Return to work after cancer: what does science say?
Around 1.6 million people of working age are diagnosed with cancer in Europe each year. Thanks to medical advancements, the number of cancer survivors is rising and more recovered patients return to work. The European Agency for Safety and Health at Work (EU-OSHA, one of the six partners), provides an overview of what is known about this emerging issue based on scientific literature. The total economic loss to the European Union due to lost work days as a result of cancer was estimated at 9.5 billion euros in 2009. However, although the return to work of cancer survivors is economically important, little is reported about the cost of failure. Many survivors of the disease struggle to return to work but this process is not always easy and they may face difficulties.
Issues with return to work
Research shows that workers affected by cancer report various effects of sickness and its treatment on their health, including mental, cognitive and physical symptoms. Fatigue, exhaustion and emotional strain are the most common aftermaths, regardless of the type of cancer. Other implications of cancer may be depression, anxiety, pain and problems with attention and memory. As a result of one or more of these symptoms, their work productivity and work ability may be undermined, making it more difficult to remain in or re-enter the job market, and cancer survivors may be unable to carry out their usual tasks. Other factors influencing return to work after cancer treatment is the meaning of work and motivation to work, and attitudes and behaviours of colleagues or employers. Negative experiences such as feeling stigmatised or discriminated or unsolicited workplace adaptations hinder the comeback.
Addressing all these factors might improve return to work rates and point out workers who are specifically at risk of not returning to work. In general, work accommodations provided by employers and support for return to work from healthcare professionals are appreciated by cancer survivors, as long as they are agreed and consulted with workers. However, although such programmes are available in a number of countries, it seems that there is a lack of awareness about them and about what can be done to maintain cancer survivors at work.
The size of the company seems to have an impact on cancer survivors’ opportunities to return to work, according to EU-OSHA’s report. In companies with fewer than 250 workers, information and awareness about resources for strategies or return-to-work programmes is particularly scarce. Return to work for self-employed and those working in small enterprises is even more problematic.
What can be done to support return-to-work by cancer survivors
Effective interventions are needed to enable return to work. A more friendly return to work of employees with cancer would improve the well-being of this vulnerable group and lessen the financial cost for workers, employers and society.
It is proven that multidisciplinary interventions concentrating on the worker increase return to work rates, albeit only to a small extent. These interventions include physiotherapy, occupational therapy, speech therapy, vocational rehabilitation, education, counselling and training. However, the report carried out by EU-OSHA shows that little is known about the effectiveness of return-to-work interventions, including those foreseeing workplace adaptations.
This is the reason why EU-OSHA’s next step is to further explore existing workplace interventions and good practice examples of return-to work programmes, as well as the experiences of enterprises through company case studies. More information will be published about successful instruments, interventions, programmes and practices and recommendations drawn from practical experiences. The ultimate aim is to provide policy options that can be considered by decision-makers in order to increase and support return to work of cancer patients. EU-OSHA is also preparing a short document that is meant to guide enterprises who are confronted with a case of cancer among their workers.