While GPs tend to sign cancer patients off work for long periods, supporting people with cancer in the workplace can help recovery, says Dr Nick Summerton.
Traditional responses to cancer diagnoses are looking increasingly heavy-handed. GPs will tend to sign people off work immediately for long periods, while employers acknowledge the tragedy and set about planning for change.
But being diagnosed with cancer is not an “end”, and many people are cured or go on to live with their condition. Survival rates are at their highest level in the UK, meaning 2.5 million people are living with cancer in the UK as a result of improvements in diagnosis and treatments, according to charity Macmillan. There is every likelihood that survival rates will continue to improve.
The number of people living with cancer means it is becoming more similar to other chronic illnesses, such as heart disease, diabetes or epilepsy. They are serious conditions that require long-term attention and treatment, but it should not be assumed that they will end someone’s working life.
My experience as a GP is that work plays an important part in improving wellbeing and hastening the recovery among cancer sufferers. Labelling someone as a victim of a cancer, who should not be in work, is detrimental to their general health and recovery.
Having six months at home to think about cancer is not doing anyone any good, not the individual and not the organisation that is missing their skills, particularly older workers, who are more likely to be affected, and their experience.
Revising culture
A change is needed in terms of attitudes to people with cancer generally, and particularly in the workplace. It is estimated that more than one-third of people living with cancer are adults of working age (under 65). When more people are working until later life, the more significant the issue becomes and the greater the importance of understanding among OH and HR professionals.
Currently, as a result of time off work and loss of income for patients (and their carers), cancer is estimated to cost employers £5.5 billion each year owing to lost productivity.
Cancer survivors often need to live with long-term consequences. Around a quarter of people treated for cancer in the UK are said to continue to need NHS care, even after being entirely cleared of the disease. Impacts following treatment can include having diabetes, an increased risk of cardiovascular problems and osteoporosis, as well as unpleasant symptoms such as urinary leakage (which affects 40% of “cured” prostate cancer patients). And 47% of survivors remain worried about cancer recurrence, leading to more serious psychological implications, problems with self-esteem, anxiety and depression.
There are policies and procedures that will help create a more accommodating environment, keeping survivors in work. Employers need to consider, think through and be open and clear on what level of support and flexibility they are able to provide employees affected by cancer. Staff need that level of certainty and reassurance.
This approach might include: flexibility in working hours for medical appointments or other treatments; making adaptations to the workplace that allows more space, time and confidentiality for people dealing with symptom concerns (such as bladder or bowel problems); and the chance for people to have private and necessary conversations with a health professional.
Regular contact and discussions of cancer symptoms are critical, and should not be dependent on waiting for a visit to the GP or a hospital check-up. Skype and phone can be useful as early diagnosis tools, as it is as much about spotting recurrences as the initial diagnosis.
Employers’ role in dealing with cancer in the workplace
In a world where cancer is such a significant part of many people’s lives – as patients, as carers or within families – employers have a large role as part of their statutory duty of care but also, more importantly, in demonstrating that they are a genuine people business.
In this context, all health and wellbeing programmes are important – anything on exercise, weight or smoking cessation is relevant to improving chances of avoiding cancer and also the likelihood of a strong recovery. Employers could provide support for monitoring cancer, cancer risk and recurrence, in order to help provide the all-important early diagnosis.
People with cancer are also often neglected by health services when it comes to general health, put into a category of “cancer care” where other potential health issues such as high blood pressure or high cholesterol are seen as less relevant in the circumstances.
But all the evidence shows that people with cancer who ignore other ongoing medical problems do less well in terms of recovery and cure. Employers can help staff keep that broader perspective, with referrals for GP consultations that can provide more regular checks and reassurance.
People are more likely to listen to health advice and attend appointments and check-ups that are facilitated by an employer, as part of a structure of wellbeing and responsibility, rather than being left to make arrangements as part of an everyday hurly-burly.
