6. Providing Cancer Patients and Survivors with the Right to Reintegration Into the Workplace
It is estimated that around half of the people diagnosed with cancer are of working age109. Any cancer diagnosis is likely to result in long periods of sickness absence because of the need to undergo medical treatments and attend appointments, as well as endure functional restrictions as a result of treatment. Indeed, a 2009 estimate suggested the total economic loss to the EU due to lost working days as a result of cancer at EUR 9.5 billion110. With further increases in the number of cancer diagnoses in the population expected, and as many countries increase the retirement age, the numbers of people working with, and/or surviving from, cancer will increase111.
Furthermore, even after treatment ends, many cancer survivors must live with long-term symptoms and impairments, often related to the treatment they receive, which may include fatigue, pain and other work relevant side effects. Other implications of cancer and its treatment that influence occupational safety and health are impaired mental health, including depression and anxiety, diminished physical functioning and symptoms such as pain and reduced cognitive capacities, including attention and memory problems. Each on their own, and often in combination, have clear employment-related impacts for the individuals concerned, including job retention, limitation of promotion and development opportunity, and even reduced ability to enter, re-enter or move in the job market. Particular impacts from a cancer diagnosis occur for the self-employed, with studies suggesting a higher negative impact to personal finances than for salaried cancer patients and survivors112.
In total, the overall risk of unemployment among cancer survivors is estimated to be 40% times higher than among people who have never been diagnosed with cancer113. A country-specific study from the Netherlands in 2014 found that the employability of cancer patients and survivors is the lowest among all chronically-ill patient groups in the country114.
Fighting cancer at European level means also fighting for an improved environment for cancer patients and survivors to return to work, and to enjoy the same chances of economically productive and fulfilling work lives as the rest of the population.
In some countries in Europe, protecting cancer patients and survivors from workplace discrimination has included utilisation of disability discrimination legislation. For example, in the UK, the law considers having cancer to be a disability, meaning the individual with cancer cannot be treated less favourably than other people (who do not have cancer) because of their cancer, or for reasons connected to the cancer115.
Primary care has a significant role to play in improving the chances of cancer patients and survivors to attain successful reintegration into the workplace. General practitioners, community pharmacists, community nurses, psychosocial professionals (psychologists, social workers, counsellors, etc.), physiotherapists, dieticians, and occupational specialists from a range of professions all can help address the personalised support needs individuals have in achieving successful readjustment after diagnosis and treatment.
But too often, primary care is not sufficiently strong within national health systems to perform this supporting role to the level of need that exists. Optimal integration between primary and secondary care also remains a significant challenge. Ultimately, what is required is the delivery of a collective role by primary care, secondary care and occupational care in assisting individuals with return to work, but too often, coordination is lacking.
A significant challenge is also presented when it comes to securing and protecting the rights of carers in respect to cancer care and survivorship. Many informal cancer caregivers make employment changes to provide care during survivors’ treatment and recovery. These employment changes can lead to reduced income and financial difficulties.
