Skip to main content

Helping Cancer Survivors Return to Work: What Providers Tell Us About the Challenges in Assisting Cancer Patients with Work Questions

Abstract

Introduction Cancer patients and survivors report receiving little work-related advice from healthcare providers about how to manage their work during treatment or when to return after completing primary treatment. This study explores the extent to which health professionals involved with colorectal cancer patients address work matters during active treatment. Methods Eighteen health professionals from oncology, occupational health and general practice were interviewed. Interviews were transcribed verbatim and analysed using thematic analysis. Results Health professionals provide conflicting and limited information to patients regarding ability to work during treatment, or when to return to work thereafter. Lack of knowledge about impacts of treatment and symptoms on work ability and sustainability, particularly in relation to different occupations and work tasks resulted in providers offering minimal guidance to patients. Current practices relied on providers’ previous experiences with employed patients, rather than a sound evidence-base. Conclusions The type of work-related information given to patients by providers is not systematic. It is necessary to develop a better knowledge base about the impacts of cancer and its treatment on work ability, sustainability and return to work that would help providers to offer more tailored advice to patients, consistently. Therefore, it is appropriate to recommend that formal training for providers is necessary. Enhancing the quality of information and training for health professionals to provide better work-related support to patients during the early stages of treatment could enable individuals to manage their work more effectively and facilitate a successful transition from patient to survivor.

This is a preview of subscription content, access via your institution.

References

  1. Bowel Cancer UK. Bowel cancer—key statistics. Available from, http://www.bowelcanceruk.org.uk/factskeystats.htm (2006).

  2. Amir Z, Moran T, Walsh L, Iddenden R, Luker K. Return to paid work after cancer: a British experience. J Cancer Surviv. 2007;1(2):129–36.

    PubMed  Article  Google Scholar 

  3. Centre for Research into the Older Workforce. Are older workers different? Available from http://www.surrey.ac.uk/education/crow.htm (2004).

  4. Riche MF. The demographics of tomorrow’s workplace: Pension Research Council working paper PRC WP 2001-14. Philadelphia: University of Pennsylvania Press; 2001.

  5. Hewitt M, Ganz PA. From cancer patient to cancer survivor lost in transition. Washington: National Academies Press; 2006.

    Google Scholar 

  6. Sanchez KM, Richardson JL, Mason HR. The return to work experiences of colorectal cancer survivors. AAOHN J. 2004;52(12):500–10.

    PubMed  Google Scholar 

  7. Choi KS, Kim E, Lim J, Kim S, Lim MK, Park J, et al. Job loss and reemployment after a cancer diagnosis in Koreans: a prospective cohort study. Psychooncology. 2007;16(3):205–13.

    PubMed  Article  Google Scholar 

  8. Schultz PN, Beck ML, Stava C, Sellin RV. Cancer survivors: work-related issues. AAOHN J. 2002;50(5):220–6.

    PubMed  Google Scholar 

  9. Bower JE, Ganz PA, Desmond KA, Bernaards C, Rowland JH, Meyerowitz BE, et al. Fatigue in long-term breast carcinoma survivors–A longitudinal investigation. Cancer. 2006;106(4):751–8.

    PubMed  Article  Google Scholar 

  10. Spelten ER, Sprangers MAG, Verbeek JHAM. Factors reported to influence the return to work of cancer survivors: A literature review. Psychooncology. 2002;11(2):124–31.

    PubMed  Article  Google Scholar 

  11. Lawrence DP, Kupelnick B, Miller K, Devine D, Lau J. Evidence report on the occurrence, assessment and treatment of fatigue in cancer patients. J Natl Cancer Inst Monogr. 2004; (32):40–50.

  12. Fann JR, Berry DL, Wolpin S, Austin-Seymour M, Bush N, Halpenny B, et al. Depression screening using the patient health questionnaire-9 administered on a touch screen computer. Psychooncology. 2009;18(1):14–22.

    PubMed  Article  Google Scholar 

  13. Massie MJ. Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr. 2004; (32):57–63.

  14. Karki A, Simonen R, Malkia E, Selfe J. Impairments, activity limitations and participation restrictions 6 and 12 months after breast cancer operation. J Rehabil Med. 2005;37(3):180–8.

    PubMed  Google Scholar 

  15. Feuerstein M, Hansen JA, Calvio LC, Johnson L, Ronquillo JG. Work productivity in brain tumour survivors. J Occup Environ Med. 2007;49(7):803–11.

    PubMed  Article  Google Scholar 

  16. Taskila T, Lindbohm ML. Factors affecting cancer survivors’ employment and work ability. Acta Oncol. 2007;46(4):446–51.

    PubMed  Article  CAS  Google Scholar 

  17. Ilmarinen J, Tuomi K, Seitsamo J. New dimensions of work ability. Int Congr Ser. 2005;1280:3–7.

    Article  Google Scholar 

  18. Kennedy F, Haslam C, Munir F, Pryce J. Returning to work following cancer: a qualitative exploratory study into the experience of returning to work following cancer. Eur J Cancer Care. 2007;16(1):17–25.

    Article  CAS  Google Scholar 

  19. Steiner JF, Cavender TA, Nowels CT, Beaty BL, Bradley CJ, Fairclough DL, et al. The impact of physical and psychosocial factors on work characteristics after cancer. Psychooncology. 2008;17(2):138–47.

    PubMed  Article  Google Scholar 

  20. Taskila T, Lindbohm M-L, Martikainen R, Lehto U-S, Hakanen J, Hietanen P. Cancer survivors’ received and needed social support from their work place and the occupational health services. Support Care Cancer. 2006;14(5):427–35.

    PubMed  Article  Google Scholar 

  21. Maunsell E, Brisson C, Dubois L, Lauzier S, Fraser A. Work problems after breast cancer: an exploratory qualitative study. Psychooncology. 1999;8(6):467–73.

    PubMed  Article  CAS  Google Scholar 

  22. Verbeek J, Spelten E, Kammeijer M, Sprangers M. Return to work of cancer survivors: a prospective study into the quality of rehabilitation by occupational physicians. Occup Environ Med. 2003;60(5):352–7.

    PubMed  Article  CAS  Google Scholar 

  23. Verbeek JH. How can doctors help their patients to return to work? PLoS Med. 2006;3(3):e88.

    PubMed  Article  Google Scholar 

  24. Main DS, Nowels CT, Cavender TA, Etschmaier M, Steiner JF. A qualitative study of work and work return in cancer survivors. Psychooncology. 2005;14(11):992–1004.

    PubMed  Article  Google Scholar 

  25. Pryce J, Munir F, Haslam C. Cancer survivorship and work: symptoms, supervisor response, co-worker disclosure and work adjustment. J Occup Rehabil. 2007;17(1):83–92.

    PubMed  Article  Google Scholar 

  26. Amir Z, Wynn P, Whitaker S, Luker K. Cancer survivorship and return to work: UK occupational physician experience. Occup Med. 2009;59(6):390–6.

    Article  Google Scholar 

  27. Sharma A, Sharp DM, Walker LG, Monson JRT. Stress and burnout in colorectal and vascular surgical consultants working in the UK National Health Service. Psychooncology. 2008;17(6):570–6.

    PubMed  Article  CAS  Google Scholar 

  28. Aitken RC, Cornes P. To work or not to work: that is the question. Br J Ind Med. 1990;47(7):436–41.

    PubMed  CAS  Google Scholar 

  29. Bains M, Munir F, Yarker J, Steward W, Thomas A. Return-to-work guidance and support for colorectal cancer patients: a feasibility study. Cancer Nurs. 2011 Mar 02: Epub.

  30. Niewenhuijsen K, Bos-Ransdorp B, Uitterhoeve LL, Sprangers MA, Verbeek JH. Enhanced provider communication and patient education regarding return to work in cancer survivors following curative treatment: a pilot study. J Occup Rehabil. 2006;16(4):647–57.

    Article  Google Scholar 

  31. Tamminga SJ, de Boer AGEM, Verbeek JHAM, Frings-Dresen MHW. Return-to-work interventions integrated into cancer care: a systematic review. Occup Environ Med. 2010;67(9):639–48.

    PubMed  Article  CAS  Google Scholar 

  32. Mason J. Qualitative researching. London: Sage Publications; 1999.

    Google Scholar 

  33. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.

    Article  Google Scholar 

  34. Merriam SB. Qualitative research: a guide to design and implementation. San Francisco: Wiley Press; 2009.

    Google Scholar 

  35. Garces YI, Hays JT. Tobacco dependence: why should an oncologist care? J Clin Oncol. 2003;21(9):1884–6.

    PubMed  Article  Google Scholar 

  36. Sarna L, Wewers ME, Brown JK, Lillington L, Brecht M-L. Barriers to tobacco cessation in clinical practice: report from a national survey of oncology nurses. Nurs Outlook. 2001;49(4):166–72.

    PubMed  Article  CAS  Google Scholar 

  37. Bouknight RR, Bradley CJ, Luo Z. Correlates of return to work for breast cancer survivors. J Clin Oncol. 2006;24(3):345–53.

    PubMed  Article  Google Scholar 

  38. Yarker J, Munir F, Bains M, Kalawsky K, Haslam C. The role of communication and support in return to work following cancer-related absence. Psychooncology. 2010;19(10):1078–85.

    PubMed  CAS  Google Scholar 

  39. Feuerstein M, Todd BL, Moskowitz MC, Bruns GL, Stoler MR, Nassif T, et al. Work in cancer survivors: a model for practice and research. J Cancer Surviv. 2010;4(4):415–37.

    PubMed  Article  Google Scholar 

Download references

Acknowledgments

We would like to thank the health professionals for taking part in this study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Manpreet Bains.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Bains, M., Yarker, J., Amir, Z. et al. Helping Cancer Survivors Return to Work: What Providers Tell Us About the Challenges in Assisting Cancer Patients with Work Questions. J Occup Rehabil 22, 71–77 (2012). https://doi.org/10.1007/s10926-011-9330-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-011-9330-4

Keywords

  • Cancer
  • Return to work facilitation
  • Work-related advice
  • Rehabilitation
  • Professional-patient relations
  • Qualitative