Supporting Cancer Survivors’ return to work: The role of physical therapists.

Physical therapists are vital in aiding functional recovery during cancer care, which is pivotal for cancer survivors' return to work. Enhancing supportive structures can further optimize this process

Background: The prevalence of cancer is on the rise, yet fortunately, advancements in treatment have led to improved survival rates. While the healthcare system excels in saving lives, there remains a crucial question: How effectively is the issue of quality of life post-cancer treatment addressed? Particularly, how do healthcare professionals tackle the complex intersection of patients' work situations? Despite reports from cancer survivors (CS) that discussions on work-related matters occur during treatment, the issue of return to work (RTW) lacks standardized follow-up procedures in the early stages of cancer care in Norway. Central guidelines underscore the importance of addressing the connection to the workforce for individuals of working age in all interactions within the healthcare system. This imperative extends to healthcare professionals, including rehabilitation experts such as physical therapists (PT). Research indicates that inadequate support from healthcare professionals may lead to adverse changes in working conditions, potentially impacting CS' quality of life.
Aim: The aim of this study was to explore how PT address the issue of RTW when facilitating CS.
Methods: Qualitative data were collected through seven semi- structured in-dept interviews with PTs working in hospitals among three different enterprises in Norway. The data were analyzed thematically.
Findings: Three main themes emerged from the interviews:1) “How to identify the issue owner of RTW” with subthemes of role clarity and professional competence; 2) “The need for tailoring”, encompassing early intervention, timeline sensitivity, and cross-sectional collaboration; and 3) “The importance of common ‘cancer and work’ knowledge” including the subthemes: knowledge of the CS’ employer, and knowledge of the CS’ profession. Overall, the PT described their role as unclear regarding RTW but recognized the relevance and importance of their competence in facilitating CS' RTW processes. They advocated for extended care pathway for cancer (pakkeforløp) and longer follow-up periods, allowing improved collaboration with municipal healthcare, Social Welfare Administration (NAV), and the enterprises.
Conclusion: Many CS express concerns about their ability to reintegrate into the workforce post-cancer treatment, fearing they may not cope with the demands of working life as adeptly as before. PT play an important role in facilitating functional improvements from the early stage of cancer care, crucial for RTW. However, the potential of PT to provide extended follow-up care is curtailed by structural limitations, thereby impeding an effective RTW process for CS. This underscores the pressing need to enhance existing structures to promote the health and quality of life of CS.