Evaluation of Methods for Dissemination of Prostate Cancer Survivorship Guidelines: A Survey of Primary Care Providers

Objectives: To assess potential knowledge gaps between primary care providers (PCPs) and cancer specialists, Michigan Cancer Consortium guidelines were developed and disseminated statewide. We evaluated the impact of dissemination of these guidelines on PCP attitudes and beliefs regarding management of prostate cancer (PC) post-treatment sequelae. Methods: Guidelines were disseminated via hard-copy and web-link mailed to 12,000 Michigan PCPs in 2009, and via 5 CME presentations to 181 PCPs in 2010-2011. 132 initial surveys were collected from CME attendees and 549 follow-up surveys were received 20 months after the initial mailing. Results: Surveyed PCPs indicated erectile dysfunction (88%), incontinence (84%), anxiety (54%) and fear of the unknown (50%) as frequent post-treatment sequelae. A minority of PCPs (≤41%) felt “very comfortable” assessing PC patients for ten post-treatment sequelae at the initial survey, which increased by up to 27% on follow-up survey. 93% of PCPs that received guidelines by mail and CME presentation had incorporated them into practice, compared with 72% of PCPs that received guidelines solely by mailing. Similarly, a greater proportion reported practice pattern changes (65% vs. 34%, p = 0.0003). A higher proportion felt CME events (69% vs. 57%) and expert presentations (64% vs. 44%) were “very effective”, when comparing attendees and non-attendees. Conclusions: Guideline distribution resulted in increased comfort with survivorship issues and incorporation into the practices of the majority of PCPs surveyed. A greater impact was observed in PCPs that attended a CME presentation than in those that received guidelines only by mailing.

Associations of self-reported and device-assessed physical activity with fatigue,quality of life,and sleep quality in adults living with and beyond cancer

Background Greater physical activity is associated with improved outcomes in people living with and beyond cancer.However,most studies in exercise oncology use self-reported measures of physical activity.Few have explored agreement between self-reported and device-based measures of physical activity in people living with and beyond cancer.This study aimed to describe physical activity in adults affected by cancer across self-reported and device-assessed activity,to explore levels of agreement between these measures in terms of their utility for categorizing participants as meeting/not meeting physical activity guidelines,and to explore whether meeting guidelines is associated with fatigue,quality of life,and sleep quality.Methods A total of 1348 adults living with and beyond cancer from the Advancing Survivorship Cancer Outcomes Trial completed a survey assessing fatigue,quality of life,sleep quality,and physical activity.The Godin-Shephard Leisure-Time Physical Activity Questionnaire was used to calculate a Leisure Score Index(LSI)and an estimate of moderate-to-vigorous physical activity(MVPA).Average daily steps and weekly aerobic steps were derived from pedometers worn by participants.Results The percentage of individuals meeting physical activity guidelines was 44.3%using LSI,49.5%using MVPA,10.8%using average daily steps,and 28.5%using weekly aerobic steps.Agreement(Cohen'sκ)between self-reported and pedometer measures ranged from 0.13(LSI vs.average daily steps)to 0.60(LSI vs.MVPA).After adjusting for sociodemographic and health-related covariates,meeting activity guidelines using all measures was associated with not experiencing severe fatigue(odds ratios(ORs):1.43–1.97).Meeting guidelines using MVPA was associated with no quality-of-life issues(OR=1.53).Meeting guidelines using both self-reported measures were associated with good sleep quality(ORs:1.33–1.40).Conclusion Less than half of all adults affected by cancer are meeting physical activity guidelines,regardless of measure.Meeting guidelines is associated with lower fatigue across all measures.Associations with quality of life and sleep differ depending on measure.Future research should consider the impact of physical activity measure on findings,and where possible,use multiple measures.

Long-term efficacy of a computer-tailored physical activity intervention for prostate and colorectal cancer patients and survivors:A randomized controlled trial

Background Physical activity(PA)can improve the physical and psychological health of prostate and colorectal cancer survivors,but PA behavior change maintenance is necessary for long-term health benefits.OncoActive is a print-and web-based intervention in which prostate and colorectal cancer patients and survivors receive automatically generated,personalized feedback aimed at integrating PA into daily life to increase and maintain PA.We evaluated the long-term outcomes of OncoActive by examining the 12-month follow-up differences between OncoActive and a control group,and we explored whether PA was maintained during a 6-month non-intervention follow-up period.Methods Prostate or colorectal cancer patients were randomly assigned to an OncoActive(n=249)or a usual care waitlist control group(n=229).OncoActive participants received PA advice and a pedometer.PA outcomes(i.e.,ActiGraph and self-report moderate-to-vigorous intensity PA(MVPA)min/week and days with≥30 min PA)and health-related outcomes(i.e.,fatigue,depression,physical functioning)were assessed at baseline,6 months,and 12 months.Differences between groups and changes over time were assessed with multilevel linear regressions for the primary outcome(ActiGraph MVPA min/week)and all additional outcomes.Results At 12 months,OncoActive participants did not perform better than control group participants at ActiGraph MVPA min/week,self-report MVPA min/week,or ActiGraph days with PA.Only self-report days with PA were significantly higher in OncoActive compared to the control group.For health-related outcomes only long-term fatigue was significantly lower in OncoActive.When exploratively examining PA within OncoActive,the previously found PA effects at the end of the intervention(6 months follow-up)were maintained at 12 months.Furthermore,all PA outcomes improved significantly from baseline to 12 months.The control group showed small but non-significant improvements from 6 months to 12 months(and from baseline to 12 months),resulting in a decline of differences between groups.Conclusion The majority of previously reported significant between-group differences at 6 months follow-up were no longer present at long-term follow-up,possibly because of natural improvement in the control group.At long-term follow-up,fatigue was significantly lower in OncoActive compared to control group participants.Computer-tailored PA advice may give participants an early start toward recovery and potentially contributes to improving long-term health.

Changes in physical activity,sedentary behavior,and self-reported cognitive function in cancer survivors before and during the COVID-19 pandemic:A cross-sectional study

Background Physical activity(PA)and reductions in sedentary behavior(SED)may mitigate cancer-related cognitive impairment.The purpose of this study was to examine(a)the associations between changes in PA,SED,and cognitive function in cancer survivors before and during the coronavirus disease 2019(COVID-19)pandemic;and(b)clinical subgroups that moderate this association.Methods A cross-sectional survey was administered online to adult cancer survivors globally between July and November of 2020.This was a secondary analysis of a cross-sectional survey examining changes in self-reported PA and quality of life in cancer survivors before and during the COVID-19 pandemic.Self-reported Questionnaires assessed moderate-to-vigorous PA(MVPA)using the modified Godin Leisure Time Exercise Questionnaire,cognitive function using the Functional Assessment of Cancer Therapy-Cognitive Function(FACT-Cog)scale,and SED using the Domain-specific Sitting Time questionnaire.Cancer survivors were classified into no change in behavior,desirable change(i.e.,increase MVPA to meet PA guidelines or decrease SED by≥60 min/day),and undesirable change(i.e.,decrease MVPA to<150 min/week or increase SED by≥60 min/day).Analysis of covariance examined differences in FACT-Cog scores across the activity change categories.Planned contrasts compared differences in FACT-Cog scores between cancer survivors with(a)no meaningful change vs.any change,and(b)a desirable change vs.an undesirable change.Results There were no significant differences in FACT-Cog scores across activity-change categories in the full sample of cancer survivors(n=371;age=48.6±15.3 years(mean±SD)).However,cancer survivors who were diagnosed≥5 years ago(t(160)=–2.15,p=0.03)or who received treatment≥5 years ago(t(102)=–2.23,p=0.03)and who had a desirable change in activity reported better perceived cognitive abilities than those who had an undesirable change.Conclusion PA promotion efforts should consider reducing SED in addition to maintaining MVPA in long-term cancer survivors to mitigate cancer-related cognitive impairment during the COVID-19 pandemic.

Body mass index trends and quality of life from breast cancer diagnosis through seven years’ survivorship

BACKGROUNDWeight gain is a potential negative outcome of breast-cancer treatment,occurringin 50%-to-96%of breast-cancer patients,although the amount of weight gain isinconsistently reported in the literature.Research has also shown a relationshipbetween overweight/obesity and breast-cancer mortality.Correspondingly,weight management is a self-care approach known to benefit quality of life(QOL).These research questions and analysis add to existing literature byexamining participants’body mass index(BMI)trend and its relationship withQOL indicators over seven years.AIMTo examine:(1)BMI trends among breast cancer survivors;and(2)The trends’relationship to QOL indicators over seven years.METHODSDuring the Breast Cancer and Lymphedema Project,378 patients’weight andheight were recorded by nurses prior to or just after beginning breast cancertreatment and repeated at quarterly-to-semiannual intervals over seven years.Additionally,participants annually completed the 36-Item Short Form HealthSurvey(SF-36),a valid and reliable tool assessing QOL and health concepts,including physical function,pain,and emotional well-being.BMI trends,changein BMI,and change in SF-36 subscales over seven years were calculated using arandom-intercept repeated-measures regression.Patients were placed into BMIcategories at each time point:Normal,Overweight and Obese.As patients’weights changed,they were categorized accordingly.RESULTSDuring the seven-year study and while controlling for age and residence,participants gained an average of 0.3534 kg/m^2(P=0.0009).This amountremained fairly consistent across BMI categories with those in the normal-weight category(n=134)gaining 0.4546 kg/m^2(P=0.0003);Overweight(n=190)gaining 0.2985 kg/m^2(P=0.0123);and obese(n=199)gaining 0.3147 kg/m^2,(P=0.0649).Age(under or over 55)and region(metro/micro vs small/rural)weresignificantly associated with BMI increase in both the normal and obesecategories.There were statistically significant(P<0.0100)changes in five of theeight SF-36 domains;however,the directions of change were different andsomewhat divergent from that hypothesized.Controlling for age and region,these five were statistically significant,so there were no change or differencesbetween the micropolitan/metropolitan and small town/rural groups.CONCLUSIONAlthough only modest increases in mean BMI were observed,mean BMI changewas associated with selected QOL indicators,suggesting the continued need forself-care emphasis during breast cancer survivorship.

After the Treatment Phase of Colorectal Cancer Care: Survivorship and Follow-Up

The number of long-term colorectal cancer (CRC) survivors has increased substantially over the past three decades due to both ongoing advances in early detection and improvements in cancer therapies. Adult survivors of CRC experience chronic health conditions due to normal issues associated with aging, which is further compounded by the long-term adverse effects of having had cancer and anti-cancer therapies. In addition, they are at a higher risk for CRC recurrences, new primary cancers, and other co-morbidities. This article will provide an overview of the clinical care of adult survivors of CRC. Epidemiologic data will be presented followed by a discussion of the approach to the care of long-term adult survivors of CRC, including surveillance of recurrences and new primary cancers, interventions to manage both physical and psychological consequences of cancer and its treatments, and strategies to address concerns related to unemployment and disability. Finally, we will explore the challenges of healthcare delivery, especially with respect to the coordination of follow-up between cancer specialists and primary care physicians, so as to ensure that all of the survivor’s health needs are met promptly and appropriately.

癌症生存者整合型照护模式的概念框架、特征及对我国的启示

癌症是世界性的重大公共卫生问题。癌症发病率的持续升高以及生存时间的不断延长导致癌症生存者数量持续攀升。癌症生存者面临着身体、心理和社会照护方面的复杂挑战,其照护服务也需要跨领域、跨部门、跨学科的有效协同与整合,建立癌症生存者整合型照护模式已经成为各国应对癌症生存者照护挑战的重要策略。然而目前我国癌症生存者照护领域的发展还相对滞后。本文梳理和总结了当前代表性的癌症生存者整合型照护模式的概念框架、特征、应用以及在我国的实践进展,结合我国卫生服务体系状况,从建立共识、试点探索、人才建设、强化基层、政策支持五个方面提出相关建议,以期为我国设计与实施癌症生存者整合型照护策略提供参考和借鉴。

Do the benefits outweigh the side effects of colorectal cancer surveillance? A systematic review

Most patients treated with curative intent for colorectal cancer(CRC) are included in a follow-up program involving periodic evaluations. The survival benefits of a follow-up program are well delineated, and previous meta-analyses have suggested an overall survival improvement of 5%-10% by intensive follow-up. However, in a recent randomized trial, there was no survival benefit when a minimal vs an intensive follow-up program was compared. Less is known about the potential side effects of follow-up. Well-known side effects of preventive programs are those of somatic complications caused by testing, negative psychological conse-quences of follow-up itself, and the downstream impact of false positive or false negative tests. Accordingly, the potential survival benefits of CRC follow-up must be weighed against these potential negatives. The present review compares the benefits and side effects of CRC follow-up, and we propose future areas for research.

Young Child-Rearing Latina Cancer Survivors Living in the US-Mexico Border Region: A Qualitative Study

Background: Despite increasing cancer incidence among young Latinas (<50 yrs.) in the US, little is known about how young, child-rearing Latinas cope with cancer in the US-Mexico border region. Objective: The purpose of this study was to explore how young, child-rearing Latinas described their challenges, strengths, and social support sources for coping with cancer in the US-Mexico border region. Methods: Nine Latinas that had been diagnosed with cancer, had at least one child 5 to 13 years old, and lived in one of two targeted border counties participated in audio-recorded, semi-structured focus groups (n = 6) or interviews (n = 3) in their preferred language (i.e., English or Spanish). Interview recordings were transcribed and inductively coded using methods based on grounded theory. Results: Three major themes emerged. First, in reporting their physical and emotional struggles with cancer as the most difficult time of their lives, participants described feeling alone as they navigated treatment side effects and continued fear of cancer. Second, they explained figuring out how to live day-by-day, reporting the negative impact of cancer on their families and on their ability to maintain their roles as mothers. Third, they highlighted factors that gave them the strength to fight and carry on, emphasizing their children and their inner strength. Conclusions: Even with a supportive family, young Latina mothers felt alone as they navigated cancer (i.e., treatment, fear, and impact on their families) and as they worked to garner the strength to overcome the stress of cancer. Interventions for young Latina survivors should be designed to address their needs, build on their fighting spirit, incorporate the family, and connect them with other survivors for personalized support. Further research is warranted to better understand cancer survivorship among child-rearing Latina mothers experiencing a cancer diagnosis in under-resourced communities like the US-Mexico border region.

Increasing BMI Z-Scores 3 Years after Diagnosis among a Multiethnic Cohort of Childhood Cancer Survivors Treated in South Los Angeles

Background: Due to successful treatment modalities, the majority of pediatric cancer patients will survive. Increased body mass index (BMI) is a complication among pediatric cancer survivors. Methods: This retrospective single-center study examined BMI changes among a cohort of predominantly Hispanic patients who were treated in South Los Angeles. Data were collected at diagnosis, 1, 2 and 3 years after. Analyses included z-scores derived from calculated BMIs compared over 3 years per gender, diagnosis, and treatment modality. The unhealthy BMI z-score was defined as >1.04. Results: Thirty-four percent of the predominantly Hispanic sample had unhealthy BMI z-scores of >1.04 correlating to at or greater than the 85th percentile for age and gender. The study cohort’s BMI z-scores significantly increased from 0.15 to 1.29 at year 3 (P < 0.0001), putting 55% of this population in the unhealthy category. Median BMI z-score significantly increased to the unhealthy category at 3 years. Conclusions: Due to the predominance of Hispanic patients in this group, culturally sensitive interventions beginning at diagnosis should be considered.

Weight gain following breast cancer diagnosis: Implication and proposed mechanisms

Weight gain occurs in the majority of women following breast cancer treatment. An overview of studies describing weight gain amongst women treated with early to modern chemotherapy regimens is included. Populations at higher risk include women who are younger, closer to ideal body weight and who have been treated with chemotherapy. Weight gain ranges between 1 to 5 kg, and may be associated with change in body composition with gain in fat mass and loss in lean body mass. Women are unlikely to return to pre-diagnosis weight. Possible mechanisms including inactivity and metabolic changes are explored. Potential interventions are reviewed including exercise, dietary changes andpharmacologic agents. Although breast cancer prognosis does not appear to be significantly impacted, weight gain has negative consequences on quality of life and overall health. Future studies should explore change in body composition, metabolism and insulin resistance. Avoiding weight gain in breast cancer survivors following initial diagnosis and treatment should be encouraged.

The Impact of Cervical Cancer Treatment on Sexual Function and Intimate Relationships: Is Anyone Listening?

The purpose of this research was to describe women’s narrative accounts of the impact of cervical cancer treatment on their sexual function and intimate relationships, and to evaluate what changes in care and education are needed to enhance quality of life and intimacy after treatment. The research approach was a narrative design, using semi-structured, in-depth interviews. Narratives were examined within and across interviews, and thematic content analysis completed. The study was done in a gynecologic oncology clinic at a public hospital in the Midwest United States. The sample consisted of twelve women, ranging in age from 27 to 59, who had completed the cervical cancer treatment with chemo-radiation or radiation and surgery, and were now followed by their gynecologic oncologists. Across narratives, five major themes were identified, including unexpected physical complications, not “getting back to normal,” emotional pain and isolation, lack of available information, and inadequate health care provider response to treatment complications and sexual relationship problems. Women’s stories reveal that sex and intimacy issues for cervical cancer survivors remain within a culture of silence. In many situations, health professionals did not provide information that realistically prepared women and partners for probable consequences of treatment, did not assess sexual issues before or after treatment, did not recognize various symptoms as being complications of cancer treatment, did not make referrals, and/or recognized complications, but accepted them as “normal” and without solution. Ethical implications for health professionals and the need for education, communication, and the development of new lines of research are discussed.

Patterns of Recurrence in Low-Risk Endometrial Cancer

Objective: Endometrial cancer is the most common gynaecological cancer in high-income countries and has a good prognosis, particularly when diagnosed early. Early stage, low-grade endometrial cancer has a low risk of recurrence, and is detectable on routine follow up. This study aims to identify rates and patterns of recurrence in low-risk endometrial cancer patients and provide evidence for transitioning to community-based follow-up care. Methods: Retrospective study of patients with early-stage, low-grade endometrioid endometrial adenocarcinoma treated with surgery from January 1981 to December 2018. The rate and patterns of recurrence were identified and analysed. Results: Of 1215 eligible patients, 24 developed recurrent disease (1.98%). The majority of recurrences were pelvic (70%), and confined to the vaginal vault (41.7%). The median duration of follow up was 44.4 months, and time from primary surgery to diagnosis of recurrent disease was 30.5 months. No significant differences were found between the group of patients who recurred and the group of patients who did not. Twelve (50%) patients with recurrences were asymptomatic, but of these, 10 (83%) had obvious findings during routine surveillance physical examination. The remaining 12 patients (50%) presented with symptoms that prompted investigation that led to the recurrence diagnosis. 78% of recurrences were treated with combination therapy (surgical excision, chemotherapy, radiotherapy and hormonal). Ten patients (42%) had salvageable disease. For the non-salvageable cases, there was a mean of 2.1 years from recurrence diagnosis to death. Conclusions: The low recurrence rate of low-risk endometrial cancer following primary surgical management, and the feasibility of detection of recurrent disease, support transitioning surveillance to community-based settings.

The Unmet Needs of African American Women with Breast Cancer

Breast cancer is the most common cancer in women and treatment includes various combinations of surgery, chemotherapy, and/or hormone therapy. The multimodal treatment of breast cancer improves survival outcomes, but it also contributes to a prolonged period of medical intervention with associated physical and emotional consequences. However, we know less about the specific clinical experiences of African American (AA) women during treatment for breast cancer and in survivorship. The studies that have addressed the issue of breast cancer in AA women have focused primarily on early detection and epidemiological variables such a screening, mortality and staging at diagnosis. In our study, in-depth semi-structured phone interviews were conducted to explore the clinical experiences, concerns and needs of AA women who had survived breast cancer. The AA women reported that their physicians did not provide adequate disease and treatment information;did not discuss clinical trials with them;and did not offer access to support services.

结直肠癌生存扩展期患者未满足健康需求调查分析

目的 调查结直肠癌生存扩展期患者未满足健康需求现状,分析其影响因素,为完善结直肠癌患者生存扩展期健康管理提供依据。方法 采用便利抽样法,选取2所三级甲等综合医院肿瘤科、胃肠外科住院部及门诊复查的结直肠癌患者111例作为调查对象,采用一般资料调查表、中文版癌症患者未满足需求量表、中文版记忆症状评估量表进行调查。结果 结直肠癌生存扩展期患者未满足健康需求总分为34.50(22.25,54.00)分。回归分析显示,治疗相关症状、工作性质、治疗方案是患者未满足需求的主要影响因素(均P<0.05),共解释未满足健康需求总变异度的58.5%。结论 结直肠癌生存扩展期患者未满足健康需求处于中等水平,医护人员及家庭照顾者应重点关注治疗相关症状得分高、以体力劳动为主、治疗方案复杂的结直肠癌患者,采取有效的护理措施,满足其健康需求。

腹腔镜与开腹胃癌根治术临床疗效比较及术后随访

目的 对比研究腹腔镜辅助与开腹胃癌全胃切除术的临床效果.方法 回顾性分析42例行腹腔镜胃癌全胃切除术患者的临床资料及术后生存情况,同期62例行开腹全胃切除治疗的患者作对照.结果 腹腔镜组切口长度（6.5±1.7）cm、平均失血量（228±29） ml、术后肛门排气时间（2.4±0.7）d、首次进流食时间（4.9±0.6）d.对照组切口长度（15.4±2.5）cm、平均失血量（260±34）ml、术后肛门排气时间（3.2±1.0）d、术后首次进流流食时间（5.4±0.5）d,两组相比差异有统计学意义（P＜0.05）;腹腔镜组手术时间[（248±47）min]显著高于开腹组（205±40）min,差异有统计学意义（P＜0.05）;腹腔镜组术后住院时间[（9.4±3.7）d]、淋巴结清扫数目[（25.1±2.7）个]与开腹组[（11.2±5.3）d、（26.0±3.4）个]相比,差异无统计学意义（P＞0.05）;腹腔镜组与开腹组术后并发症发生率分别为14.3%与19.4%;术后随访3年内生存率差异无统计学意义（P＞0.05）.结论 在不影响远期效果的情况下,腹腔镜辅助全胃切除术具有术中出血量小、手术切口小、术后肛门排气时间短、术后进流食时间短等优点.

乳腺癌女性的自我赋权何以可能:基于癌症叙事的思考

癌症等慢性病意味着病人人生进程的中断。医学人文学者因此关心癌症叙事及深层的社会文化意义,将叙事作为理解病人身份特别是其主体性重建的重要途径。通过回溯癌症叙事研究的类型学传统,指出从"病人角色"到"幸存者身份"都是现代国家治理术的集中体现。但身处多重结构性逻辑的癌症病人,如乳腺癌女性,依然可以主动通过与女性文化、网络文化和传统文化等自我技术耦合的方式,即认同病人和女性角色以外其他角色的正常,进而实现自我赋权。

中西医结合肿瘤康复多学科门诊模式的初步构建与实践经验探讨

肿瘤康复是帮助癌症幸存人群通过综合康复支持,从而获得更高生活质量的新兴学科。探索与建立符合我国特色与患者需求的肿瘤康复模式是这一学科目前所面临的迫切问题。2015年11月中国老年学与老年医学学会肿瘤康复分会成立,中国中医科学院西苑医院肿瘤科作为学会主委所在单位以及首批肿瘤康复基地,初步构建了中西医结合肿瘤康复多学科门诊模式并进行了实践探索。本文详述该模式中的三个关键环节,并列举典型肿瘤康复案例,分析和总结在目前多学科肿瘤康复模式中的经验、存在问题以及进一步改善方向。

乳腺癌生存者的管理——循证而行

目前,乳腺癌生存率不断提高,生存者数量急剧攀升,乳腺癌生存者对治疗后随访、康复和生命质量的需求持续升高,已经成为影响社会公共卫生领域的重要问题。作为癌症生存者中最大的群体之一,乳腺癌生存者在国外关注和研究较早,已颁布多个较为成熟系统的指南。国内在此方面越来越引起重视,本文就乳腺癌生存者研究的历史发展,指南要点和国内发展状况进行综述,旨在促进我国学者和研究机构对乳癌生存者的研究。

Job and housework during radiotherapy: Comparisons between leaving out activities and disease treatment

Background: Researches about work limitations related to cancer treatment and survival are recent. This study describes the characteristics of patients who keep their work and house work activities during radiotherapy, and comparison between some disease data and leaving out those activities. Methods: Data were collected from medical records of patients admitted in a Brazilian Radiotherapy Private Health Service. Descriptive statistical analysis was performed, as hypotheses texts, Chi-square and Fisher’s exact test. Results: Data of 111 individuals were presented;being 65.77% of workers of paid activities and 34.34% of careers of home. Between employees, 50.7% kept their job activities, and 92.1% between house workers. The association between absence from work activities and tumor type (primary or metastasis) and between absence and KPS (p < 0.05) were observed. Discussion: It is observed that breast, brain and lung tumors significantly affect employees’ performance, causing the withdrawal of workers from their activities. Data from the literature review clearly demonstrated the importance of work activities in social support of the worker, but his overall performance may be impaired. Implications for cancer survivors: The study indicates the need for assessment of the individual, work or activity environment and required as well as the continuity research aiming at the development and validation of evaluation tools such as questionnaires or scales.