Roles:
- Medical team
- Rehabilitation team
- Workplace team
- Insurance team
- Other helpful professionals: healthcare team
- Other helpful professionals: rehabilitation team
- Other helpful professionals: workplace team
Medical team
There are many healthcare professionals involved in cancer patient care, such as medical oncologists, radiation oncologists, oncology surgeons, family doctors, nurse practitioners, oncology nurses and psychiatrists. Patients, other healthcare providers, insurance providers and employers seek advice from healthcare providers on the patient’s work abilities and their need for medical, rehabilitation and psychological care to improve work ability. Healthcare professionals also provide guidance on cancer symptoms and treatment effects, assess work abilities, and recommend services and strategies to promote returning to and remaining at work.
Family doctor
Family doctors (also called general practitioners or GPs) play a key role in assessing, treating and addressing issues that may affect patients’ ability to work. Family doctors know about the patient’s cancer and its treatments but are also aware of other health conditions they may have that may contribute to their cancer recovery.
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Medical oncologist
A medical oncologist is a doctor who specializes in caring for patients with cancer using chemotherapy, hormonal therapy, biological therapy and targeted therapy. Some oncologists specialize in one type of cancer, such as breast or lung. Medical oncologists prescribe cancer treatments and medications to treat their side effects. They may also be part of research on experimental cancer drugs. Right now, there is little research on the effect of certain cancer treatments on work abilities. With new treatments constantly being developed, medical oncologists often know the most about the effect of treatments on work ability.
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Radiation oncologist
Radiation oncologists are doctors who specialize in radiation to treat cancer, to control the growth of cancer or to relieve symptoms such as pain. Radiation oncologists work closely with medical oncologists, surgeons, and other doctors to plan their treatment and manage any side effects that may occur due to radiation therapy. Radiation oncologists know about radiation effects through their clinical experience, and they are the best doctors to advise on how radiation treatment can affect work ability.
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Surgical oncologist
Surgical oncologists (or cancer surgeons) are doctors who have additional training to diagnose, biopsy and surgically treat cancers of all types. They specialize in removing cancerous lesions, tumours and organs and obtaining tissue samples to make a diagnosis. They are experts in assessing the effect of cancer surgery on work ability. Major surgeries like amputations can significantly affect work ability. The same is true for other surgeries, such as colostomy or ileostomy. Brain or neurological surgery can also affect work ability because this type of surgery can affect physical and mental functioning.
Surgical oncologists are the best doctors to advise on recovery time after surgery and how it may affect work ability. Cancer survivors may go on to have other treatments such as chemotherapy and radiation. In these cases, the oncologist or family doctor may be better at assessing the cumulative effects of treatment on their ability to work.
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Psychiatrist
A psychiatrist is a medical doctor with additional training in assessing and treating those with mental health challenges such as anxiety, depression, post-traumatic stress and psychosis. Psychiatrists can provide therapy, prescribe psychiatric medication and help determine if psychological reactions are caused by medical problems, such as cancer and its treatment. They can also help determine the effects of psychological challenges on work ability. Neuropsychiatrists specialize in treating people whose psychological problems are caused by neurological changes. Many large cancer centres provide access to psychiatrists and neuropsychiatrists.
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Rehabilitation team
Occupational therapist
An occupational therapist (often abbreviated OT) assesses how an individual’s physical, cognitive and affective health impacts their ability to complete activities. Interventions may include restoration of skills or adaptation of the activity and environment to enable participation in activities. Occupational therapists can assess the job tasks, the patient’s functional abilities, and the work environment to make recommendations such as modified job tasks or routine, use of aids or assistive technology and healthy ergonomics to promote maximum work engagement. Education to manage symptoms, such as fatigue or memory impairment, may also promote successful return to work.
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Vocational rehabilitation counsellor
Vocational rehabilitation counsellors help people with health conditions or disabilities address their employment concerns. They help cancer survivors get the rehabilitation, medical and psychological services they need to stay productive at work or improve their function so they can return to work. They can assess work skills and abilities, provide career counselling and recommend suitable kinds of work. Vocational rehabilitation counsellors negotiate accommodations with employers and teach people how to search for new jobs if they want to make a change.
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Neuropsychologist
A neuropsychologist is a psychologist trained in the assessment, treatment and prevention of behavioural and emotional conditions. Neuropsychologists focus on how injuries or illness of the brain affect cognitive functions, such as attention and memory. They can provide assessments, education, rehabilitation and counselling related to changes in thinking abilities. Referral to a neuropsychologist can be very helpful to those whose work tasks require cognitive abilities. Neuropsychologists can assess cognitive strengths and challenges that might impact work performance and provide guidance on ways to compensate to help maintain or enhance functioning at work.
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Physiotherapist
Physiotherapists (also called PTs, physical therapists or physios) treat people who have been impaired due to injury or illness. They assess people’s ability to move and maximize their quality of life through prevention and rehabilitation. Physiotherapists can help patients reduce their pain and stiffness, increase their endurance, strength and balance, and regain work ability. They can help survivors safely return to work by assessing the demands of their job, analyzing their work abilities, developing programs to get them ready to return to work, and deciding when they are ready.
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Kinesiologist
Kinesiologists (sometimes abbreviated RKin or kin) are experts at assessing fitness and designing exercise programs. They have a deep understanding of body training and how the body responds to exercise. They help people increase their fitness to maximize their physical abilities and prepare them to return to work. A kinesiologist can design an exercise routine customized to the survivor’s health and work needs.
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Workplace team
Typically, medium or large employers have professionals on staff whose areas of expertise include return to work. For smaller employers, this is less likely but they may have access to such professionals through contracted services.
Human resources professional
As part of their work, human resources professionals may manage the disability insurance claims of employees who are off work by reviewing reports from the employee’s healthcare providers and ensuring that all required forms have been completed and filed. They often help employees safely return to work as soon as possible (commonly called early and safe return to work) by keeping in touch with the worker throughout their recovery and by coordinating the development of the return to work plan in collaboration with the employee, supervisor and healthcare providers. After the employee is back on the job, the human resources professional may monitor the progress of the employee on the return to work plan, periodically reviews it, and coordinates any necessary changes.
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Return to work coordinator
Return to work coordinators ease the return to work by communicating with employers, insurers and employees during the survivor’s absence and when they are ready to go back to work. They identify any programs and insurance benefits available to the employee. They hasten the return to work process by answering questions, addressing concerns, and creating a return to work plan that supports the employee. They then track the plan’s progress to make sure it succeeds.
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Occupational health nurse/advisor
Occupational health advisors are often nurses who are hired by employers as staff or consultants. They specialize in workplace health and can help your patient with returning to work. Occupational health nurses/advisors can help make arrangements with the employer if the patient is ready to return to work after treatment and recommend accommodations that will allow them to stay at work. For more information link to union help for cancer patients. You may also want to connect with the Canadian association of occupational therapists.
Union representative
If your patient belongs to a union, a representative may be able to provide valuable advice on return to work processes at that work site. Duties of union officials include working with employers to find reasonable accommodation solutions for employees with disabilities. For more information, see union help for cancer patients.
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Insurance team
Case manager
A case manager works with the other insurance team members to make decisions regarding an employee’s insurance claim and to monitor it. The case manager gathers information on the employee’s ability to work, tracks their rehabilitation progress, refers them to vocational rehabilitation services, and helps calculate benefit payments during a gradual return to work.
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Vocational rehabilitation consultant
The vocational rehabilitation consultant (see also vocational rehabilitation counsellor) can provide professional assessment, determine employability and employment options, make referrals to rehabilitation services, and consult with your patient’s physician and employer to aid their return to work. Because vocational rehabilitation consultants are typically employed by insurance providers, they do not act as counsellors but can be helpful to employees in developing a vocational rehabilitation plan to identify and overcome barriers to working.
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Insurance consultant
The insurance consultant is often the person who sold the insurance policy (typically short- and long-term disability or critical incident insurance) to the patient’s employer, union or professional association. These consultants are often familiar with the terms of the insurance contract and can be helpful in interpreting, navigating or advocating for the employee or the employer if the insurance company is not meeting the terms of the contract.
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Other helpful professionals and how they can help return to work
Healthcare team
Physiatrist
Physiatrists are rehabilitation physicians who have completed training to assess and manage long-term or permanent nerve, muscle and bone injuries or deficits (due to surgery, diseases or conditions) that affect how patients move. Some have specialized training in cancer since cancer and its treatment can impact these components.
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Pain and symptom management/palliative care doctor
Pain and symptom management/palliative care doctors focus on providing patients with relief from the symptoms, pain, and the physical and mental stress of a serious illness – whatever the diagnosis, including cancer. These doctors can offer symptom management advice and treatment to help patients return to work after cancer treatment or stay at work during or after treatment, and in particular, for those with a palliative diagnosis.
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Nurse
Registered nurses (RNs) and licensed practical nurses (LPNs) work with cancer patients to answer questions, monitor symptoms and side effects, and provide support to patients and their families. Registered nurses may be specially trained to provide chemotherapy treatments and support patients undergoing radiotherapy. Registered nurses are often the first line of communication between the patient and their healthcare team, meaning they can help address symptoms of cancer and treatment that might affect patients’ work ability.
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Nurse practitioner
A nurse practitioner (NP) is a registered nurse with additional training and education in physical assessment, diagnosis and treatment. A NP can complete medical histories, perform physical examinations, order diagnostic tests and prescribe medications. Nurse practitioners work with physicians and other members of the healthcare team to manage symptoms and treatment side effects. Like oncologists, nurse practitioners specializing in oncology have extended knowledge about cancer treatment and side effects, and are qualified to provide guidance in symptom management to improve function at work.
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Ophthalmologist
An ophthalmologist is a physician with specialized training in the anatomy and function of the eye and vision disorders. Neuro-ophthalmologists have specialized education and training in visual difficulties arising from the invasion of diseases such as cancer into the visual centres of the brain. Ophthalmologists can recommend vision aids (glasses), assess the limits of vision and help coordinate referrals to vision services to improve function, such as the Canadian National Institute for the Blind or, in the case of brain injury, to neuro-rehabilitation.
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Otolaryngologist
An otolaryngologist is a physician specialized in the medical and surgical treatment of disorders of the ear, nose and throat, as well as related structures of the head and neck. With cancers specifically affecting these regions, such as head and neck cancers, otolaryngologists can provide advice on adaptive aids for hearing or speech to help patients return to work.
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Pharmacist
A pharmacist can provide guidance on the safe and effective use of medications. Pharmacists offer advice about drug selection, monitoring for side effects, avoiding drug interactions and assessing therapy outcomes. They can inform patients how side effects or interactions with medications might impact their ability to function at work.
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Rehabilitation team
Oncology social worker/clinical counsellor
Oncology social workers/clinical counsellors are trained in and have experience supporting cancer patients and their families as they adjust to the many challenges that can occur with cancer. They can help with social, emotional, relationship and practical issues related to self-image, depression, family, work, finances, insurance, disability, distress and anxiety, and can identify appropriate supports. Returning to work following cancer may be a challenging time for many. Social workers/counsellors can help survivors reflect on and clarify their thoughts, as well as gain perspective on their cancer experience and its impact on work. They can also help survivors make decisions and goal setting to aid in return to work and can refer patients to services that deal with job loss, finances, disability, mobility issues and other vocational concerns.
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Psychologist
A psychologist is trained to understand the impact of normal and mental health challenges on cognitive, emotional and behavioural functions. A clinical psychologist may provide psychological assessment and support to a person who is struggling with a cancer diagnosis and can provide counselling to address psychological issues that could affect functioning at work.
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Speech-language pathologist
Speech-language pathologists (also called SLPs or speech therapists) assess and manage communication and swallowing disorders. They help people communicate better by improving their pronunciation, word-finding, understanding, reading and writing, reasoning, problem-solving, memory and organizational skills. Speech-language pathologists also help people with swallowing challenges by providing therapy or teaching strategies to allow them to eat safely without the risk of choking or developing pneumonia.
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Lymphedema therapist
Many healthcare providers treat lymphedema after cancer, including physical medicine physicians, nurses, physiotherapists, occupational therapists and massage therapists. Patients may need to tell their employer about lymphedema because not all are aware that lymphedema can be a complication of cancer treatment. Lymphedema therapists can recommend wearing a compression sleeve or garment as a precaution. They can also help rehabilitate lymphedema symptoms and may provide guidance on lifting capacity, range of motion and specific movements to avoid further pain, negative symptoms and injury.
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Workplace team
Employee assistance counsellor
An employee assistance counsellor is a clinical counsellor, social worker or psychologist who can listen to your patient’s concerns about the workplace and their wellbeing. They can help patients cope with stress, address interpersonal issues and, in some cases, explore career changes. Employment assistance counselling is typically funded through extended workplace healthcare plans. For more information, see the Disability Management and Accommodating Employees with Disabilities by the Yukon Health Public Service Commission (PDF; page 13).
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Disability management professional
Disability managers work for employers to find alternative work that suits an employee’s functional abilities, as defined by their healthcare team. They also arrange accommodations and assistive devices that follow the recommendations of the employee’s doctors. Disability managers facilitate employees’ return to work by helping their managers remove any barriers in the return to work process. They also improve the administration of disability management by developing policies and procedures and promoting return to work through education and training.
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