Diagnosing and Treating Adult Cancers and Associated Impairments (2021) / Chapter Skim
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1 Introduction
1 Introduction
Pages 17-30
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From page 17... ...
Fortunately, recent progress in cancer research has yielded new knowledge about cancer biology and resulted in a number of innovative treatments for people who have cancer. This report is an overview of the current status of the diagnosis, treatment, and prognosis of select common adult cancers, particularly breast cancer and lung cancer, and their effects on the health and functioning of people with cancer.
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During the past century, cancer treatment planning focused almost solely on the anatomic extent of cancer, best characterized by a staging system that quantifies tumor size, as well as the extent of regional and distant spread. Now pathologists identify the unique expression of a tumor's genetic and immune features on an initial biopsy so that this information can be incorporated with traditional diagnostic approaches to chart a personalized treatment plan for the patient.
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. To help address the needs of the growing population of child and adult cancer survivors, in 1996 the National Cancer Institute (NCI)
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The improved survival rates that have resulted from new and emerging treatments mean that cancer survivors are living longer but may also experience long-term and late-onset impairments from those treatments for a longer period of time. In turn, longer periods of impairment may have consequences for cancer survivors' ability to work because of such factors as their increased need for workplace accommodations, occupational supportive care throughout treatment, and disability benefits for a longer time than previously expected (Kiasuwa Mbengi et al., 2016)
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, particularly survivors of breast cancer, gastrointestinal cancers, and cancers of the female reproductive organs. The negative effects of long-term unemployment include a decreased quality of life and lower self-esteem as well as a level of financial distress that can cause other detrimental effects (Beesley et al., 2018; van der Noordt et al., 2014; Verbeek et al., 2003; Zagozdzon et al., 2014)
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For example, receiving disability benefits from SSA is based on one's inability to work, perform basic job duties, or engage in any other kind of substantial gainful activity; thus, SSA disability benefits provide the necessary support to people who can no longer work as a result of their health. Conversely, the ADA protections benefit individuals who can still perform essential parts of their jobs but may need reasonable accommodations from their employers -- such as providing a reasonable amount of additional unpaid leave for medical treatment, making existing facilities usable by disabled employees, or allowing a flexible work schedule -- to do so3 (Greidanus et al., 2018; Williams-Whitt et al., 2016)
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Provide an overview of the current status of the diagnosis, treatment, and prognosis of adult cancers including, but not limited to, breast cancer and lung cancer, and the relative levels of associated functional limitation typically associated with these cancers, common treatments, and other considerations in the U.S. population age 18 and older; 2.
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Committee members and project staff identified additional literature and information using traditional academic research methods and online searches throughout the course of the study. The committee's work was further informed by previous National Academies reports related to disability and to cancer, which are referenced throughout the report.
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SSA asked the National Academies committee to focus on breast cancer and lung cancer, but it also asked that the committee consider other cancers for which changes in incidence, diagnosis, treatment, or prognosis are occurring. Thus, the committee addressed those cancers most prevalent in SSA's disability claims (for more information on SSA disability claims, see Chapter 2)
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To address SSA's request that the committee also consider other cancers as appropriate, Chapter 7 highlights new information on the incidence and treatment of several cancers frequently seen in SSA disability claims, including gastrointestinal cancers (colorectal, pancreatic, and liver and bile duct cancers) , hematologic cancers (leukemias, lymphomas [Hodgkin and non-Hodgkin]
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Finally, Appendix A presents short biographical sketches of the committee members and consultant, and Appendix B contains the agendas for the committee's public sessions. REFERENCES ACS (American Cancer Society)
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2012. Risk factors of devel oping long-lasting breast pain after breast cancer radiotherapy.
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2014. Effect of un employment on cardiovascular risk factors and mental health.
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