| Abstract: | Background/Aims Surgical treatments for rectal cancer include intestinal ostomy (externalization of the bowel to the abdominal wall) or, more frequently, an anastomosis (reconnection) of the rectum. These surgeries can give rise to long-term after-effects. We examined differences reported between survivors with ostomies (SO) versus anastomoses (SA) with respect to their work and volunteer activities, and how much they perceived their cancer affected these experiences. Methods We mailed our survey to 1,000 long-term (=5 years post-diagnosis) rectal cancer survivors in KP Northern California and KP Northwest during 2010-2011. Our overall response rate was 57.7% (577/1,000). The survey asked about current employment status and the impact of their cancer on labor force participation, demotions, job discrimination, forced retirement, and volunteer activities. Responses from 446 survivors (SA=292 (65%), SO=154 (35%)) were analyzed for differences in changes in work- and volunteer activities. Results Mean ages for both groups were significantly beyond the retirement age for most Americans (SA=72 yrs, SO=74 yrs). SAs were more likely to be currently working (FT+PT = 30% (89/292)) than SOs (FT+PT = 17% (25/151)), while SOs were more likely to be retired (67% (101/151) vs. 55% (160/292) (p<.05). Rates of permanent disability were similar between the groups-SOs=6.6% (10/151), SAs=5.5% (16/292). One-fifth of survivors (SA=22% (65/290), SA=18% (28/154)) reported volunteering on a regular basis an average of 11 (SOs) to 15 (SAs) hours/week. SAs reported more support from employers than SOs (64% (138/215) vs. 53% (60/113), p<.05), and from co-workers (68% (146/214) vs. 57% (64/112), p<.05). SAs and SOs did not differ in marital status at times of diagnosis or survey. The distribution of marital status shifted between diagnosis and survey: 72% (305/425) were married and 10% (43/425) were widowed at diagnosis; 62% (263/424) were married and 20% (84/424) were widowed at time of survey. No differences were reported by treatment about being forced into retirement. Discussion Compared to SOs, SAs were more likely to be currently employed, to receive higher rates of support from employers and coworkers, and to volunteer more hours. Perhaps interventions can be developed to allow ostomy survivors to participate more in these functions in their communities. |
