Work functioning in cancer patients: looking beyond return to work

This thesis is about cancer and work, more specifically about the work functioning of employees who have returned to work after cancer diagnosis for at least 12 hours per week. In this unique study, 384 cancer patients were followed during a period of 18 months, in which we have examined various factors such as health status, treatment and work.One-third of the cancer patients experienced low work functioning after return to work, which was associated with higher levels of fatigue, depressive symptoms and higher levels of work-specific cognitive symptoms. Cancer patients reported decreases in fatigue and depressive symptoms, but work-specific cognitive symptoms remained stable during the study period. Cancer patients with non-manual job tasks reported higher levels of work specific cognitive symptoms over time, compared to cancer patients with both manual and non-manual job tasks. Cancer type and cancer treatment were not associated with work functioning.Cancer patients with poor work functioning after return to work need additional guidance and support after return to work. Fatigue, depressive symptoms and work-specific cognitive symptoms need to be addressed in an integrated approach. As work functioning and health outcomes improve after returning to work, cancer patients should be encouraged to resume work once they are physically and mentally able to work, as recommended in the Dutch guideline ‘Cancer and Work’ of the Netherlands Society of Occupational Medicine (NVAB). Occupational physicians should guide and support the cancer patient when back at work