Novel occupational medicine initiative helps patients balance work with cancer treatment
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Approximately half of the 18 million cancer survivors in the United States are of working age.
Many struggle to keep up with the physical, logistical and financial challenges that result from balancing work with treatment or follow-up appointments.
Cancer centers often lack the resources and training to help patients overcome these difficulties.
To address this, the Center of Health Work and Environment at Colorado School of Public Health launched WeCanWork.
The novel program — the full name for which is Well-Being and Cancer at Work — aims to offer comprehensive support to people with cancer as they balance treatment with workplace obligations.
“People who are employed at the time of their cancer diagnosis — and often their caregivers, as well — tend to not leave work unless it’s an extreme set of circumstances,” Cathy Bradley, PhD, dean of Colorado School of Public Health and deputy director of University of Colorado Cancer Center, told Healio. “Cancer is an expensive disease to treat so, if a patient gets health insurance through their employer, they’re not likely to leave their job. Oncologists aren’t necessarily familiar with the work side of the equation for patients. They’re new to thinking about this.”
Leveraging occupational medicine
WeCanWork promotes collaboration between public health and oncology professionals at University of Colorado Cancer Center and occupational medicine practices.
A referral to the program enables patients to see an occupational medicine physician at no out-of-pocket cost.
“Occupational medicine is not occupational therapy or occupational rehab. These are physicians who are trained to treat injured or sick workers, and provide guidance on their return to work,” Liliana Tenney, DrPH, MPH, director of outreach and programs at Colorado School of Public Health’s Center for Health, Work & Environment, told Healio. “We are trying to provide support that oncology care team members aren’t trained to provide and often don’t have the bandwidth to provide.”
The program streamlines the referral process for oncology practices, enabling them to efficiently send patients for consultation with these specialists.
During appointments with occupational medicine physicians, patients can access recommendations for work accommodations, get help completing forms for disability and paid sick leave, and receive advice about how to discuss their diagnosis and potential work accommodations with their employer.
The program gives patients access to experts who can regularly evaluate their need for work accommodations and assess their ability to continue working during times of illness and disability.
“Oncologists are there to treat the cancer. Their mindset is, ‘Take off work; do whatever you have to do to treat the cancer,’” Bradley said. “An occupational medicine group can screen and say, ‘Well, if you worked remote on the days you get chemotherapy, or if you took a half day, you can keep working while getting your treatment.’”
Some patients continue to work due to financial reasons. However, many people find this also can provide a sense of community and purpose, Bradley said.
“Work is one place where they’re not being treated like a patient, or being tiptoed around,” she said. “It’s often one place where they feel a sense of normalcy.”
‘A significant gap in practice’
The program is in its early stages but has been well received by team members in both oncology and occupational medicine, Bradley said.
Tenney and her team have conducted qualitative research — including focus groups and interviews with oncology care team members — to understand their perceptions about patient employment challenges. They interviewed social workers, nurses, nurse navigators, oncologists and other oncology providers.
“We wanted to understand the time they spent with patients communicating about work challenges and the resources for possible intervention,” Tenney said. “What we heard from all oncology team members was that they recognized that this is a significant gap in practice, and there was a desire to have additional support for these patients.”
Although they have not yet evaluated outcomes to determine patient benefits, both team members and patients have described this as “something needed,” Tenney said.
“We’re really working through these initial logistical pieces to raise awareness that this is a new service,” she said. “We want more patients to understand how this can benefit them.”
This program could be replicated by other cancer centers, Tenney said — particularly because many cancer centers exist within systems that are associated with occupational medicine clinics.
“The biggest hurdles would be figuring out how to select the referral of occupational medicine within the electronic medical record, and training providers to do that,” she said. “Also, layering in another provider for patients to see could be a challenge. We’re trying to make it seamless and remove as many barriers as possible.”
Reference:
- Colorado School of Public Health launches innovative program to support working cancer patients (press release). Available at: https://news.cuanschutz.edu/coloradosph/colorado-school-of-public-health-launches-innovative-program-to-support-working-cancer-patients. Published July 10, 2024. Accessed Aug. 9, 2024.
For more information:
Cathy Bradley, PhD, can be reached at cathy.bradley@cuanschutz.edu.
Liliana Tenney, DrPH, MPH, can be reached at liliana.tenney@cuanschutz.edu.
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