Unemployment due to brain or spine cancer is linked to more pain and depression

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 in the February 8, 2023, online issue of 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 study author Heather Leeper, MD, MS, of the University of Chicago, a member of the American Academy of Neurology and previously of the National Cancer Institute's Center for Cancer Research in Bethesda, Maryland, where the study was conducted.

"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 primary central nervous system tumors, which are caused when abnormal cells form in the tissues of the brain or spinal cord. Participants had an average age of 45.

The 200 people who were employed either full-time, part-time, or self-employed were compared to 77 people who were unemployed. Participants were given assessments of their symptoms and how they affected their daily lives.

One assessment measured the impact of illness or treatment on physical, mental, social, and emotional functioning within a person's overall quality of life. Questions included items asking whether they had issues walking, dressing themselves, and performing usual activities, as well as what level of pain or discomfort and anxiety or depression they experienced.

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.

Researchers found that Hispanic people were more than twice as likely to be unemployed than others.

When looking specifically at people with brain tumors, unemployed people reported on average three more symptoms as moderate-to-severe than employed people did.

Researchers also found that people who had an annual household income of less than $25,000 were more likely to be unemployed than employed. Conversely, they found participants with brain tumors who had an annual household income of more than $150,000 were more likely to be employed than unemployed.

"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 added. "It is important that people be screened for these 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."

The study was a snapshot in time and did not look at changes over time in symptoms or employment. Another limitation of the study was that participants reported their own symptoms and may not have remembered events correctly.

The study analyzed data collected as part of the Neuro-Oncology Branch Natural History study.