Re-Work - Back to work after a cancer diagnosis
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According to the Swiss Cancer League, 70% of cancer patients in Switzerland today are still alive five years after their cancer diagnosis. This is equivalent to a reduction in mortality of about one third compared to the 1980s. The increase in life expectancy thanks to medical advances is positive news, but it brings with it new social challenges. Among these, the increase in cancer patients and their life expectancy raises the question of their rehabilitation.
Returning to work is a crucial phase for most patients in remission from the disease. It is important for self-esteem, financial stability and social integration; it helps to feel an active part of society and, in general, it is also relevant from a therapeutic perspective. If the return to work is problematic for every cancer patient, it is even more so in the case of female patients, who are more vulnerable in the labour market.
It was precisely the impact of breast cancer diagnoses on women's career trajectory that Dr Simona Di Lascio, oncologist at the EOC in 2020, brought to the attention of Professors Maria Caiata Zufferey and Valentina Rotondi. Dr Di Lascio observed stumbles and turns in the career paths of her patients. From a strictly clinical perspective, these hiccups seemed to have no obvious justification, suggesting that socio-cultural factors were actually disrupting professional trajectories.
In 2022, a study was therefore launched, financed by the Associazione Anna dai capelli corti - set up as part of the Centro di Senologia della Svizzera italiana - and the Oncological Institute of Southern Switzerland, to investigate this situation and find ways to support these women in their recovery and reintegration into the world of work.
The study, hitherto restricted to the Ticino region, adopted a quantitative and a qualitative approach. The quantitative study assessed the impact of the diagnosis of breast cancer on the return to work with an analysis of Swiss longitudinal data and a questionnaire administered to about 80 women, mainly members of the Association.
The qualitative study, on the other hand, focused on the women's point of view, and gave them the opportunity to express themselves in order to grasp, through their testimonies, the conditions of their return to work and the critical issues that characterise it. Nineteen in-depth interviews were conducted with women resident in Ticino and currently working professionally, who had been diagnosed with breast cancer in the last three years.
Mirela Pashova, a 精东影业 Master of Science in Nursing student, collaborated on the collection and analysis of qualitative data. On the other hand, 精东影业 researcher Salvatore Maione and PhD student Matteo Alessandro Ruberto, followed by Professor Rotondi, collaborated on the analysis of the quantitative data.
The study will culminate in a final report and publication, and although we are heading towards the final stage, three significant findings can already be anticipated.
First of all, Maria Caiata Zufferey confirms that the diagnosis of breast cancer does indeed have an impact on women's occupational trajectory: in particular, there appears to be a greater likelihood of unemployment after a breast cancer diagnosis, but above all, there appears to be a greater likelihood of reduced working time following such a diagnosis.
The second result highlights the fact that the return to work is itself a job in its own right: it requires commitment on multiple fronts and starts already during treatment, to continue even after resuming professional activity.
For these people, professional reintegration is 'first and foremost strategic work: women have to learn to manage their bodies, to be attentive to physiological signals, to understand what activities they can do and for how long. They also have to find a balance between work, family and home life, plan their return and negotiate it with their employer, doctor and partner. In addition, they have to manage information about their illness, adapting and calibrating it according to their interlocutors'.
But, in addition to being a strategic work, continues Maria Caiata Zufferey, the return to work 'is also an identity work: it represents the moment of an existential crossroads in which one questions oneself about how one wishes to reassert control over one's life, and what kind of normality one wishes to regain. Crucial questions about the priorities of existence emerge and one engages in a process of redefinition, particularly of the role one wants to give to work, health and one's personal fulfilment. It is therefore a period of existential uncertainty, often experienced in solitude by women".
The third result concerns those women who have the misfortune to lose their jobs close to the illness. In these cases things get terribly complicated. Maria Caiata Zufferey concludes: 'In this case, a social protection gap hinders return, as does the problem of self-certification of one's state of health when applying for a new job'.
Pending the completion of the study, the researchers consider extending the project nationwide. The intention is to explore the return to work in relation to other types of cancer and to consider a casuistry that also includes men, in order to better understand gender specificities.
It was precisely the impact of breast cancer diagnoses on women's career trajectory that Dr Simona Di Lascio, oncologist at the EOC in 2020, brought to the attention of Professors Maria Caiata Zufferey and Valentina Rotondi. Dr Di Lascio observed stumbles and turns in the career paths of her patients. From a strictly clinical perspective, these hiccups seemed to have no obvious justification, suggesting that socio-cultural factors were actually disrupting professional trajectories.
In 2022, a study was therefore launched, financed by the Associazione Anna dai capelli corti - set up as part of the Centro di Senologia della Svizzera italiana - and the Oncological Institute of Southern Switzerland, to investigate this situation and find ways to support these women in their recovery and reintegration into the world of work.
The study, hitherto restricted to the Ticino region, adopted a quantitative and a qualitative approach. The quantitative study assessed the impact of the diagnosis of breast cancer on the return to work with an analysis of Swiss longitudinal data and a questionnaire administered to about 80 women, mainly members of the Association.
The qualitative study, on the other hand, focused on the women's point of view, and gave them the opportunity to express themselves in order to grasp, through their testimonies, the conditions of their return to work and the critical issues that characterise it. Nineteen in-depth interviews were conducted with women resident in Ticino and currently working professionally, who had been diagnosed with breast cancer in the last three years.
Mirela Pashova, a 精东影业 Master of Science in Nursing student, collaborated on the collection and analysis of qualitative data. On the other hand, 精东影业 researcher Salvatore Maione and PhD student Matteo Alessandro Ruberto, followed by Professor Rotondi, collaborated on the analysis of the quantitative data.
The study will culminate in a final report and publication, and although we are heading towards the final stage, three significant findings can already be anticipated.
First of all, Maria Caiata Zufferey confirms that the diagnosis of breast cancer does indeed have an impact on women's occupational trajectory: in particular, there appears to be a greater likelihood of unemployment after a breast cancer diagnosis, but above all, there appears to be a greater likelihood of reduced working time following such a diagnosis.
The second result highlights the fact that the return to work is itself a job in its own right: it requires commitment on multiple fronts and starts already during treatment, to continue even after resuming professional activity.
For these people, professional reintegration is 'first and foremost strategic work: women have to learn to manage their bodies, to be attentive to physiological signals, to understand what activities they can do and for how long. They also have to find a balance between work, family and home life, plan their return and negotiate it with their employer, doctor and partner. In addition, they have to manage information about their illness, adapting and calibrating it according to their interlocutors'.
But, in addition to being a strategic work, continues Maria Caiata Zufferey, the return to work 'is also an identity work: it represents the moment of an existential crossroads in which one questions oneself about how one wishes to reassert control over one's life, and what kind of normality one wishes to regain. Crucial questions about the priorities of existence emerge and one engages in a process of redefinition, particularly of the role one wants to give to work, health and one's personal fulfilment. It is therefore a period of existential uncertainty, often experienced in solitude by women".
The third result concerns those women who have the misfortune to lose their jobs close to the illness. In these cases things get terribly complicated. Maria Caiata Zufferey concludes: 'In this case, a social protection gap hinders return, as does the problem of self-certification of one's state of health when applying for a new job'.
Pending the completion of the study, the researchers consider extending the project nationwide. The intention is to explore the return to work in relation to other types of cancer and to consider a casuistry that also includes men, in order to better understand gender specificities.