Cancer and Work, predicting long term work perspective of cancer patients. (WC2006-040)


Starting date: 15/05/2010
Chronic fatigue and return to work in cancer survivors
Fatigue is a common side effect of cancer and its treatment, as reported by cancer survivors all over the world. Apart from hindering these survivors in daily house-hold activities, leisure time or social interactions, fatigue can have a significant impact on work ability. Moreover, fatigue is associated with loss of productivity, reduction of working hours and sick leave from work. Cancer survivors often experience return to work as getting back to normal life and regaining a sense of control. However, fatigue may influence return to work for several years, even after treatment has been completed. It may even lead to permanent work disability. Therefore, the relationship between cancer-related fatigue and work ability deserves our attention. Especially in cancer survivors on long-term sick leave, who report ongoing fatigue. Numerous prospective studies have investigated the relationship between fatigue and work ability. Though, most studies focus on the association between fatigue and return to work within two years of sick leave. Therefore, it is necessary to study prognostic factors for fatigue in cancer survivors on long-term sick leave, and to assess the association of fatigue with work ability in these survivors. Since fatigue is expected to affect return to work, gaining insight in the course of fatigue may support the insurance physician in the assessment of work ability of cancer survivors on long-term sick leave.
In this study, we aim, both quantitatively and qualitatively, to identify predictive factors for fatigue in cancer survivors, who are on long-term sick leave, and its relation with return to work. In addition, we aim to develop a prognostic instrument, by which insurance physicians can assess future functional abilities of these cancer survivors.
Quantitative study
The study population of the prospective cohort study (n=400) will exist of cancer survivors who apply for a WIA benefit at the head office of UWV in Amsterdam i.e. they approach a 104 weeks period of sick leave and make a first application for WIA benefit. The primary outcome measure of the study is the level of fatigue, measured using the Functional Assessment of Cancer Therapy-Fatigue (FACT-F) scale. Secondary outcome measures include perceived work ability, disability percentage, depression, quality of life, coping, support and depressive reaction, work load, work stress, need for recovery, physical limitations, supervisor and co-worker social support, and additional UWV file data. Measurements take place at baseline and after twelve months.
Qualitative study
The study population will consist of health care professionals, with various backgrounds, knowledge and experiences. That is, oncologists, insurance physicians, and occupational physicians. Three focus groups will be formed, to gain insight in their ideas about prognostic factors for cancer-related fatigue and mediating factors for return to work in cancer survivors on long-term sick leave. Study measures are related to, amongst other, attitude, social support, self-efficacy, barriers and skills.
Staff and Partners
VU Medical Centre Amsterdam
EMGO+ Institute/Research Centre for Insurance Medicine 

P. van Muijen, MD, MSc

K.Groenewoud, MSc

S.F.A. Duijts, PhD
Prof. J.R. Anema, MD, PhD
Prof. A. van der Beek, PhD 

Fore more information:

Peter van Muijen
Junior researcher
P +31-20-4448298

Saskia Duijts 
Senior researcher
P +31-20-4441738