In the course of her research studying employment and cancer, Cathy J. Bradley, PhD, MPA, deputy director of the University of Colorado Cancer Center, has heard from people diagnosed with cancer who would skip a chemotherapy treatment rather than skip work and risk losing their job.
She has heard from breast cancer survivors who worked more hours after returning to the workforce than they did before treatment, because they needed to keep their health insurance. And she has heard that while treatments may attack the tumor, the impact of cancer can continue for the rest of a person’s life.
Bradley will focus on these and the financial impacts of cancer as keynote speaker at “Cancer, Work & Employment,” an international scientific conference Nov. 21-22 in Paris, France, hosted by the French National Cancer Institute. This presentation follows one she gave at ONCOLille Days Nov. 2-4 in Lille, France, focusing on the economic consequences of cancer.
“When we think about a person’s full life cycle, treating cancer shouldn’t just be focused on making tumors smaller,” Bradley says. “It impacts the whole person, not just the collection of cells.”
Treating the whole person
Bradley’s two recent invitations to speak at international conferences highlight the ongoing and growing shift in cancer treatment toward multidisciplinary care that includes economists and psychologists alongside oncologists.
“We’re seeing incredible research and development in treatments for cancer, but they’re coming on the market at more than $100,000,” Bradley says. “They may have promise for patients in treating the tumor, but many people can’t afford them, or can’t afford the co-pays, or start these drugs and then stop because the costs are so high. When these drugs are developed, the endpoint is generally progression-free survival, not really considering the fact that the treatment is so expensive that people may decide it’s not worth bankruptcy.”
Further, Bradley says, cancer drug development and clinical trials don’t usually account for how treatments will affect a person’s ability to work. “If treatment saves someone’s life but gives them peripheral neuropathy, for example, and they can no longer do their job, in this country that means they no longer get health insurance,” Bradley says. “At that point, the patient’s access to all care, not just cancer care, is severely restricted.”
A significant portion of Bradley’s research has focused on the nexus between cancer and economics, and has drawn results indicating the need to treat the whole person and not just the tumor.
Presenting to audiences from outside the United States is an interesting opportunity to gain perspective on cancer treatment in the U.S. and contrast it with health care systems and methodologies around the world, Bradley says.
“For a lot of people from outside the U.S., it’s unfathomable that a person would have to make a choice between continuing to work and receiving cancer treatment,” she says. “Medical bankruptcy is a serious problem in the U.S. and cancer is the leading cause. We know that 60% of all cancer survivors in this country are employed after their diagnosis and treatment, and many continue to work because they need the health insurance.”
She adds that fewer than a third of cancer patients discuss what they do for a living with their oncology care team, making it more difficult to provide holistic care that takes into consideration how treatment may affect livelihood.
“We have better detection methods now, better screening, so younger and younger people are being diagnosed with cancer, people who may be a long way from retirement,” Bradley says. “We’re approaching 20 million cancer survivors in the U.S., so it’s important we collaborate with our international colleagues. In the U.S. we’re focused on innovation and bringing drugs to market, but in Europe there’s a strong interest in keeping people working and the long-term consequences of cancer, so there’s a lot we can learn.”