Receiving a cancer diagnosis when you are still of working age is common; almost half of adult survivors are under age 65. For many people, the after-effects of surgery and treatments can alter their ability to work and their prospects for employment. For people who are able, work improves quality of life and self-esteem. It’s also important for society, because the costs of disability will increase as the number of people living with cancer increases. For many people, going back to work is a personal benchmark for completing their initial cancer journey and recovery.
Fortunately, many cancer survivors are able to return to work without disabilities. However, many people struggle with cognitive, physical and treatment-related changes, meaning it takes longer getting back to work than they anticipated. Cancer survivors are almost one and a half times more likely to be unemployed than healthy people of working age. Most survivors who were working at the time of diagnosis need to take a few months off during active treatment. For most, their ability to work slowly returns. In some studies, however, former cancer patients report a 26 per cent deteriorated physical work ability and a 19 per cent deteriorated mental work ability between two and six years after diagnosis.
Some common problems keep survivors from working. Many report difficulty remembering and concentrating – commonly referred to as “chemo brain” or “brain fog.” For some people, treatments lead to measurable cognitive changes, sometimes due to anxiety and depression. Surgeries can impact physical abilities related to job tasks, so that going back to work may require survivors to retrain. Fatigue can be overwhelming, and survivors can feel its effects for years.
Employers would benefit from education about the needs of survivors. Some employers aren’t financially prepared or don’t understand their employees’ need for a slow re-entry to work. Organizations would benefit from creating plans and systems that prepare for the interruption of work and the measured reintroduction of their employees to the workplace. One clear message from the literature is that getting back to work requires energy.
Survivors can facilitate their own return to work. Staying fit and exercising within the limitations of treatment, both during and after, can speed the return to work. However, the few studies testing the effectiveness of return-to-work strategies indicate that programs are most effective when they are multidisciplinary and include physical, psychological and vocational interventions. Survivors can set themselves up for success by educating themselves, improving fitness and talking to professionals, other survivors and their employers about concerns. And they can benefit from engaging the health system or community programs for rehabilitation.
Moving beyond cancer includes steps to increase the readiness for work.
What can you do?
First, start by learning. The Canadian Partnership Against Cancer recently published summaries of programs that facilitate patients’ return to work in North America, the U.K., and Australia. These summaries are available at Cancerbridges.ca (see the blog post for November 13, 2012). You can also find the information at cancerview.ca.
Next, take advantage of programs that offer support:
- The B.C. Cancer Agency provides a successful model for vocational counselling, and Wellspring has “brain fog” and “back to work” programs in Calgary and elsewhere.
- Dr. Nicole Culos-Reed’s Thrive Centre in Calgary provides free workout facilities and can provide a physiological assessment for fitness program for cancer survivors.
- Better Choices, Better Health is a free program of Alberta Health
- Services designed to support people living with ongoing chronic health conditions, including cancer.
- In Alberta you can receive financial advice and help from cancer social workers in psychosocial resources departments in Calgary and Edmonton, and many rural locations.
- Rehabilitation departments can also provide occupational, physical, nutrition and speech therapy.
- Psychological help (individual, group, family, and art therapy) for depression, anxiety, fatigue and sleep is also available free through Alberta Health Services psychosocial resources and community-based organizations.
- Look at cancerbridges.ca for related programs on the live calendar.