Return-to-work support in cancer patients: Which methodology?

[Investigation the contents of employment consultation and support in a cancer center hospital]

OBJECTIVES

This study aimed to analyze and categorize the actual situation of employment consultation and support according to consultation times or employment status at the Consultation Support Center of the National Cancer Center Hospital of Japan.

METHODS

We retrospectively analyzed the patient backgrounds, consultation contents, and the number of employment consultation cases conducted at the Consultation Support Center of the National Cancer Center Hospital during a 6-month period from May to December 2018.

RESULTS

During the study period, 117 patients (male: female = 46:71) visited the Consultation Support Center. The median age of patients was 48 years old. The most common primary cancer site was the breast in 28 patients followed by the lung in 16 patients, and then gynecologic cancer in 10 patients. The most common cancer treatment was chemotherapy in 53 patients (45.3%), and 12 patients (10.2%) were recurrent patients. Fifty-two patients were in regular employment, 24 were unemployed, 17 were of unknown employment status, 16 were in non-regular employment, and 8 were classified/categorized as other. In terms of working status, 40 were on leave, 35 were working, 15 were seeking work, 8 were unemployed, and 19 were categorized as other. The median number of consultations was 1 (1,11). The content of consultations was the social security system in 44 cases (37.6%) job seeking in 24 cases (20.5%), how to inform the workplace in 14 cases (12%), and workplace environment adjustment in 13 cases (11.1%).

CONCLUSIONS

We conducted a survey on the actual status of employment consultation in a cancer center hospital. The majority of consultations were completed in one session. In terms of the content of consultations, there was a high need for consultations on the social security system and job seeking. Further study is needed on the characteristics of employment consultations according to employment status and other attributes.

The need to consider return to work as a main outcome in patients undergoing surgery for diffuse low-grade glioma: a systematic review

OBJECTIVE

For a long time, return to work (RTW) has been neglected in patients harboring a diffuse low-grade glioma (LGG). However, a majority of LGG patients worked at time of diagnosis. Moreover, these patients now live longer given current treatment paradigms, especially thanks to early maximal surgery.

METHODS

We systematically searched available medical databases for studies that reported data on RTW in patients who underwent resection for LGG.

RESULTS

A total of 30 studies were selected: 19 considered RTW (especially rate and timing) as an outcome and 11 used scales of health-related quality of life (HRQoL) which included work-related aspects. Series that considered RTW as a main endpoint were composed of 1014 patients, with postoperative RTW rates ranging from 31 to 97.1% (mean 73.1%). Timing to RTW ranged from 15 days to 22 months (mean 6.3 months). Factors related to an increased proportion of RTW were: younger age, better neurologic status, having a white-collar occupation, working pre-operatively, being the sole breadwinner, the use of awake surgery, and greater extent of resection. Female sex, older age, poor neurologic status, pre-operative history of work absences, slow lexical access speed, and postoperative seizures were negatively related to RTW. No studies that used HRQoL scales directly investigated RTW rate or timing.

CONCLUSIONS

RTW was scarcely analyzed in LGG patients who underwent resection. However, because they are usually young, with no or only mild functional deficits and have a longer life expectancy, postoperative RTW should be assessed more systematically and accurately as a main outcome. As majority (61.5-100%) of LGG patients were working at time of surgery, the responsibility of neurosurgeons is to bring these patients back to their previous activities according to his/her wishes. RTW might also be included as a critical endpoint for future prospective studies and randomized control trials on LGGs.

[Predictive factors of maintain of employment and return to work after cancer]

BACKGROUND

Return-to-work after cancer depends on several factors related to the disease but also other socio-professional factors. The primary aim of this study was to identify socio-demographic, disease related and professional factors influencing the return-to-work process.

METHODS

It was a prospective and descriptive study reporting the return-to-work process in 89 cancer patients, in a professional activity age, who had cancer treatment and a follow up in the Oncology department in Tahar Maamouri Teaching Hospital of Nabeul, between September 2015 to December 2019.

RESULTS

Our study included 89 patients. Mean age was 45 years±8. The population was predominantly feminine (59 %). They were employees in 45 % of cases. Private professional sectors included 60 % of all patients. An open-ended contract was performed in 87 % of cases. Most frequent primary tumors were breast tumors (45 %) and colon tumors (20 %). Thirty-four patients went back to work after recovery. Seventy-nine percent of them were female patients and 70 % had breast cancer. Predictive factors identified in univariate statistical analysis and correlated to return-to-work were gender (P=0.002), occupation (P<10^-3), initial duration off sick (P=0.015), fitting out measures at work (P=0.01), primary tumor origin (P=0.01), disease stage (P=0.037), treatment (P=0.014) and disease outcome after treatment (P=0.024).

CONCLUSION

Our study underlined a need to create a pluridisciplinary platform unifying collaborators among oncologists and occupational health professionals in order to enhance professional reintegration process and to hold patient's professional equilibrium after cancer recovery.