Digest Commentator: Nicole Anna Rutkowski, PhD student in Clinical Psychology, School of Psychology, University of Ottawa

Digest Editor: Mary Ann O’Brien, PhD, Department of Family and Community Medicine, University of Toronto

Digest Commentary

Returning to work is an important milestone and financial necessity for many cancer survivors, however many misperceptions and barriers preclude survivors from successfully transitioning back into a working environment. This article addresses an important gap in cancer survivorship, as little research has been done within the Canadian context on cancer survivors’ experiences returning to work. The Canadian Partnership Against Cancer launched a Return to Work Initiative to gain a better understanding of Canadian cancer survivors’ needs as they transition back into the work force.  The purpose of this study was to determine survivors’ and caregivers’ concerns related to working, challenges employers face accommodating survivors, and ways to better support employees, managers, and caregivers.  

In order to gain a comprehensive understanding, the Return to Work Initiative examined the perspectives of survivors, caregivers, and workplace representatives. During the preliminary phase, the researchers conducted a literature review, an environmental scan, and conducted key informant interviews. The findings suggested a shortage of services available to survivors experiencing challenges resuming work activities. With a greater understanding of the lack of resources and programs available for survivors, the researchers turned their focus to trying to understand the individual experience of survivors and their caregivers. A national online survey captured cancer survivors’ (n=410) and caregivers’ (n=60) challenges when returning to work. To gain the perspective of employers, in-depth interviews were conducted with 41 workplace representatives (i.e. managers, union leaders, insurers). After the initial analysis, results were reviewed and discussed with cancer survivors and employers through separate focus groups to develop solutions for identified challenges. Recommendations were developed on how to better meet the needs of cancer survivors returning to work.       

Despite many survivors reporting feeling supported by employers, concerns remained. Major concerns for survivors included decreased income, an inability to resume previous work activities, a lack of accommodations, difficulties negotiating with employers, and a lack of information on assistive programs. Interestedly, many similar concerns were raised amongst employers, survivors, and caregivers. All expressed a need for more education on workplace accommodations, improved communication, and a need for additional community resources and supports. Additionally, receiving more information on how to access financial supports was deemed to be important by survivors and caregivers.  Employers expressed interested in addressing survivors’ return to work concerns, however they also encountered difficulties navigating insurance and government sponsored benefits for employees. Unfortunately, survivors re-entering the workplace were not seen as a priority due to the relatively low numbers of cases and an absence of re-entry policies for cancer survivors. Importantly, survivors expressed fears of informing employers of their diagnosis due to perceived negative repercussions on job duties, promotions, and possible termination. Limitations of the study included convenience sampling which likely contributed to a well-educated, predominately female sample and a high portion of breast cancer survivors (46%). Further, employers may have over emphasized the support provided to employees and minimized weaknesses.   

Why I liked this article:

This article provides insight into some of the barriers cancer survivors, caregivers, and employers face regarding return to work. By understanding the challenges and unique experiences of these groups we can begin to develop and implement adequate re-entry policies and programs to ensure cancer survivors receive appropriate support as they transition back to the work place.

Fitch MI & Nicoll I. (2019). Returning to work after cancer: Survivors’, caregivers’ and employers’ perspectives. Psycho‐Oncology; 1-7. doi.org/10.1002/pon.5021

Journal website: https://onlinelibrary.wiley.com/journal/10991611

website: http://www.ccsrc.ca/AboutUs/our-team/margaret_fitch