CLINICAL QUESTION

What effects do nonmedical interventions have on the ability of people with cancer to return to work?

EVIDENCE-BASED ANSWER

Physical interventions (physical training, such as walking; resistance exercises, such as strength training and yoga; or training of bodily functions, such as vocal training) improve the ability of people with cancer to return to work (number needed to treat [NNT] to have one more person return to work = 7; 95% CI, 4–20).¹ Multidisciplinary training (any combination of psychoeducational, vocational, and physical interventions) also improves the ability of people with cancer to return to work (NNT = 7; 95% CI, 5–14). However, neither of these types of interventions improves quality of life (QOL). Psychoeducational interventions (eg, counseling and coping skills taught by any qualified professional) alone appear to have no effect on ability to return to work or QOL. (Strength of Recommendation: B, inconsistent or limited-quality patient-oriented evidence.)

PRACTICE POINTERS

Cancer diagnoses among working-age adults younger than 65 years are increasing due to early screening.¹ With improved detection and treatments, the 5-year life expectancy is 67%. However, individuals who survive cancer are 1.4 times more likely to be unemployed than those who have never had cancer. Returning to work can improve QOL, give patients a sense of purpose, and enable them to financially support themselves and their families. The authors of this Cochrane review sought to evaluate nonmedical interventions that can enhance the ability of people with a cancer diagnosis to return to work.