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.
背景：癌症幸存者在治疗后常出现一系列影响生活质量的症状，这些症状可能以集群形式共存。本研究旨在探讨症状及症状群如何影响癌症幸存者的工作能力。方法：我们采用癌症幸存者门诊常规收集的症状严重程度与工作能力数据，这些患者均已完成以治愈为目的的初始治疗。通过单连接聚类法及重标距离阈值<10的标准界定症状群，并采用逻辑回归分析症状及症状群与工作能力的关联性。结果：研究纳入561名平均年龄58岁、确诊后1.5年的癌症幸存者，病种包括乳腺癌（40.5%）、结直肠癌（32.3%）和血液系统恶性肿瘤（15.3%）。34.9%的参与者报告工作能力受限。经历疼痛、情绪及认知症状群的患者报告工作能力受限的概率增加14-17%。年龄较大及疾病分期较高的幸存者更易出现工作能力受限。结论：加强对症状严重程度及症状群的认知与管理，或有助于提升存在症状困扰的癌症幸存者群体治疗后重返工作岗位的比例。
Symptom Clusters in Survivorship and Their Impact on Ability to Work among Cancer Survivors
肿瘤(癌症)患者之家