This is a great overview of people who get cancer and struggle at their workplace. It is important to know your rights and responsibilities. There are enough stressors in life, after a diagnosis of cancer - than to struggle with the complexities of keeping a job.

https://www.theaustralian.com.au/commentary/editorials/cancer-patients-workplace-rights/news-story/9fdf6b58af8da3be792eb098a54e55a0 - EDITORIAL


Among 150,000 Australians who will be diagnosed with cancer this year, many will be in the workforce. They will have families to support and financial commitments. Many will need time off for treatment and will be relying on sick and long-service leave. Extended illnesses among staff can create problems, especially for small businesses. Goodwill and flexibility on both sides help. Much depends on the severity of the illness, the treatment and the practicality of options such as working part time or from home. Many patients recover and return to work for decades.
Liz Tapping, 56, a Melbourne mother of three who was sacked after she asked to take personal and annual leave for breast cancer surgery and treatment, has made an important point for those forced to quit their jobs in such circumstances. At the hospital, she was told she could continue to work and juggle her treatment around it. And the company accountant told her she had accrued holiday and sick leave to cover her absence. But after she lost her job in 2019, she decided to fight her dismissal. She reached a financial settlement with her employer, Empress Diamonds, after the Federal Circuit Court found the company contravened the Fair Work Act by terminating her employment because she proposed to exercise her rights to take leave. 
Her situation is not unique, advocates for women with breast cancer told workplace editor Ewin Hannan. Breast Cancer Network Australia policy, advocacy and member support director Vicki Durston said employers faced a complex situation when employees were diagnosed with cancer. The problem was often a lack of understanding, and lacking the resources and tools to understand how to tackle the challenge of one of their employees having a cancer diagnosis. 
Cancer patients do not need the stress of fighting for their rights in court. Neither do businesses. Ms Tapping’s illness has returned, sadly. But lessons can be learned from the stand she took and from the outcome. As Ms Durston says, the issue for employers is “about making sure that you have the conversation with your staff, and you understand what this means and knowing your rights”.

This article is an article from the USA, but the principles remain the same. I like to offer a referral to the Palliative care community services, fairly early in the diagnosis of metastatic cancer. The support from the Community Palliative care nurses is invaluable. There are a range of extra services which can be accessed, including Advanced Care Directives, legal paper work, etc.

Palliative care referrals in Australia are not just for end-of-life care. It is worth discussing with your doctor.



Supportive care, started early, will improve more lives
BY LYDIA DENWORTH

https://apple.news/AVmTHvsveRjWvAaA-UEAyQw

IN THE LAST months of my mother’s life, before she went into hospice, she was seen at home by a nurse practitioner who specialized in palliative care. The focus is on improving patients’ quality of life and reducing pain rather than on treating disease. Mom had end-stage Alzheimer’s disease and could no longer communicate. It was a relief to have someone on hand who knew how to read her behavior (she ground her teeth, for instance, a possible sign of pain) for clues as to what she might be experiencing.
I was happy to have the help but wished it had been available earlier. I’m not alone in that. Evidence of the benefits of palliative care continues to grow. For people with advanced illnesses, it helps to control physical symptoms such as pain and shortness of breath. It addresses mental health issues, including depression and anxiety. And it can reduce unnecessary trips to the hospital. But barriers to access persist—especially a lack of providers. As a result, palliative care is too often offered late, when “the opportunity to benefit is limited,” says physician Kate Courtright of the Perelman School of Medicine at the University of Pennsylvania.
In 2021 only an estimated one in 10 people worldwide who needed palliative care received it, according to the World Health Organization. In the U.S., the numbers are better—the great majority of large hospitals include palliative care units—but it’s still hard for people who depend on small local hospitals or live in rural areas. Outpatient palliative care is especially hard to find.
Experts are also working to correct misconceptions. “When people hear the words ‘palliative care,’ they think ‘end-of-life care—I’m going to die,’ ” says physician Helen Senderovich, a palliative care expert at the University of Toronto. Although palliative medicine grew out of the hospice movement, it has evolved into a multidisciplinary specialty encompassing physical, psychological and spiritual needs of patients and their families throughout the trajectory of disease, Senderovich says. That path includes the time when treatments are still being tried.
So palliative care specialists have begun referring broadly to “supportive care”—“anything that is not directly modifying the disease,” says medical oncologist and palliative care specialist David Hui of the MD Anderson Cancer Center. For example, wound care and infusions to improve red blood cell counts in cancer patients are supportive; chemotherapy is not.
Generally, the earlier that supportive care is offered, the more satisfied patients report feeling. And ideally, people who need it now get referred to palliative medicine around the time they are diagnosed with a serious illness. An influential study in 2010 found that patients with lung cancer who received palliative care within eight weeks of diagnosis showed significant improvements in both quality of life and mood compared with patients who got only standard cancer care. Even though those receiving early palliative care had less aggressive care at the end of life, they lived an average of almost three months longer.
More recent studies have confirmed the life-quality advantages of earlier palliative care, although not all studies have shown longer survival. “Patients don’t just start having pain and anxiety and weight loss and tiredness only in the last days of life,” Hui says. Starting palliative care earlier allows patients and the care team to “think ahead and plan a little bit,” he adds.
Nor is palliative care effective only for cancer, although that’s where much of the research has been done. It benefits those with heart failure, chronic kidney disease, dementia, chronic obstructive pulmonary disease (COPD), Parkinson’s, and other serious illnesses.
In January 2024 the Journal of the American Medical Association published a pair of studies that broke “new ground” in developing sustainable, scalable palliative care programs, according to an accompanying editorial. One, the largest-ever randomized trial of palliative care, included more than 24,000 people with COPD, kidney failure and dementia across 11 hospitals in eight states. The researchers made palliative care an automated order, where doctors had to opt out of such care for their patients instead of going through an extra step of opting in. The rate of referrals to palliative care increased from 16.6 to 43.9 percent, says Courtright, lead author of the study. Length of hospital stay did not decline overall, but it did drop by 9.6 percent among those who received palliative care only because of the automated order.
The second study looked at 306 patients with advanced COPD, heart failure or interstitial lung disease. Half these people participated in palliative care via telehealth visits with a nurse to handle symptom management and a social worker to address psychosocial needs; the other people in the study did not get such care. Those who received the calls quickly showed improved quality of life, and the positive effects persisted for months after the calls concluded.
Because there are not enough palliative care providers, Hui advocates for a system that directs them to patients who would benefit most. Usually, and not surprisingly, those are people with the most severe symptoms. This system uses early screening of symptoms to identify these people. Hui calls the approach “timely” palliative care. “In reality, not every patient needs palliative care up front,” Hui says, so timely care uses scarce resources as effectively as possible.
I don’t know exactly when my mother needed to start palliative care, but I hope that going forward more caregivers and more families know to ask about it sooner. ⬣
Lydia Denworth is an award-winning science journalist and contributing editor for Scientific American. She is author of Friendship (W. W. Norton, 2020).

From TIME Magazine: https://apple.news/AGg-EjXWuS1uL_aPR3y5LZw - written by Alice Park

This is an article published in the TIME magazine. The majority of the data and links are US based, but the principles remain the same.

An expert panel in the U.S. says women should begin mammogram screening at age 40—a decade earlier than previously recommended.
​
ALICE PARK IS A SENIOR HEALTH CORRESPONDENT AT TIME. SHE COVERS THE COVID-19 PANDEMIC, NEW DRUG DEVELOPMENTS IN CANCER AND ALZHEIMER'S DISEASE, MENTAL HEALTH, HIV, CRISPR, AND ADVANCES IN GENE THERAPY, AMONG OTHER ISSUES IN HEALTH AND SCIENCE. SHE ALSO COVERS THE OLYMPICS, AND CO-CHAIRED TIME'S INAUGURAL TIME 100 HEALTH SUMMIT IN 2019. HER WORK HAS WON AWARDS FROM THE NEW YORK PRESS CLUB, AND RECOGNITION FROM THE DEADLINE CLUB. IN ADDITION, SHE IS THE AUTHOR OF THE STEM CELL HOPE: HOW STEM CELL MEDICINE CAN CHANGE OUR LIVES.

Most women should start mammogram screenings for breast cancer at age 40, and get screened every other year until they reach age 75, according to new recommendations from an expert panel.
The U.S. Preventive Services Task Force (USPSTF), which is an independent group of experts funded by the government, regularly reviews data and makes recommendations on health issues, and many health providers follow them. It decided to revise its advice on mammogram screening that was last issued in 2016. That guideline said women should start regular mammogram screening every other year beginning at age 50, and that women ages 40 to 49 should discuss with their doctors the best screening regimen for them.
Here's what to know about the latest change.

When should most women get their first mammogram?
The new recommendation is based on additional evidence that has emerged since 2016, says Dr. John Wong, vice chair of USPSTF. According to data from the National Cancer Institute, the rates of breast cancer for women in their 40s began increasing by 2% annually in 2015, and that trend justified a change in the recommendations to start screening a decade earlier. “Our current data shows that this recommendation could potentially save as many as one out of five women who would otherwise die if they waited to be screened until they were 50,” says Wong. “That’s potentially saving 25,000 women from dying of breast cancer. We think that’s a big win.”

Dr. Maxine Jochelson, a radiologist at Memorial Sloan Kettering Cancer Center, says the revision is long overdue. “The data have shown for years that by not screening women between ages 40 and 50, if women in that age group develop breast cancer, they are more likely to need chemo, more likely to need larger surgery, and more often get more aggressive cancers," she says. "I think they are late to the party.”
It's not clear what is contributing to increased risk among women in their 40s. But Wong says the task force analyzed whether USPSTF’s recommendation around that time—to start mammograms once women turned 50 rather than 40, as the group's previous guideline advised—was a factor, as some advocates had warned. “Screening rates remained consistent throughout that period,” he says. “So that’s not the cause.” The most recent data do include different populations of women, however, incorporates different types of screening and treatment options that weren’t available when the previous populations were studied, so more screening may be leading to more diagnoses, for example.

The current recommendation now brings the USPSTF’s guidance more in line with that of other health groups including the American Cancer Society. That group advises women to start screening at age 45 annually until age 54, then every other year.

Why did the recommendation change?
Wong says the new guidelines reflect the changing benefits and risks of screening and its consequences, which include additional testing, as well as the risk of false positives. The increased risk of breast cancer among women in their 40s tipped the balance in favor of beginning screening earlier.

What about women with dense breasts?
About half of women in the U.S. have dense breast tissue; for them, mammograms are less reliable at detecting cancer. The task force is less clear about whether these women should follow the same recommendations. It says the evidence supporting the benefits of additional screening—with MRIs or ultrasounds, which doctors often recommend if mammograms are negative or inconclusive—isn’t “sufficient.” Wong says more research is needed to understand if those additional imaging tests help women to get diagnosed earlier and ultimately allow them to live longer. “We just don’t have clear evidence at this time,” he says.

Will insurance cover mammograms starting at age 40?
All insurance companies (with few exceptions) must cover the cost of mammograms with no co-pay for women who get them as part of regular screening beginning at age 40. That’s part of the Protecting Access to Lifesaving Screenings Act that was passed by Congress in 2019. Because of this act, the new guidelines should not affect insurance coverage of mammograms for women in their 40s.

But since the task force says the evidence for additional screenings is "insufficient," women with dense breast tissue may still have to pay out of pocket for additional tests beyond a mammogram. That could lead to lower follow-up for these women and ultimately may delay any breast cancer diagnoses until later stages, when the disease is harder to treat. “We worry about what it means for access and utilization for those women, to say that there is inconclusive evidence to support supplemental imaging,” says Molly Guthrie, vice president of policy and advocacy at the Susan G. Komen Breast Cancer Foundation.

Guthrie notes that already, many states require that mammography centers notify women if they have dense breast tissue, so they and their doctors are aware that the mammogram readings may have missed potential red flags for cancer. That requirement will apply to all mammography facilities beginning this September, after the U.S. Food and Drug Administration, which regulates the facilities, issued a new rule last year mandating the information. “The FDA is trying to get to the point of pushing the conversation about dense breast tissue so women have a dialogue with their providers,” says Guthrie. “But if you are not doing anything to change coverage, you are not going to increase utilization."

Wong stands by the task force’s conclusion, seeing it as an invitation for further study. "We would love to have sufficient evidence that would help women with dense breast tissue to live longer, healthier lives, and we are urgently calling for more research to obtain that evidence,” he says. “We always look at the latest and best science—and at the benefits and harms—to make recommendations that help people in this nation stay healthy and live longer.”

Correction, April 30
The original version of this story mischaracterized the increase in cancer deaths among women in their 40s. The incidence of cancer, not the death rate, has been rising at 2% per year.