Cancer often has a distressing financial impact on survivors and their families, especially when patients are unable to work during treatment and / or struggle to return to work. And it’s not just the financial realities that are soul-destroying.
Work is an integral part of our identity. It is a clear component in how we see ourselves and how we are perceived by others. Being unable to work provides emotional and psychological challenges that undermine our overall sense of self and wellbeing.
And then there’s the practical realities; dilemmas about work often includes questions such as:
The bottom line is that there are an increasing number of working age people surviving cancer and a growing association between cancer survivorship and unemployment.
I’m Lou James and I’ve been working in the field of cancer rehabilitation for over 10 years. People need help; they need specialist help that makes a meaningful difference and I believe we should be providing that help routinely!
Cancer survivors are at a higher risk of unemployment or leaving the workforce early. Research combining the results of 36 studies showed that people have a 37% higher risk of unemployment after cancer and a threefold risk of disability compared to people without cancer (de Boer, Taskila, Ojajavi, van Dijk, and Verbeek, 2009).
The majority of people with cancer will return to work but without the right support may experience difficulty in remaining in work (Taskila, 2007).
Research has shown that 18 months after a diagnosis of cancer, a lack of workplace interventions was associated with fatigue, which in turn was correlated with higher levels of depression (Taskila, de Boer, van Dijk, and Verbeek, 2011).
The exact cost of cancer related absenteeism in New Zealand and Australia is unknown. But let’s look at what we do know.
The increased costs for the person with cancer is self- evident; loss of earnings and increased expenses attending hospital appointments, medications, childcare etc. If the employee has income protection insurance cover, they may have some or all of their lost earnings covered… but this cost is met by the insurance companies.
Family members often also suffer additional costs and reduced earnings – taking more time off work to support the person with cancer and contributing to the very real financial burden.
There can be significant impact on people’s educational and qualification attainment when necessary resources are diverted to help ‘fight cancer’ – outcomes that impact on a family’s future financial earnings as well.
There are financial implications for employers and businesses through lost productivity and sick leave for the person with cancer. Plus the reality that their support network will no doubt also require time off work whether or not that is directly paid for under the employer’s sick leave policies.
Cancer-related unemployment provides an inevitable burden on the State. Not just the immediate costs in unemployment benefits but ongoing services to help individuals find a job. Long term unemployment is associated with poorer quality of life – emotionally and physically, placing even greater burdens on our public health system and related services.
Fatigue is the most frequently reported symptom of both cancer and its treatment. It has been shown as causing the greatest interference with patients’ ability to return to work. Just to be clear - it is very different from the fatigue experienced by healthy individuals in that it persists even after rest and sleep.
This kind of fatigue severely impacts on an individual’s ability to work due to compromised mental and physical functioning, difficulties problem solving, and decreased motivation and vigour in the completion of required tasks.
Further, research shows that individuals being treated for cancer whilst continuing to work can experience higher levels of fatigue compared to those who cease work (Pryce, Munir, & Haslam, 2007).
Cancer rehabilitation physiotherapists are experienced in the management of fatigue during and after cancer treatment. It is very important to manage fatigue symptoms; to provide adequate support for people remaining at work as well as returning to work.
There is growing evidence that cancer rehabilitation prescribed for the individual undergoing cancer treatment delivers greatly improved physical and functional status, and can help reduce other cancer-related treatment side effects.
There is also an abundance of evidence that regular moderate exercise can decrease feelings of tiredness, lack of energy and fatigue. During cancer treatment it is often possible to continue exercising if it is carefully prescribed by a medical professional with cancer rehabilitation experience.
If symptoms are not managed throughout treatment there is a greater risk a patient will have problems coping. The combined burden from treatments and lack of physical activity can cause de-conditioning which can further exacerbate fatigue and lead to a longer road to recovery.
If cancer rehabilitation physiotherapists are able to assess and treat patients early after diagnosis, they are more likely to be able to implement successful self-management strategies that will help the patient in staying or returning to work.
By enabling people with cancer to stay at work or return to work, the financial implications will be reduced whilst supporting improved quality of life for the individual. This has a huge impact not only on the patient and their family but also will reduce the financial burden of cancer for the employer, Government benefit support systems and insurance companies.
Research indicates that rehabilitation should be part of the clinical pathway for cancer patients. Our PINC & STEEL physiotherapy network now extends throughout Australasia and is now starting to infiltrate into the UK, Ireland and beyond!
Together our pioneering oncology rehabilitation physiotherapists are helping more and more patients but there is still an enormous discrepancy in the amount of people suffering from side effects of cancer treatment and those being referred to rehabilitation.
Cancer Rehabilitation is funded by some insurers! AMP is one insurer that is already actively supporting rehabilitation for cancer patients – is yours?!
Now’s the time to ask the question. Do your insurers and your health professionals know where to refer patients for effective rehabilitation? What support is there for your loved ones to make sure they get the help they need, now and long term?
And please share this article. We’re passionate about getting cancer survivors the meaningful rehabilitation services they need. But we need your to help spread the word.
Written by Lou James Founder of the PINC and STEEL and Next Steps Cancer Rehabilitation programmes, AMP scholarship Ambassador.