"The only way I know how to live is to work": a qualitative study of work following treatment for prostate cancer.

OBJECTIVE: For many survivors of prostate cancer, returning to work posttreatment is a realistic goal. However, little research to date has explored work among prostate cancer survivors. The focus of this study was to explore the meaning of work among prostate cancer survivors and to describe the linkages between masculinity and work following prostate cancer treatment. METHOD: Fifty prostate cancer survivors who were in paid employment prior to their diagnosis completed a semistructured interview following completion of their treatment and of these, 41 also completed a 12-month follow-up interview. Framework analysis of the 91 transcripts was undertaken. RESULTS: The majority of the men had returned to work at the 12-month interview. Four themes were identified, and these were labeled "Work and self-identity," "Work-related implications of treatment side effects," "Disclosure of cancer," and "Perceptions of future as a cancer survivor." A degree of embarrassment and concern about residual side effects and whether these would present a challenge within the workplace was apparent among our sample and was compounded by a reluctance to disclose these. CONCLUSIONS: The descriptions provided by the men in this study reveal that the experience of prostate cancer can lead to challenges for both social and work-related roles. The influence of prostate cancer on men's reports of masculinity was variable, and recognition of these differences is required. In addition, some survivors of prostate cancer may require specific interventions aimed at helping them to manage disclosure of their illness, particularly within a work environment.

Distinct work-related, clinical and psychological factors predict return to work following treatment in four different cancer types.

OBJECTIVE: Many factors influence return to work (RTW) following cancer treatment. However specific factors affecting RTW across different cancer types are unclear. This study examined the role of clinical, sociodemographic, work and psychological factors in RTW following treatment for breast, gynaecological, head and neck, and urological cancer. METHODS: A 12-month prospective questionnaire study was conducted with 290 patients. Cox regression analyses were conducted to calculate hazard ratios (HR) for time to RTW. RESULTS: Between 89-94% of cancer survivors returned to work. Breast cancer survivors took the longest to return (median 30 weeks), and urology cancer survivors returned the soonest (median 5 weeks). Earlier return among breast cancer survivors was predicted by a greater sense of control over their cancer at work (HR 1.2; 95% CI: 1.09-1.37) and by full-time work (HR 2.1; CI: 1.24-3.4). Predictive of a longer return among gynaecological cancer survivors was a belief that cancer treatment may impair ability to work (HR 0.75; CI: 0.62-0.91). Among urological cancer survivors constipation was predictive of longer RTW (HR 0.99; CI: 0.97-1.00), whereas undertaking flexible working was predictive of returning sooner (HR 1.70; CI: 1.07-2.7). Head and neck cancer survivors who perceived greater negative consequences of their cancer took longer to return (HR 0.27; CI: 0.11-0.68). Those reporting better physical functioning returned sooner (HR1.04; CI: 1.01-1.08). CONCLUSION: A different profile of predictive factors emerged for the four cancer types. In addition to optimal symptom management and workplace adaptations, the findings suggest that eliciting and challenging specific cancer and treatment-related perceptions may facilitate RTW.

The organisational perspective on the return to work of employees following treatment for cancer.

INTRODUCTION: Due to improved survival rates across cancer types there is an ever increasing group of cancer survivors of working age with a unique set of needs associated with living with cancer and with returning to work. Little is known about the services provided for cancer survivors or the needs of organisations in the return to work process. This study aimed to provide this information through a survey of the organisational perspective of the return to work of cancer survivors. METHODS: Questionnaires were sent to human resource or occupational health departments of 815 medium to large organisations. The questionnaire focussed on the companies' policies and procedures, their return to work services and beliefs about the experiences of cancer survivors returning to the workplace. RESULTS: 252 organisations returned completed questionnaires (response rate 31%). 48% of respondents were unable to provide information about the number of employees diagnosed with cancer in the past 12 months. A range of return to work services was provided although only 38% provided employees with written information or guidelines about return to work policies or services. Respondents tended to view employee related factors, such as employee attitude and emotional functioning, as key to a successful return to work. CONCLUSIONS: Organisations aim to be supportive of cancer survivors returning to the workplace and potentially offer a range of return to work services. However, employees may not be adequately informed of such services and a lack of information and clear communication may hinder a positive return to work experience.