Changes, challenges and support in work, education and finances of adolescent and young adult (AYA) cancer survivors: A qualitative study

Purpose: An increasing number of adolescents and young adults (AYA) are becoming cancer survivors and are dealing with long-term effects of the disease and its treatment. We aimed to collect detailed self-reported information about the areas of work, education, and the financial situation of AYA survivors after acute treatment. We further examined sources of support that were perceived as particular helpful. Method: We conducted semi-structured interviews with a sample of 11 AYA cancer survivors (on average 5 years from diagnosis; mean age at diagnosis = 25.7 years) that had been recruited for the AYA-Leipzig longitudinal study. Interviews were transcribed and data were analysed using qualitative content analysis. Results: The following themes emerged as relevant: (1) career modifications and job loss, (2) career interruptions and delays, (3) uncertainty in the return-to-work process, (4) reduced work ability, (5) discrimination at the workplace, (6) changes in the personal importance of work and (7) financial burdens. Sources of considerable support included relatives as well as German social security institutions. Conclusions: Health care providers should address the specific risk of a financial burden and the somewhat complex social legal situation of young adult survivors after cancer diagnosis. AYA cancer survivors need agespecific comprehensive cancer survivorship support programs. These should accompany them in the long term and be targeted to the individual need for career modification or reorientation - even after the completion of cancer treatment and rehabilitation.

Automated summary

An increasing number of adolescents and young adults (AYA) are coping with the long-term effects of cancer and its treatment. This study aimed to collect detailed information about the work, education, and financial situation of AYA cancer survivors after acute treatment, and identified sources of support. The findings highlighted career modifications and job loss, uncertainty in the return-to-work process, discrimination at the workplace, and financial burdens as significant themes. Relatives and German social security institutions were identified as important sources of support.