When do I go back to work?

Most people experience a period of absence for work in their experience of cancer around initial tests or investigations for unexplained symptoms, once they receive a diagnosis or start treatment. As we know, cancer treatments vary greatly in their impact on your capacity depending on how many treatment types you have (i.e., surgery, chemotherapy, radiation, hormone therapy), how many treatments or surgeries you have, the duration of your treatment, if you experienced any complications or depending on how many side-effects you experience (and how severely). 

We also know that paid work looks different for everyone! Some people have very flexible jobs in terms of how, when and where people work, whilst others are more rigid in what they require. We all have different demands – mental, physical, emotional, social or all of these demands! The environment that you work in may be able to be highly controlled or very dynamic, you may be supported by a large organisation with HR resources or work for a small business, or be self-employed. Or, you may have been in between roles or not have been able to retain your position or contract because of your diagnosis. You may have leave or other entitlements you can access or you may not have access to any financial support.

All of these factors can influence whether an individual is able to continue working throughout treatment, work for periods in between treatments or are required to take a more extended period of absence from work. Whatever circumstance you are facing, transitioning back to work after a cancer diagnosis can be difficult to navigate alone.

The purpose of this topic is to start a conversation with your Valion Oncology Care Coordinator about your work situation. They will help you understand your treatments, how side-effects may continue to impact you after you have completed treatment (or if you are on a maintenance treatment) and what you might consider in consultation with your GP or treating team when planning to return to work during or after treatment.

Whilst this is not a complete list, below are some of the key things to consider when planning your return to work:

• Proactively manage your side-effects – talk with your GP or team about the symptoms that are most concerning you and ways that you might be able to improve or optimise your recovery.
• Gradually expose yourself to more stimulating environments or practise completing a reading task or activity with a distraction present (i.e., radio on in background)
• Improving the quality of your sleep to support changes to the new requirements in wake-time weeks in advance of your return.
• Consider the strategies you plan to use to help you leave work on time, take your breaks, delegate work-tasks or ask for help.
• Plan your work days! Sit down and plan your work day – when to best have your breaks? how to fuel yourself (i.e., high-protein snacks)? what to do in your breaks to help restore? what extra activities at home will need to be re-organised or re-negotiated (i.e., meal plan, decide who is cooking) and how you will achieve exercise or relaxation?

Most symptoms and side-effects will not have fully resolved at the time that you return to work. Whilst most people experience initial improvements after treatment (often relative to how ‘unwell’ they were feeling) they often under-estimate how long symptoms may persist and when they will return to their full physical and mental capacity (or ‘baseline functioning’). This can lead to the following challenges:

• Over-compensating for inefficiency – most people report that they are ‘slower’ and it takes them longer to get tasks achieved. People often work beyond their reduced hours to ‘make up’ for perceived inefficiency rather than cut back on what they estimate they can do!
• Return to baseline activities levels too quickly – taking back chores and caring responsibilities in the home, returning to work, saying yes to more social activities, fitting in a new exercise routine, all at once.
• Not recognising the early warning signs of fatigue and reaching a feeling of exhaustion- being more emotional or teary, easily irritable, not wanting to be touched, finding things loud or bright, and reduced quality sleep (falling asleep early but waking at 1-2 am).

Using a 7 day activity planner can help you to get a full landscape view of the activities that you need to plan your energy levels around. Most people don’t achieve a full recovery of their cognitive or physical capacity before they return to work. A planner can also ensure that you block or schedule in the activities that you would like to retain or start such as attending a class, exercise, or going to the movies again! 

Track your fatigue once you return to work! Having a scale to measure daily fatigue levels is useful in drawing its connection to work, extra activity and sleep. This can also help you make decisions about when to upgrade your hours or maintain what you are doing, if you are going back to work gradually!

You can use the simple scale and log developed by Valion Health to record your daily fatigue level. A body scan meditation can help you identify when you may need to stop and take a break rather than waiting until you reach the point of being exhausted.

Fatigue and cognitive changes are the two most common side-effects that can persist long after treatment has finished. Having a good understanding of how to optimise managing fatigue and cognitive performance can help you develop a realistic return to work plan with your doctor.  

Find out more about Managing Cancer-Related Fatigue or Managing brain fog.

• The Cancer Council offers extensive support around working during treatment and recovery, understanding your entitlements, workplace rights, legal and financial issues around work. Be sure to reach out on 13 11 20 or visit their website for more information.
• Speak with an Exercise Physiologist, Physiotherapist, Dietitian to ensure you are optimising your recovery and fuelling (or powering) yourself for success!
• Occupational Therapists often work within cancer treatment centres or outpatient rehabilitation programs. They can help you make a plan, help you adapt activities, and build strategies to help manage persisting treatment effects. Check with your hospital care team or GP about what is available.