Across the most commonly diagnosed cancers (breast, colorectal, lung and prostate), advances in curative treatment have led to improvements in cancer survival. Workplace policies for medical leave however, may have been instituted when surgery alone was sufficient treatment for cancer. The duration of adjuvant therapy may not be incorporated into laws providing temporary financial assistance or protecting patients from workplace dismissal. Our objective is to determine the median duration of curative treatment and recovery time for the four common cancers and to understand the implications in the broader context.
BC Cancer provides cancer care for a population of 4.6 million. A retrospective review was completed of referred patients from 2010-2016, ≤ 65 years old, newly diagnosed with stage I-III breast, colorectal, lung, prostate cancer, received curative intent treatment that includes either chemotherapy or radiotherapy. Information was collected on baseline characteristics, date of diagnosis, surgical procedure and date, radiotherapy type, duration and intent (neoadjuvant/ concurrent/ adjuvant), chemotherapy type, duration and intent.
26,995 patients were included in the study, 11,911 (44%) received definitive radiotherapy or multimodality treatment.Table: 1655P
|Breast N = 12706||Prostate N = 6360||Colorectal N = 5336||Lung N = 2593|
|No adjuvant treatment||4605||5377||3491||1611|
|Definitive radiation or multimodality treatment||8101||983||1845||982|
|Median time from diagnosis to definitive treatment (weeks)||5.14||13.71||4.29||5.42|
|Median time between definitive treatment and adjuvant therapy (weeks)||8.14||18.14||8.42||8.57|
|Median duration of adjuvant chemotherapy (weeks)||14.29||N/A||20.00||10.00|
|Median duration of adjuvant radiation +/- chemotherapy (weeks)||3.85||6.71||5.00||5.57|
|Median duration of definitive radiation +/- chemotherapy (weeks)||N/A||6.42||N/A||6.42|
|Median duration from definitive treatment to completion of all treatment (weeks)||23.57||6.85||28.29||18.00/6.14* *chemo/xrt|
Almost half of patients who undergo curative cancer treatment require definitive radiotherapy or multimodality treatment. The median duration of therapy varies widely depending on primary site and modality (6.14 - 28.29 weeks). This has implications for financial support such as United Kingdom’s Statutory Sick Pay (28 weeks) and Canada Employment Insurance (15 weeks), as well as workplace dismissal in the United States where the Family and Medical Leave Act protects employees for 12 weeks absence. Governments should consider amending the laws to reflect current cancer treatment durations.
Clinical trial identification
Legal entity responsible for the study
Has not received any funding.
C. Ho: Honoraria (self), Research grant / Funding (self): AstraZeneca; Honoraria (self), Research grant / Funding (self), Travel / Accommodation / Expenses: Boehringer Ingelheim; Honoraria (self), Travel / Accommodation / Expenses: Pfizer ; Honoraria (self): BMS; Honoraria (self), Travel / Accommodation / Expenses: Roche; Honoraria (self): Lilly; Research grant / Funding (self): Genzyme; Honoraria (self), Research grant / Funding (self): Eisai; Honoraria (self): Merck; Honoraria (self): Bayer. All other authors have declared no conflicts of interest.