Patients with brain and spine cancer suffer more symptoms when unemployed

Mid adult woman in isolation at home during COVID-19

People who are unemployed due to brain or spine cancer may experience more severe symptoms of pain, discomfort, anxiety and depression than people with these cancers who are employed, according to a study published February 8 in Neurology.

“The financial consequences of receiving a cancer diagnosis can be great and affect a person’s ability to keep their job and access health insurance,” said first author Heather Leeper, MD, Assistant Professor of Medicine at the University of Chicago Medicine. “This is especially true for people of working age who may have fewer financial resources than older adults who are retired and qualify for Medicare.

"Our research found that being unemployed due to brain and spine cancer is strongly linked with more symptoms, more difficulty being able to perform daily tasks, reduced quality of life, as well as psychological distress, which may affect a person’s ability to return to work.”

The study involved 277 people, with an average age of 45, with primary central nervous system tumors., with an average age of 45. Two hundred were employed either full-time, part-time, or self-employed and compared to 77 people who were unemployed. Participants were asked to assess their symptoms and their impact on their daily lives.

One survey measured the impact of illness or treatment on physical, mental, social and emotional functioning within a person’s overall quality of life. The individuals recorded issues with walking, dressing and performing usual activities, as well as levels of pain, discofort or anxiety.

Researchers found 25% of unemployed people reported moderate-to-severe depression symptoms compared to 8% of employed people. For anxiety, 30% of those unemployed reported moderate-to-severe anxiety symptoms compared to 15% of those employed.

In rating pain or discomfort, 13% of unemployed people reported the highest level of pain or discomfort compared to 4% of employed.

Those who were unemployed reported more problems with performing daily activities such as walking, washing, dressing and a reduced quality of life. When looking specifically at people with brain tumors, unemployed people reported on average three more symptoms as moderate-to-severe than employed people did.

Race and socioeconomic status may also play a role. The team found that Hispanic people were more than twice as likely to be unemployed than others. In addition, people with an annual household income of less than $25,000 were more likely to be unemployed than employed. Conversely, participants with brain tumors with an annual household income of more than $150,000 were more likely to be employed.

The study was a snapshot in time and did not review changes over time in symptoms or employment. Another limitation of the study was that it relied on participants' reports of their own symptoms, which are subjective and can be affected by other experiences and factors.

Still, the researchers say, the results highlight the importance of understanding the pressures faced by cancer patients and their families.

“Unemployment including a lack of health insurance and reduced earnings can lead to even more physical and psychological problems for people living with these brain and spine cancers,” Leeper said.“It is important that people be screened for financial issues that can affect their cancer journey and that programs be developed to help minimize their impacts such as creating return-to-work programs or other forms of financial assistance.”

This story was originally posted by the American Academy of Neurology.

Heather Leeper

Heather Leeper, MD

Heather Leeper, MD is an Assistant Professor of Medicine at UChicago Medicine.

Learn more about Dr. Leeper