Work resumption after breast cancer

"It is crucial to start counseling in a timely manner. It is best for patients to receive information about their job prospects right from diagnosis."

Undeveloped land

After graduation, young Huget Désiron worked as an occupational therapist in a hospital. There she regularly saw rehabilitation patients with questions about their work situation. Questions to which she did not know the right answers from her training and field. She took additional training in ergonomics and started an independent practice to assist companies with the reintegration of their employees.

"Thirty years ago that was still wasteland, especially for cancer patients. Not only were the chances of recovery much smaller, it was not very obvious to return to work after cancer. If there was a link between occupational therapy and cancer at all, it focused mainly on the private situation, such as side effects with an impact on daily life and on the household. Work was barely discussed."

Huget Désiron filled that gap and - together with the PXL college occupational therapy students she taught - conducted research on the reintegration of breast cancer patients. Her doctorate (biomedical sciences KU Leuven, 2016) also dealt with this theme: 'Return to work in breast cancer patients'.

Questions and Answers

Thanks to a research project at Jessa Hospital Hasselt and UZ Gasthuisberg Leuven (and funded by Kom Op Tegen Kanker), Désiron gained a better understanding of the conditions for a smooth resumption of work.

"It is crucial to start counseling in a timely manner. It is best for patients to receive information about their job prospects right from the diagnosis, and not just about the medical and psychosocial aspects of their illness. People have questions anyway: what do I tell my boss, how long am I on sick leave, can I keep working part-time or ask for adapted work when I return? It helps if they can turn to an expert at the hospital with those questions. That's not always the case now."

To map this out, Désiron and her college students (and funded by the Riziv's disability knowledge center) created a study: Practice Based Evidence. This asked healthcare providers in hospitals whether and to what extent support to work is offered today and what they believe is needed to optimize this process. There is clearly still work to be done: only 10% of hospitals say they are able to offer this service in a structured way, in the form of a social service or oncoach who systematically raises the issue with patients. Some 20% of participating hospitals are not (yet) taking on this role, and over 70% are still looking for a good approach.

Puzzle pieces

About 60% of breast cancer patients return to work on their own. Huget Désiron: "So 40% do not succeed. And don't forget the drop-outs: women who start working but after a while still have to throw in the towel."

Guidance in resuming work is customized, she emphasizes, because you have to take into account the situation of both patient and employer. An SME in economically turbulent waters provides a different context than a thriving business. "It gives me great personal satisfaction when all the pieces of the puzzle finally fall into place. Important: the framework of the puzzle is best laid by the patient herself. When does she see herself returning to work, how does she see her return to work? With that proposal we go to the employer (often with the occupational physician as contact person), who nuances or adjusts, after which the advisory doctor of the health insurance fund takes the final decision and gives the go-ahead."

By the way, Désiron would like to clear up a misconception. "In the media you mostly hear and read stories about employers who show little understanding for sick employees or even turn them away at the door. In my opinion, these are exceptions. Most of the employers I have worked with, and there are a lot of them, do have a heart for their employees and are very committed to helping them get back to work."