Workers’ experiences with returning to work after cancer

There is a need of better collaboration and coordination of the return-to-work process of cancer survivors. Return-to-work should be included in the Care Pathway (pakkeforløp).

Background: Many cancer survivors (CS) experience long-lasting symptoms after cancer treatment, such as fatigue, depression, pain and reduced cognitive function. For workers, these symptoms may result in problems with returning to work. To help these workers return to work (RTW) some get support and supervision by job supervisors (JS) employed by the Social Welfare Administration (NAV) or by a work integration enterprise (arbeidsmarkedsbedrift).
Aim: The aim of this study was to explore CS’ experiences in returning to work - with a particular focus on the support received from JS.
Methods: We interviewed in depth five cancer survivors who had received supervision by a JS and five JS who had supervised CS. Data were transcribed verbatim and thematically analysed in accordance with Brown & Clark (2021).
Results: Based on the data from both the CS and JS, three themes were identified: 1) Transition from being a patient to being a worker, 2) Social support, and 3) Collaboration between key stakeholders. Overall, the CS and JS had relatively similar descriptions of CS’ resources, needs, and challenges. The CS were very motivated to RTW but found it difficult to accept their reduced work ability, and also to relate to differing advice given by family, friends, doctors and NAV – ranging from “just apply for disability pension” to “you are healthy, just start working full time as soon as possible”. Despite conflicting advice, the CS felt they received valuable emotional support during their RTW process from their family, doctors, JS, as well as their employers and colleagues. Some employers were positive to make adjustments at work, but others were not – and particularly not if the adjustments lasted for long. Employers’ understanding of late effects experienced by CS seem insufficient. NAV did not organize the standard Dialogue Meeting 2 for any of the CS, resulting in inadequate communication between important stakeholders (i.e., the CS, general practitioner, NAV, union, and employer). The CS described the support and help from the JS in very positive terms and regarded the emotional and instrumental support they received as crucial. Nevertheless, both CS and JS demanded more and better competence in, and collaboration between, health services, NAV, employers, and work integration enterprises when it comes to supporting CS in their RTW.
Conclusion: CS are very motivated to RTW, but the process may be difficult and long-lasting. There is a need of better collaboration and coordination of the RTW process of CS with long-lasting late effects of the cancer treatment. RTW should be included in the Care Pathway (pakkeforløp) for CS of working age.