Difficult return to work · Enserm, science for health
More than 20% of women with breast cancer are not working two years after diagnosis. Is it by will or by necessity? A question answered by the Canto Work study: Health status and treatments certainly have their share of responsibility, but family and socio-economic status also play an important role.
Article can be found in Inserm Journal No. 58
In France, breast cancer is the most common type of cancer among women. The 5-year survival rate is 87% and the mortality rate decreases from year to year. Despite this positive development, and while more than 70% of women work in Western countries, “ 21% of women diagnosed with breast cancer have not returned to their professional activity two years after diagnosis “says Gwen Mainville, Director of Research Insrm, an epidemiologist at the Gustave Roussy Institute in Villejuif. Identifying all the obstacles to this recovery in order to suggest ways to remove them is one of the current challenges in the management of this cancer. To implement this approach, Gwen Menville and Inès Vaz-Louis, an oncologist on the same team, and Agnès Dumas, a sociologist and INSERM researcher at the Clinical Epidemiology and Economic Evaluation Unit applied to vulnerable populations in Paris, designed the Canto-study.a job. This is based on Kanto Regiment (to Cancer toxicity), which began in 2012, follows the treatment of more than 12,000 women for localized breast cancer. Its goal is to determine the after-effects of treatments on long-term quality of life. ” The advantage of this group is that it collects clinical information on the type of tumor, treatments, and health status, as well as data on the woman’s social, family, and professional status and quality of life, since diagnosis and for a period of six years. “, specifies Gwen Mainville.
Clinical obstacles…but not only
Thus Cantu-Work showed that two years after diagnosis, “ The most invasive treatments – removing the breast and lymph nodes in the armpit – and taking trastuzumab, a medication Antibody Monoclonal It is used as an anti-cancer agent, It is accompanied by a reduced return to work », explains the epidemiologist. Added to this are the undesirable effects of treatment – for example significant arm disability after surgery, nerve pain or intestinal damage – as well as the subsequent psychological effects: depression and anxiety. like that, ” Extreme fatigue – especially emotional – is A very common symptom, which appears up to four years after diagnosisIt is described as the most annoying to women, and it plays a role in that “, adds Ines Vaz Lewis.
” But back to work It also depends on the family and socio-economic situationRegardless of health condition and treatment “For the same household income at the time of diagnosis, women who live as a couple return less quickly and work more part-time,” asserts Gwen Mainville. Furthermore, being responsible for three or more children is an aggravating factor, but only for the most disadvantaged groups. It is as if these women were victims of a double whammy. », defines the epidemiologist. Finally, nearly half are women Restoring the balance between private and professional life in favor of the former. This phenomenon is exacerbated by a lack of interest in work – employees are less likely to return to work than managers – and a feeling of lack of support on the part of employees. bossCancer’s negative interferences in daily life, for example fear of relapse that hinders plans or feelings of guilt for not being available to his family. But this change in life priorities is also linked to the fact that the experience of illness can be seen as having a “positive” impact on the meaning of one’s life, interest in one’s health, and better self-esteem.
Multiple and personalized help
” Vocational reintegration faces various difficulties, and some patients are at increased risk of cancersums up Gwen Mainville. They must therefore be identified in order to provide an individual approach as soon as possible after diagnosis, especially since there are tools to help them. For example, “ Adapted physical activity or cognitive and behavioral therapy Helps reduce fatigue, Complements Ines Vaz Lewis. That’s why, We developed an algorithm This makes it possible, through diagnosis, to determine the level of risk of severe fatigue that may occur after treatment “. Moreover, researchers have shown thatPatients preferred support with digital tools, while maintaining human contact. They will therefore evaluate personal monitoring for two years through two apps and regular phone calls. The clinical aspects will depend on Resilience, an “app” developed at Gustave-Roussy, focused on the management of clinical symptoms. Alex platform designed by start We care@businessIt allows us to support patients on their career journey, starting with the announcement of a diagnosis. Please note that this is not about getting women back to work military man“But that” “Everyone chooses his career path in an informed way.”warns Gwen Mainville, who also specifies: “ The story does not end with recovery. We also care about maintaining professional activity in the long term and its conditions. Our goal is to identify methods of stable and above all quality recovery. »
Gwen Mainville and Ines Vaz Lewis conduct their research in the unit Biomarkers and new therapeutic targets in oncology (Unit 981 Inserm/Gustave Roussy/Université Paris-Saclay), at the Institut Gustave Roussy in Villejuif. Agnès Dumas, sociologist, researcherClinical Epidemiology and Economic Evaluation Unit applied to populations at risk (Unit 1123 INSERM/Université de la Cité de Paris)
Author: F.D.M.
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