years later. "

These two sentences say completely different things. The first states that it is a comparison, while the second is an absolute rate. The key to the comparison is how many women who weren't diagnosed with breast cancer were unemployed four years later. If that number is also 30%, effect due to cancer/chemo would be zero.


#4

I don't know enough about this, but can you speak to the line

"particularly when the expected benefit is low."

If the expected benefit for (most?) patients of adjuvant chemotherapy is indeed very low, then it seems to me that the effect on a person's later ability to work should be taken into account by a patient.

I assume it's almost impossible for anyone to rationally consider odds in a situation like this, so most people probably think anything that might improve the chance of survival is a good thing. But, like the changes in screening recommendations, it does seem as if chasing after tiny improvements in prognosis is not always the best thing to do.

(I may not be understanding Xeni's take on this, natch.)


#7

I'd expect it to vary wildly, depending on the cancer and when it's detected. I've known guys with prostate cancer (detected early) who have taken medical leaves of a couple of weeks and then been back at it, and they very likely suffered little in terms of professional circumstances. Something later or less easily treatable? Could cause problems. It's an interesting question (assuming the question is if men fare better than women), but I think it would be tough to find groups that you could reasonably compare, given that men and women can be afflicted with different kinds of cancers with different prognoses. Those are big variables.


#8

It's true that the article doesn't actually mention the difference in employment rates for cancer survivors vs non-cancer survivors.

Headline and first sentence aside, Xeni's post was more about the effects of adjuvant chemo, and the article does address that: patients who had had the chemo were 1.4 times more likely to be unemployed.


#9

I call into question that "1.4 times as like" number, as well. There is no mention of the analytical methods used, or anything really that would give it critical merit. All they did was name drop a big medical college. It is trivially easy to invent numbers like this using bad statistical methodologies. This article also makes no mention of comparable research that may or may not show other diseases are better or worse for unemployment rates.

I'd wager that advanced cases Lyme disease are far worse on survivors' unemployment rate, due to irreversible cognitive decline. This smacks of a pity party article devoid of any real perspective on the matter; it's just yanking numbers out of the abstract of the report.

Not that I'm surprised. It's pretty obvious this was published by CBS to generate page views, not discussion.

Edited to add in context due to OP deleting his post.


#10

Wait: the current unemployment rate is 30%?

Of course not. Not even close. You're exaggerating to make it seem like it's no big deal that working women who are chemo survivors have a greater chance than the norm (whatever that norm is) of losing their jobs as a result of treatment.

But yes, I would like to see the compare-&-contrast with working men going through chemo as well. We might find out the numbers are even starker. Or we might find out that employers really are that mercenary toward everyone.


#11

It is not the 28th of April issue. That's is the date of online publication.(there is no april 28th issue)
http://onlinelibrary.wiley.com/doi/10.1002/cncr.28607/full


#13

It's neither pedantic nor minimizing to point out that one's a comparison and one's a actual value. The true value and the comparisons (especially when you figure out what that comparison is against) contain important information.

Yes, obviously the unemployment rate isn't 30%. But I don't think Jerry meant to "exaggerating to make it seem like it's no big deal," rather than give a quick, clean example of why it's important to watch how you present numbers. Attacking Jerry misses the point and assumes a motivation and mindset not clear from his post.


#14

And of those looking at the numbers - here are the numbers from the abstract (I don't have access to full article)
http://onlinelibrary.wiley.com/doi/10.1002/cncr.28607/abstract

RESULTS
Of the 1026 patients aged < 65 years at the time of diagnosis whose breast cancer did not recur and who responded to both surveys, 746 (76%) worked for pay before diagnosis. Of these, 236 (30%) were no longer working at the time of the follow-up survey. Women who received chemotherapy as part of their initial treatment were less likely to be working at the time of the follow-up survey (38% vs 27%; P = .003). Chemotherapy receipt at the time of diagnosis (odds ratio, 1.4; P = .04) was found to be independently associated with unemployment during survivorship in a multivariable model. Many women who were not employed during the survivorship period wanted to work: 50% reported that it was important for them to work and 31% were actively seeking work.


#15

Wait, this article is very confusing. It seems to be implying that the usual course of action for a company when one of their production units workers isn't meeting their quota being "productive" isn't to simply fire them on the spot. I've always been under the impression that if I am not in perfect body or mind 24/7/365 (because being a junior level programmer also means you have to be on-call, all the time), I'm out on the street and on my ass, and that "job security" is something that only upper management and C-levels can hope to ever have even faint dreams or aspirations of.

This isn't the case? People are actually entitled to "job security" at some point in their life? I can catch influenza one year, and if I'm too sick to get out of bed and coughing up blood, I wont have my immune system become a liability that would get me fired/laid off/downsized on the spot for failing to meet my daily quota? I can ask for a raise after working for fifteen years at minimum wage and not have my job eliminated through a Temporary Foreign Worker program? I can turn off my phone for a quiet night with my significant other and not turn up to work the next day to find my desk and workplace possessions ejected from the nearest window, splattered on the ground in a million splinters, with a bill attached for damages and a pink slip stapled to it?

Wow. What a wondrous world we live in. I had no idea that the plutocrats captains of industry were so charitable!


#16

Would be interesting to see the study done on a non-US population.


#18

Even "beating" cancer (or leukemia), you're at a high risk to get cancer in the future. This article gives an excellent overview of what that means:

How I lost my health insurance at the hairstylist's
http://www.dailykos.com/storyonly/2009/7/7/223249/7838

If you worked for a company that offered insurance, if you carried your family’s insurance, next year your insurer would slap a million dollar surcharge on the company policy for carrying a leukemia patient. The company would get the bill and someone in accounting would question "what is this extra million dollars we are being billed?"

The insurance company would explain to them that the million is for you, and it is yearly, but is, ahem, "fixable." They will say "as long as she is on your insurance (wink, wink) this charge will be there. So what you have to ask yourself (more wink, wink) is whether this employee is worth a million dollar a year salary on top of what you are already paying her."

Social worker said she had seen small business owners go almost broke trying to cover this charge, and had even heard of one who defiantly did go broke, throwing all of the employees out of work. But more usually, she said, they just fire you.


#19

"I'd wager testicular cancer, which is just as prevalent as breast
cancer, is probably just as bad for employment prospects. *Not that I
have proof, but this article did nothing to provide that either*."

Shorter version: O NOEZ AN ARTICLE THAT ONLY IS ABOUT WIMMINZ! WHAT ABOUT TEH MENZ? I mean, I don't have any actual numbers or anything but because they mention BOOBIES I get to mention TESTICLES!

Seriously, this article makes me mad. Most women who are diagnosed with breast cancer are already older to begin with and are starting to look disposable in today's market. OTOH I have seen many cases where men who had prostate surgery are ENCOURAGED to go back to work, rally, and "bounce back" much to the cheers of all--my own Dad included. Sick woman=go the fuck away, we don't want to know about it, go knit socks for your grandkids. Sick man=beat that cancer, bro! Get back in the game! Show the world how virile you still are....


#20

If you don't like the way she writes, then why do you read her blog?


#21

Honest question: why bother to say this when you clearly didn't read the journal article in question?

What is wrong with you? You have some bizarre bone to pick, and now you're simply spouting nonsense to try and hold up your point.

It was a fair point (made by someone else) to clarify and correct the use of "30%." The rest of this is just weird.


#22
  1. Source has been there the whole time, at the bottom of Xeni's post.
  2. The abstract is more than enough to counter the claim that "there is no mention of the analytical methods used, or anything really that would give it critical merit." And even if you didn't have the original article, the burden of proof would have been on you to show that they are "inventing numbers" as you said. Your statement was based on nothing other than your dislike of the story.
  3. You are being completely unreasonable when you feel the need to simply decide that a study is making up statistics, and that a cancer-surviving journalist has a "blatant bias" towards writing about cancer. No, huh, she isn't writing about Lyme disease as much. We got that. Write your own articles about Lyme disease.

Cool off, re-read your posts and understand why you're coming off as a jerk.

There is an implication here that somehow breast cancer survivors should be deferred for special treatment by employers.

Really and honestly, step back a moment. The article wasn't about that. It was about the awful calculus that a person needs to make when deciding whether to have additional treatment (adjuvant chemotherapy) which may improve their chance of surviving, but will also make them less likely to remain employed. Re-read Xeni's article again in this light, and you'll see that you got completely the wrong end of the stick.


#23

In veterenary medicine, its the animal's owners that are the real client, the patient on the table isn't considered to have a stake in the outcome. Which kind of health care do we have in this country again? I can never be sure.


#24

Um, not a whole lot more messed up than health care in the US in general?