Employment, work ability and sick leave in melanoma patients within the first year of diagnosis.

Abstract

Background and objectives: Malignant melanoma affects younger working individuals. This study investigated work ability and sick leave within one year after diagnosis, as well as the impact of rehabilitation and psycho-oncological measures on employment outcomes.

Patients and methods: In this monocentric, prospective, observational cohort study, 221 patients (62.4% females), aged 19-65, participated. 78.5% had tumor stage IB or lower at baseline. Routine clinical documentation, occupational history, work ability, subjective prognosis of employment, need for and satisfaction with rehabilitation measures were repeatedly assessed.

Results: 181 patients (82%) were employed at first visit, 172 (78%) at last visit. Approximately 75% of patients initially rated work ability as "moderate", with up to 9 sick leave days. In the following year, sick days increased significantly in patients with stage IB and IIA (p = 0.044) and highly significantly in patients with stage II B and above (p < 0.001). Psycho-oncologic consultation (24%) and rehabilitation (18%) did not change the significantly worse self-rated work ability of these patients.

Conclusions: Melanoma affects work ability, even in tumor stages without lymph node involvement or distant metastasis. Controlled clinical trials would be useful to evaluate the success of rehabilitation and psycho-oncological interventions for patients with melanoma.