"Armed with this information, patients can more effectively plan for extended periods of nonemployment with the optimism that they are likely to be able to return to work 1 year after diagnosis," write the authors. "We suggest that the impact of cancer and its treatment on employment be considered alongside clinical and quality-of-life assessments when patients and physicians make prostate cancer treatment decisions," they conclude.
The authors acknowledge several limitations of the study, including the fact that all men surveyed were from the Detroit, Mich., metropolitan area, which may not represent other geographic areas. The study also did not take into account treatment dosages or intensity, or use of rehabilitation services among the cancer patients--all of which could affect work ability.
In an accompanying editorial, James A. Talcott, M.D., of the Center for Outcomes Research at Massachusetts General Hospital in Boston, discusses the implications of the research for helping doctors and patients select a course of treatment. Prostate cancer treatments vary from removing the prostate by surgery, to hormone therapy, to chemotherapy--each of which may be effective but may differ in terms of side effects and medical complications. "It would not be surprising if some men found the likely impact on future employment decisive in choosing a treatment," he writes. Indeed, the study found that men who underwent surgery were more likely to be among the unemployed 6 months after the diagnosis than men receiving other treatments, whereas those who elected hormone therapy were more likely to remain working, although the reasons for this difference were not examined.