Cancer & Work
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2. Assess functioning

Step 2 of 11 in getting ready to return to work:

Part of understanding work abilities, whether or not someone is ready to consider returning to work, is assessing their function. This step will allow you to determine the person’s limitations and restrictions, and identify their workplace accommodation needs. Assessing function will also establish a baseline for tracking improvement and identifying when it levels off. Assessment is very important to vocational rehabilitation planning, because it can help determine the need for assessing whether the patient can return to their former job (with or without accommodation) or whether a cancer survivor needs to consider another job or a change of career.

Finding another job at the current workplace, looking for a new job somewhere else or changing careers takes time, especially if retraining is involved. It is therefore important to identify and anticipate early on the patient’s maximum level of functioning with reference to work. Read cancer and its impact to learn more about the potential physical, emotional and mental aspects of going back to work after cancer diagnosis.

Assessing physical functioning

Cancer and its treatments may have an array of side effects that may affect physical functioning. Understanding the impact of such effects is very helpful in determining ability to work, particularly for employees in physically demanding jobs.

Cancer-related fatigue is a common occurrence in patients with cancer, both during and after treatment. Cancer related-fatigue affects over 50% to 90% of all those affected by cancer and is one of the most common side effects experienced throughout treatment. 12 Fatigue may also continue well after treatment has ended in about 30% of cancer survivors.2 It can be helpful in preparing for return to work to assess or help the patient self-assess their energy levels to help inform work readiness or restrictions and limitations that may require job accommodation. An example of this would be to ask how long they can sustain activities during the day before feeling tired

Just as job demands vary according to each job and worksite, physical abilities vary for each cancer survivor. These variations need to be taken into account and addressed in preparing the survivor for return to work. For ideas on how to assess the physical functioning of a cancer survivor, see assessing physical abilities.

Cognitive functioning

Cognitive functioning has been increasingly recognized as a work challenge for cancer survivors, particularly for those in mentally demanding jobs. Speed of processing cognitive thoughts, finding the right words, handling distractions and multitasking can be harder for survivors who experience cognitive changes. Healthcare providers can:

  • assess cognitive functioning
  • refer or make recommendations to specialists who can assess cognitive challenges
  • encourage cancer survivors to consider ways to improve their cognitive functioning
  • refer survivors to resources that can help them address cognitive challenges

Psychological functioning3

As we know, it is common to be emotionally affected by a cancer diagnosis. Depressed mood and anxiety are common and can manifest at various times during cancer screening, diagnosis, treatment, recurrence, and in the survivorship phase. Psychological distress, regardless of its degree, can affect quality of life and potentially impede on a cancer survivor’s return to work. Here is how one cancer survivor so aptly expressed that, although he was physically ready to go back to work, he did not feel emotionally ready:

Physically I was better enough. I was still walking with a cane, but physically there was no reason I couldn’t do an office job, like a cushy office job by most people’s description. But it was the head that was off, psychologically. I wouldn’t say [I was] destroyed, but not really in a good place to go back [to work] and start dealing with everything I knew would be there.

Early assessment and treatment of distress can reduce the risk of this being a barrier to return to work. For ideas on how to assess psychological functioning, view our emotional assessment information. You can also refer patients in distress to appropriate professionals for assessment and treatment and recommend that disability insurers fund it.

Next step:

Step 3: Understand and address return to work challenges

Back to the list of return to work preparation steps