Disease Related Factors
Cancer type has the strongest determinant in employment of cancer survivors. Lower employment and work ability are commonly seen in cancer patients of nervous system, lung and hematological (leukemia). The fact that the recurrence rate of the cancer of nervous system is rather high coupled with the unpleasant side effects of the treatment and complications of the cancer, such group of cancer patients are less favored when it comes to employment. As for lung cancer, the survival rate is low with 10% men and 13% women achieve five year survival rate.
Breast, colorectal, prostate and testicular cancers are among the most prevalent and have higher survival rate due to advances in cancer treatment. Thus, the chances of returning to work following diagnosis and treatment within these groups are comparatively higher.
Other existing chronic illness like diabetes, hypertension and hyperlipidemia would also affect the return to work and work ability of the employees.
Chemotherapy being a common treatment modality for cancer usually causes side effects like fatigue, menopause and cognitive impairment as compared to other mode of treatments. Fatigue level independently predicts how soon an employee with cancer is ready to return to work and significantly impact on work ability. Treatment related symptoms significantly decrease the quality of life among patients undergoing treatment. Such side effects should be addressed during follow up in order for the medical team to make necessary adjustments on the treatment.
Sociodemographic factors of the employees do play a role in employment and work ability of cancer survivors. Employers are less likely to hire those who are older, working in blue collar jobs and have lower educational backgrounds. It is not uncommon for lower educated employees to work in more physically demanding jobs. Physical capacity of the these cancer survivors may be compromised by the diseases or even the treatment itself. Thus, it is not surprising that cancer survivors with a lower education might be more likely to discontinue their work after a bout with cancer than those with a higher education.
The work ability of the employees resuming a job upon treatment would be improved greatly if there is practical support from their supervisors in the form of taking the illness into consideration when allocating work tasks to the employees at the workplace.
Potential social issues that cancer survivors may encounter upon rejoining the workplace are, fear of discrimination, unwillingness to change work tasks, and unwillingness to change their current jobs for the fear of losing insurance coverage. Such worries and fears have a negative impact on their quality of life and productivity.
The social support from the workplace, occupational physician and the willingness of the employer to accommodate the cancer survivors are the important factors in assisting cancer survivors to return to work.
Impairment of work ability associated with cancer varied in various reports from about 20% to 30%. It is crucial to identify those cancer survivors who are at the highest risk of impaired work ability and would most likely discontinue their working life earlier. Once this group of employees are identified, a more comprehensive type of return to work program could be designed and serve as a part of management of cancer survivors in returning to work via early assessment and intervention program.
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