How do gynecologists face to social problems among women cancer survivors?

Abstract

In recent decades, surgical techniques, new anticancer drugs' development, and radiation equipment have led to continuous improvements in cancer survival rates and quality of life of cancer survivors (CSs). While 61.0% of gynecological cancer survivors (GCS) in Japan belonged to a working‐age group (20–64 years old), the number of working GCS within the working‐age population has increased. In Japan, it seems that there has been more interest in striking a balance between cancer treatment and work, especially since 2016 when the Cancer Control Act was amended and national guidelines for working CSs were published. Maintaining employment after gynecological cancer diagnosis remains an important issue for not only GCS and their families but also employers and society. GCS suffered from various symptoms including cancer‐related fatigue, pain, menopausal symptoms, lymphedema, and psychological distress, which made maintaining employment difficult for them. Full return to work (RTW) rate at 365 days after the initial days of sick leave among was 77.6% and median time to full RTW among GCSs was 172 days. Five‐year work continuance rate after RTW among GCSs was 63.4%. It is better for gynecologists to write a certificate for workplace in words of not “symptoms,” but “caseness words (such as, workable as long as it is sedentary or clerical work. Partial RTW (4‐h work, 6‐h work) might be desirable for a while after RTW,” in order to support GCSs' maintaining employment.

What can surgeons do to prevent job leave soon after cancer diagnosis? A brief report on colorectal cancer survivors in Japan

“…The activities of occupational physicians may vary across different nations [ 12 ], however, a multifaceted approach to medical and work-related factors is imperative to assist the work performance of employees with cancers [ 23 ]. Clinicians can write a certificate for the workplace by describing specific situations, not just diagnoses and symptoms, such as “workable as far as sedentary work” or “the patient may need a short rest four to six times a day for work,” facilitating the understanding of workplaces [ 24 ], and, if applicable, directly collaborating with occupational physicians to prevent such resignations upon diagnosis [ 25 ]. However, medical personnel should be mindful that patients often have no access to occupational physicians at the workplace, as shown by the present study.…”