Symptom Clusters in Survivorship and Their Impact on Ability to Work among Cancer Survivors

SIMPLE SUMMARY: Lasting impacts and symptoms of cancer treatment can affect survivors’ daily lives. We explored how symptoms and symptom clusters can impact the ability to work among 561 cancer survivors previously diagnosed with breast, colorectal, and haematological malignancies, who were on average 58 years old and 1.5 years since diagnosis. We found almost 35% of survivors reported limitations in their ability to work. We identified three main symptom clusters: pain, emotional, and cognitive symptoms. Survivors experiencing these symptom clusters were approximately 14–17% more likely to report limitations in their work ability. Older survivors and those with more advanced cancer stages were also more likely to experience limitations in their work ability. In conclusion, a significant number of cancer survivors struggle to work due to their symptoms after treatment. Out results suggest that by better understanding and managing these symptoms, survivors can have improved opportunities to participate in work after their cancer treatment. ABSTRACT: Background: Cancer survivors often experience a range of symptoms after treatment which can impact their quality of life. Symptoms may cluster or co-occur. We aimed to investigate how symptoms and symptom clusters impact the ability to work among cancer survivors. Methods: We used symptom severity data and ability to work data routinely collected from cancer survivors attending a survivorship clinic after primary treatment with curative intent. We defined symptom clusters using single linkage and a threshold on the rescaled distances of <10. We then conducted a logistic regression to examine how symptoms and symptom clusters were related to the ability to work. Results: We analysed data from 561 cancer survivors, mean age 58 years and 1.5 years post diagnosis, with mixed diagnoses including breast (40.5%), colorectal (32.3%), and haematological cancers (15.3%). Limitations to work ability were reported by 34.9% of participants. Survivors experiencing pain, emotional, and cognitive symptom clusters were 14–17% more likely to report limitations in their ability to work. Older survivors and those with a higher stage disease were more likely to report limitations in their ability to work. Conclusion: A better understanding and management of symptom severity and symptom clusters may help the sizable proportion of cancer survivors experiencing symptoms to participate in work after treatment.