Returning to work after cancer

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Published: 9 Sep 2017
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Dr Cecilie Kiserud - Oslo University Hospital, Oslo, Norway

Dr Kiserud speaks with ecancer at ESMO 2017 about the barriers to cancer survivors returning to work.

She reports on results from a survey of cancer survivors from multiple disease types, in which certain factors were found to be consistent barriers to resuming their previous employment. 

Among these Dr Kiserud notes non-Hodgkin lymphoma as a disease with the lowest proportion of patients returning to work, possibly due to secondary disease and long-term side effects, and that there was a difference between men and women returning to work.

Read more about these findings here.

It’s a study on self-reported work ability among cancer survivors treated in young adulthood. It’s a questionnaire-based study and we included patients treated for breast cancer, colorectal cancer, melanoma, non-Hodgkin’s lymphoma and leukaemia in the period 1985 to 2009. We asked them about several late effects and their current work ability.

What were the general trends that you saw?

The main result is that there are many both psychological and somatic factors that impact on the self-reported work ability, both late effects but also other conditions.

How did those vary across the disease type?

We didn’t find significant associations between the disease type and the work ability except for those treated for non-Hodgkin’s lymphoma which are at increased risk for having lower work ability. But it’s because there is a more indirect effect of the treatment to more intense treatment giving a higher risk for some late effects that we found were associated with having lower work ability. So it’s more the effect goes through the late effects and not directly from treatment or disease.

Were there any other factors related to poor work ability recovery?

Female gender and having a lower educational level was also associated with having impaired work ability.

I guess that just comes down to the broader sociological barriers to returning to work for women anyway?

Yes, I think so. Also about half of the participants were female treated for breast cancer which also might have an impact on that result.

What was the general response among patients who were completing these self-assessment forms?

The patients were identified through the cancer registry of Norway and we sent them a mail questionnaire and they sent it back in a prepaid envelope. So we actually don’t ask them if they are happy to answer the questionnaire or not.

I guess then the question is what do we do with this information going forwards if we are coming up with treatments and regimens for patients trying to get them treated adequately but also with a high ability to continue with a healthy normal life going forwards after their treatment? What does this mean for further research?

We have some specific rehabilitation programmes in our health region to help cancer patients and survivors back to work. Many cancer survivors also struggle with staying at work over a longer period. There are needed efforts on several levels, both information to general practitioners and the welfare system that helps people who have trouble with their work situation, knowledge that cancer survivors might experience late effects that might impact on their work ability. And also specifically rehabilitation programmes that might help cancer survivors to have a better work ability. If you can also have a better system for detecting and treating late effects of treatment that will also probably give a better work ability.

As a final note, what are your thoughts on having an ESMO session at this conference specifically for survivors of cancer and helping people in their life after cancer?

I think it’s fantastic that also ESMO acknowledge that life after cancer is an important issue. I think that’s very nice.