The Employment and Insurance Concerns of Cancer Survivors

  • Barbara Hoffman


The employment and insurance concerns of cancer survivors have changed dramatically during the past generation. In the 1970s, fewer than one-half of those diagnosed with cancer survived more than 5 years. Treatment options were few, often disabling, and commonly ineffective. Myths about cancer prevailed. Consequently, many survivors experienced substantial problems obtaining and retaining employment and adequate health insurance.


Health Insurance Cancer Survivor American Cancer Society Cancer History Employment Discrimination 


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  1. 1.
    McKenna RJ. Employment Discrimination Against Cancer Victims and the Handicapped: Hearings on H.R. 370 and H.R. 1294, Before the Subcommittee on Employment Opportunities of the House Committee on Education and Labor, 99th Cong. 15 1985.Google Scholar
  2. 2.
    Mellette S. The Semantics of Cancer and Disability. In: Proceedings of the Workshop on Employment, Insurance and the Patient with Cancer. New Orleans: American Cancer Society 1986;24–26.Google Scholar
  3. 3.
    Hoffman B. Employment Discrimination Based on Cancer History: The Need for Federal Legislation. 59 Temple Law Quarterly 1 1986.Google Scholar
  4. 4.
    Wasserman AL, Thompson ET, Wilmas JA, et al. The psychosocial status of survivors of childhood/adolescent Hodgkin’s disease. Arch Pediatr Adolesc Med 1987;141:626–631.Google Scholar
  5. 5.
    Leigh S. Cancer Rehabilitation: a consumer perspective. Seminars in Oncology Nursing 1992;8(3):164–166.PubMedCrossRefGoogle Scholar
  6. 6.
    Jemal, Ahmedin. Annual report to the nation on the status of cancer, 1975–2001, with a special feature regarding survival. Cancer 2004;101(1):3–27.PubMedCrossRefGoogle Scholar
  7. 7.
    Gansler T, Henley SJ, Stein K, Nehl EJ, Smigal C, Slaughter E. Sociodemographic determinants of cancer treatment health literacy. Cancer (in press).Google Scholar
  8. 8.
    Gansler, Ted. Personal communication, May 5, 2005.Google Scholar
  9. 9.
    Yabroff KR, Lawrence WF, Clauser S, et al. Burden of illness in cancer survivors: findings from a population-based national sample. Journal National Cancer Institute 2004;96(17):1322–1330.CrossRefGoogle Scholar
  10. 10.
    Clark E, Stovall E. Advocacy: the cornerstone of cancer survivorship. Cancer Practice 1996;4(5):239–244.PubMedGoogle Scholar
  11. 11.
    Hewitt M, Rowland J, Yancik R. Cancer survivors in the United States: age health, and disability. The Journals of Gerontology, Series A: Biological Sciences 2003;58(1):82–91.Google Scholar
  12. 12.
    Bradley C, Bednarek H. Employment patterns of long-term cancer survivors. Psycho-Oncology 2002;11:188–198.PubMedCrossRefGoogle Scholar
  13. 13.
    Short P, Vasey J, Tunceli K. Employment pathways in a large cohort of adult cancer survivors. Cancer 2005;103(6):1292–1301.PubMedCrossRefGoogle Scholar
  14. 14.
    Steiner J, Cavender T, Main D, et al. Assessing the impact of cancer on work outcomes: what are the research needs? Cancer 2004;101(8):1703–1711.PubMedCrossRefGoogle Scholar
  15. 15.
    Messner C, Patterson D. The challenge of cancer in the workplace. Cancer Practice 2001;9(1):50–51.PubMedCrossRefGoogle Scholar
  16. 16.
    Stone RW. Employing the recovered cancer patient. Cancer 1975;36(1):285–286.CrossRefGoogle Scholar
  17. 17.
    Crothers H. Employment problems of cancer survivors: local problems and local solutions. In: American Cancer Society: Proceedings of the Workshop on Employment, Insurance and the Patient with Cancer. New Orleans: American cancer Society, 1986;51–57.Google Scholar
  18. 18.
    Mor V. Work loss, insurance coverage, and financial burden among cancer patients. In: American Cancer Society: Proceedings of the Workshop on Employment, Insurance and the Patient with Cancer. New Orleans: American Cancer Society, 1986:5–10.Google Scholar
  19. 19.
    Spelten E, Sprangers M, Verbeek J. Factors reported to influence the return to work of cancer survivors: a literature review. Psycho-Oncology 2002;11:124–131.PubMedCrossRefGoogle Scholar
  20. 20.
    Bloom J, Stewart S, Chang S, et al. Then and now: quality of life of young breast cancer survivors. Psycho-Oncology 2004;13:147–160.PubMedCrossRefGoogle Scholar
  21. 21.
    Wheatley GM, Cunnick WR, Wright BP, et al. The employment of persons with a history of treatment for cancer. Cancer 1974;33(2):441–445.PubMedCrossRefGoogle Scholar
  22. 22.
    Yankelovich Clancy Shulman, Cerenex Survey on Cancer Patients in the Workplace: Breaking Down Discrimination Barriers (1992).Google Scholar
  23. 23.
    Ferrell B, Grant M, Dean G, et al. Bone tired: the experience of fatigue and its impact on quality of life. Oncol Nurs Forum 1996;23(10):1539–1547.Google Scholar
  24. 24.
    Dow K, Ferrell B, Anello C. Balancing demands of cancer surveillance among survivors of thyroid cancer. Cancer Practice 1997;5:289–295.PubMedGoogle Scholar
  25. 25.
    Feldman FL. Work and Cancer Health Histories. American Cancer Society, California Division 1982 (five-year study of the work experiences of 344 white collar workers, blue collar workers, and youths with cancer histories between 1975 and 1980).Google Scholar
  26. 26.
    Fobair P, Hoppe RT, Bloom J, et al. Psychosocial problems among survivors of Hodgkin’s disease, J Clin Oncol 1986;4(5):805–814.PubMedGoogle Scholar
  27. 27.
    Koocher GP, O’Malley JE. The Damocles Syndrome: Psychosocial Consequences of Surviving Childhood Cancer. New York: McGraw-Hill, 1982.Google Scholar
  28. 28.
    Polinsky M. Functional status of long-term breast cancer survivors: demonstrating chronicity. Health Soc Work 1994;19(3):165–174.PubMedGoogle Scholar
  29. 29.
    National Cancer Institute, 2004. accessed May 10, 2005.Google Scholar
  30. 30.
    Ferrell B, Schmidt G, Rhiner M, et al. The meaning of life for bone marrow transplant survivors, party 2: improving quality of life for bone marrow survivors. Cancer Nursing 1992;15:247–253.PubMedCrossRefGoogle Scholar
  31. 31.
    Ferrell B, Dow K. Quality of life in breast cancer survivors as identified by focus groups. Psycho-Oncology 1997;6(13):20–21.Google Scholar
  32. 32.
    Hoffman B. Between a disability and a hard place: the cancer survivors’ catch-22 of proving disability status under the Americans with Disabilities Act, 59. Maryland Law Review 2000;352.Google Scholar
  33. 33.
    National Coalition for Cancer Survivorship, Amgen, National Survey on Cancer and the Workplace, (random telephone survey of 662 employed adult Americans interviewed from June 13 to June 15, 1997).Google Scholar
  34. 34.
    Kornblith A, Herndon JE, Zuckerman E, et al. Comparison of psychosocial adaptation of advanced stage Hodgkin’s disease and acute leukemia survivors. Ann Oncol 1998;9:297–306.PubMedCrossRefGoogle Scholar
  35. 35.
    Working Women, Amgen, Cancer in the Workplace Survey (conducted by CBD Research & Consulting: random telephone survey of 500 survivors employed at time of their treatment, 100 supervisors, and 100 co-workers in May 1996).Google Scholar
  36. 36.
    Equal Employment Opportunities Commission, ADA Charge Date by Impairments/Bases—Receipts, Accessed May 10, 2005.Google Scholar
  37. 37.
    Blanck P. The Economics of the Employment Provisions of the Americans with Disabilities Act: Part I. Workplace Accommodations, 46 DePaul Law Review 877, 1997.Google Scholar
  38. 38.
    Grant J, Hatcher T, Patel N. Expecting Better: A State-by-State Analysis of Parental Leave Programs, National Partnership for Women and Families, accessed at, May 10, 2005.Google Scholar
  39. 39.
    Nicoll R. Long-Term Care Insurance and Genetic Discrimination Get It While You’re Young and Ignorant: An Examination of Current Discriminatory Problems in Long-Term Care Insurance Through the Use of Genetic Information. 13 Albany Law Journal of Science & Technology 751 2003.Google Scholar
  40. 40.
    National Conference of State Legislatures, State Genetics Employment Laws, Accessed May 10, 2005.Google Scholar
  41. 41.
    Colker R. The Americans with Disabilities Act: A Windfall for Defendants. 34 Harvard Civil Rights Civil Liberties Law Review 99 1999.Google Scholar
  42. 42.
    Arozullah A, Calhoun E, Wolf M, et al. The financial burden of cancer: estimates from a study of insured women with breast cancer, Journal of Supportive Oncology 2004;2:271–278.PubMedGoogle Scholar
  43. 43.
    Centers for Disease Control and Prevention, Comprehensive Cancer Control: Collaborating to Conquer Cancer, Fact Sheet 2004/2005.Google Scholar
  44. 44.
    Himmelstein D, Warren E, Thorne D, et al. Illness and injury as contributor to bankruptcy, February 2, 2005, Health Affairs, Web Exclusive, W5-63 to W5-73.Google Scholar
  45. 45.
    Thorpe K, Howard D. Health Insurance and Spending Among Cancer Patients, April 9, 2003, Health Affairs, Web Exclusive, W3-189 to W3-198.Google Scholar
  46. 46.
    Crothers HM. Health insurance: problems and solutions for people with cancer histories. In American Cancer Society: Proceedings of the Fifth National Conference on Human Values and Cancer. San Francisco, California Division of the American Cancer Society, 1987;100–109.Google Scholar
  47. 47.
    Fuchs B. Expanding the Individual Health Insurance Market: Lessons from the State Reforms of the 1990s. The Robert Wood Johnson Foundation, Research Synthesis Report No. 4, 2004.Google Scholar
  48. 48.
    Hays DM, Landsverk J, Sallan SE, et al. Educational, occupational, and insurance status of childhood cancer survivors in their fourth and fifth decades of life. J Clin Oncol 1992;10(9):1397–1406.PubMedGoogle Scholar
  49. 49.
    Vann JC, Biddle AK, Daeschner CW, et al. Health insurance access to young adult survivors of childhood cancer in North Carolina. Medical Pediatric Oncology 1995;25(5):389–395.CrossRefGoogle Scholar
  50. 50.
    Glajchen M. Psychosocial consequences of inadequate health insurance for patients with cancer. Cancer Practice 1994;2(2):115–120.PubMedGoogle Scholar
  51. 51.
    Roetzheim R, Pal N, Tennant C, et al. J Nat Cancer Inst 1999;91(16):1409–1415.PubMedCrossRefGoogle Scholar
  52. 52.
    Ayanian JZ, Kohler BA, Abe T, et al. The relation between health insurance coverage and clinical outcomes among women with breast cancer. N Engl J Med 1993;329:326–331.PubMedCrossRefGoogle Scholar
  53. 53.
    Bradley C, Gardiner J, Given C, et al. Cancer, Medicaid enrollment, and survival disparities. Cancer 2005;103(8):1712–1718.PubMedCrossRefGoogle Scholar
  54. 54.
    Politz K, Tapay N, Hadley E, et al. Early experience with “New Federalism” in health insurance regulation. Health Affairs 2000;19(4):7–22CrossRefGoogle Scholar
  55. 55.
    Stovall E, Clark E. Survivors as Advocates. In: Hoffman B, ed. Charting Your Journey: A Cancer Survivor’s Almanac. Wiley: Hoboken, NJ 2004;302–308.Google Scholar
  56. 56.
    Back A, Baile W. Communication skills: myths, realities, and new developments. Journal of Supportive Oncology, 2003;1:169–171.PubMedGoogle Scholar
  57. 57.
    Clark E. You and Your Health Care Team. In: Hoffman B, ed. Charting Your Journey: A Cancer Survivor’s Almanac, Wiley: Hoboken, NJ 2004;56–68.Google Scholar
  58. 58.
    Kattlove H, Winn R. Ongoing care of patients after primary treatment for their cancer. CA Cancer J Clin 2003;54:172–196.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Barbara Hoffman
    • 1
  1. 1.National Coalition for Cancer SurvivorshipRutgers University School of LawNewarkUSA

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