UCLA

Objective. Work provides personal satisfaction, meaningfulness, and financial stability to adolescent and young adult (AYA) cancer survivors. However, progressive health changes because of cancer and its treatments, may compromise safety and diminish ability to work. Workplace regulations and processes also influence productivity and employment sustainability for AYA cancer survivors. This dissertation explored interactions, and factors influencing interactions, among employed AYA cancer survivors, five years or more after treatment, and occupational and environmental health professionals (OEHPs) within the workplace.

Methods. Data were collected and analyzed using constructivist grounded theory. Individual interviews generated data from twelve AYA cancer survivors (age 15-39 at diagnosis). The sample of AYA cancer survivors (n = 12) was obtained from the California

Surveillance Program in Los Angeles. During interviews, AYA cancer survivors identified OEHPs they encountered in the workplace. Then, twelve OEHPs were interviewed based upon the specified professional categories. Qualitative analysis developed theoretical frameworks based upon the narratives of the participants.

Results. Data revealed the complexity of employment issues surrounding AYA cancer survivors during a career. Disclosure of a cancer survivor identity was central to the frameworks. Four processes were identified: Weighing the risks of revealing the survivor-self, sustaining work ability, weighing advocacy, and accessing or providing support. Additionally, employment challenges were organized into themes: Evading the cancer card, working around limitations, and powering-through for AYA survivors. On the other side of legal protection, OEHPs were becoming agents of change by discovering AYA cancer survivors, navigating systems to provide support, and identifying changes needed.

Conclusion. This dissertation illuminated the unique experiences of AYA cancer survivors and OEHPs in the workplace. Availability of services provided by OEHPs facilitated AYA cancer survivors’ work ability if services were available, known to survivors, and if survivors were willing to reveal needs. Education about OEHP services by employers would improve interactivity and provide a supportive work environment for survivors. Education for workers is needed to enhance sensitivity and improve communication with employees who have a history of cancer. Legislation is needed to promote long-term work ability among AYA cancer survivors by protecting confidential communication to promote greater utilization of OEHP services.