In this article we look at work life after cancer treatment, and the need for thorough review of patients' capacity to work so that they return to suitable conditions. Reviews for eligibility to drive after cancer treatment might be a good starting point.

It might seem an archaic stigma but, according to rehabilitation physician Dr Andrew Cole, it's not one that has disappeared yet: that rehabilitation for cancer patients is a less worthy practice than for patients of other diseases or afflictions. “There's a discrimination!” said Dr Cole at the recent People at Work Conference.

He talked about a continuum of cancer survival outcomes, and the many people with cancer who do return to work after treatment. There is also, he said, a continuum of return to work issues – such as stamina, focus and managing – for which rehabilitation would be of worthy assistance.

“People who receive rehabilitation for their cancer-related disability do respond to rehabilitation,” he said. “It's frankly discriminatory to look at a person and not take them into rehab because of their cancer.”

When it comes to assessing how ready a cancer patient may be to return to work, depending on the type of work the patient has been involved in, one mode of assessment might be to use the same review to determine readiness to drive.

Driving, said Dr Cole, can be a good proxy for work itself. Both involve multiple tasks, a detailed physical and cognitive examination, observation of complex task performance – and both require certification.

The general rule for cancer is that if there's any evidence of primary or secondary cancer in the brain, you can't return to drive. There must be a stable physical/mental ability. You can't drive if significant impairment or perceptual neglect is present.

All of these rules, said Dr Cole, presuppose a very full history and examination and reviewing of special assessments. “Returning to drive is not a universal right by any means,” he said.

When it comes to returning to work, reviews should be just as thorough. There should be an adequate range of assessment – the person's tasks and the job they were doing before should be reviewed. The individual should be assessed in their workplace, and the whole process should be documented. It's also important to have periodic reviews. If a patient returns to a workload or work environment that is unsuitable, the work will not be sustainable.