Cancer care providers should talk with cancer patients soon after diagnosis about their goals for continuing or returning to work and consider referring them to counselors and other resources, according to experts.
The experts outlined ways in which health care providers and employers can support cancer patients and their caregivers at a recent National Comprehensive Cancer Network (NCCN) oncology policy summit.1
“When [health care providers] take that social history, ‘What do you do for work?’ is a very important part of the conversation,” said one of the speakers at the summit, Angela A. Mysliwiec, MD, medical director of oncology at WellMed, a network of health care providers for older adults.
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Health care providers should go into detail about what a patient’s work entails and their goals for continuing to work during or after treatment, Dr Mysliwiec added. Through these conversations, providers can talk about how treatment options may affect patients’ time, energy, and ability to do their work.
As Dr Mysliwiec and other experts at the summit discussed, the ability of patients to fulfill their work goals while receiving treatment or follow-up care depends on the complicated interplay between patients, their caregivers, health care teams, and employers.
Some processes are already in place to support patients’ careers, such as training nurses to act as patient advocates and developing support programs for caregivers. However, the experts say, more needs to be done.
Determine the Patient’s Work Priorities
Misconceptions are a major barrier for cancer patients in the workforce, according to Rebecca V. Nellis, executive director of Cancer and Careers, a nonprofit organization that helps employees with cancer.
“Everybody comes to the table with [misconceptions],” Nellis said when speaking at the NCCN summit. “You can find them with your medical provider, your employers, your family, your coworkers.”
It is critical that every member of a patient’s health care team understand their work priorities, Nellis added.
“Do you work because it is your greatest passion, or do you work because it makes you feel normal? Do you work because you cannot live without the health benefits? It is usually a combination of those things,” Nellis explained.
A 2018 survey by Cancer and Careers and Harris Interactive suggested that most cancer patients and survivors want to continue working.2 In fact, 74% of the patients and survivors surveyed said that work provides a source of personal pride and accomplishment that is critical for recovery.
Nurses are often the ones who talk with patients about their work needs and goals, said Randy Jones, PhD, RN, professor and associate dean for partner development and engagement at the University of Virginia School of Nursing, when speaking at the NCCN summit.
Nurses can also address patients’ concerns, such as disclosing their condition to their employer and requesting time off for treatment, he added.
“When we train our nursing students, we talk about communication and building the rapport with patients and caregivers quickly,” Dr Jones said.
Depending on each patient’s situation, nurses can also connect them with community health navigators and counselors to help them learn about available resources, such as financial and transportation support, Dr Jones explained.
Create a Supportive Work Environment
Many employees opt not to tell their employer about a cancer diagnosis out of fear that they may be fired, thrown off their career trajectory, or seen differently, Nellis said.
While many factors go into this highly personal decision, not disclosing a cancer diagnosis may make it harder for employees to access benefits. These may include employee support networks and reasonable accommodations, such as working from home or taking more frequent breaks.
“The way in which an employee feels safe enough to go and disclose, and to then discover the world that is available to them, comes down to trust,” Nellis explained.
Strong workplace leadership can go a long way in making cancer patients and survivors feel safe and supported, Dr Mysliwiec said.
Many different people at a company or organization can be leaders if they “can assess the situation and make adjustments necessary for their teammates,” she noted. “The leader that we want is one that can be accommodating while encouraging inclusion and transparency.”
Training managers to talk about medical conditions and connect workers with resources and benefits can foster a workplace culture in which employees feel they can disclose their cancer diagnosis, said Lynn Zonakis, principal of Zonakis Consulting and former managing director of health strategy and resources for Delta Air Lines, when speaking at the NCCN summit.
One such resource is Triage Cancer. This national nonprofit organization offers a range of free help to cancer patients and caregivers, from choosing and utilizing health insurance coverage to understanding disability and leave benefits. The organization also teaches medical providers about these issues.
“Health care professionals, and certainly the overarching cancer community, could be [providing more education to employees],” said Joanna Fawzy Morales, Esq, chief executive officer of Triage Cancer, when speaking at the NCCN summit.
Support Caregivers Too
In many cases, caregivers do not get the same level of support and benefits at work and through the health care team as patients themselves, Dr Jones noted.
“Caregivers have been left out there a little bit,” Dr Jones said. “I would like to see more traction in the caregiver space. Oftentimes, they share the anxiety, they share the fatigue, along with the patients.”
When employers are deciding on benefit policies, they should consider what could help employees who are caregivers of a cancer patient, Nellis said. Typically, caregivers need work flexibility, to take care of themselves, and have their mental health cared for, she explained.
However, “organizations that are often ill-equipped to manage a person on staff with cancer can be even more ill-equipped to manage the caregiver,” Nellis said.
Networks of cancer providers and clinics are becoming more aware of the need to help caregivers and develop programs, Dr Mysliwiec noted. WellMed has a caregiver support program that offers coaching and stress reduction skills for caregivers of patients with cancer and other illnesses.
The American Cancer Society and NCCN also have resource guides, which counselors and navigators can refer to when helping caregivers, Dr Jones said.
References
1. Cancer Care in the Workplace: Building a 21st Century Workplace for Cancer Patients, Survivors, and Caretakers. NCCN Oncology Policy Summit. June 17, 2022.
2. 2018 Harris Poll Survey. Cancer and Careers. Published December 2018. Accessed June 26, 2022.
This article originally appeared on Cancer Therapy Advisor
