More than 20% of women diagnosed with breast cancer are unable to work two years after diagnosis. Is it a will or a compulsion? A question that the Canto Work study answers: Of course, the state of health and the treatments are partly responsible, but the family and socio-economic situation also play an important role.
An article that can be found in the magazine Inserm No. 58
In France, breast cancer is the most common cancer among women. The 5-year survival rate is 87% and mortality decreases each year. Despite this positive development and although more than 70% of women work in Western countries, “ 21% of breast cancer sufferers did not return to work two years after diagnosis » says Gwenn Menvielle, research director Insert, epidemiologist at the Gustave Roussy Institute in Villejuif. Therefore, one of the current challenges in the treatment of this cancer is to identify all the obstacles that stand in the way of this recovery and to propose ways to eliminate them. To implement this approach, Gwenn Menvielle, Ines Vaz-Luis, oncologist in the same team, and Agnès Dumas, sociologist and Inserm researcher in the Department of Clinical Epidemiology and Economic Assessment for Vulnerable Populations in Paris, designed the Canto study.work. This is based on the Canto cohort (For Cancer toxicities), which was launched in 2012 and follows more than 12,000 women treated for localized breast cancer. The aim is to determine the after-effects of treatments on long-term quality of life. “ The advantage of this cohort is that it collects clinical information about the type of tumor, treatments, health status, but also data about the women’s social, family and professional situation and their quality of life from diagnosis and over a six-year period », specifies Gwenn Menvielle.
Clinical obstacles… but not only
Canto-Work thus showed that two years after the diagnosis “ the most invasive treatments – removal of the breast and lymph nodes in the armpit – and taking trastuzumab, a antibody monoclonal used as an anticancer agent, are associated with a reduced return to work », explains the epidemiologist. In addition, there are undesirable effects of treatments – for example significant disabilities in the arm after an operation, neuropathic pain or intestinal damage – as well as psychological sequelae: depression and anxiety. Also, ” severe fatigue – especially emotional – that is a very common symptom that occurs up to four years after diagnosisand described by women as the most annoying, plays a role » adds Ines Vaz-Luis.
“ But back to work also depends on the family and socio-economic situationregardless of health status and treatments », emphasizes Gwenn Menvielle. Given the same household income at the time of diagnosis, women living as a couple are less likely to return to work part-time and more quickly. “ Furthermore, responsibility for three or more children is a complicating factor, but only for the most disadvantaged. It’s as if these women are victims of a double whammy. », Specifies the epidemiologist. After all, almost half of the women are To rebalance personal and professional life in favor of the former. This phenomenon is compounded by a lack of interest in work – employees are less likely to return to work than managers – and a feeling of lack of support Manager, the negative impact of cancer on daily life, for example the fear of a relapse hindering plans or the guilt of having been less present for the family. This change in life priorities is also related to the fact that experiencing an illness can have a “positive” influence on the meaning of life, attention to one’s own health and better self-esteem.
Diverse and personalized help
“ There are various difficulties with reintegration into the workforce and certain patients are at increased risk of developing cancersummarizes Gwenn Menvielle. They therefore need to be identified in order to offer an individual approach as soon as possible after diagnosis, especially since there are tools that can help them. “. For example, ” adapted physical activity or cognitive and behavioral therapy helps reduce fatigue, completes Ines Vaz-Luis. Therefore, We have developed an algorithm This makes it possible, based on the diagnosis, to determine the risk of severe fatigue that could occur after treatment “. In addition, the researchers showed thatPatients supported support with digital tools while maintaining human contact. You will therefore evaluate personalized monitoring for two years with two applications and regular telephone contacts. The clinical aspects are based on Resilience, an “app” developed at Gustave-Roussy that focuses on treating clinical symptoms. The Alex platform, designed by Startup Wecare@workenables us to support patients on their career path from the moment the diagnosis is announced. Please note that this is not about getting women back into working life soldierbut that ” Everyone chooses their career path consciously.”warns Gwenn Menvielle, who also specifies: “ The story doesn’t end with recovery. We are also interested in the long-term maintenance of professional activity and its conditions. Our goal is to identify the means for a stable and, above all, high-quality recovery. »
Gwenn Menvielle and Ines Vaz-Luis conduct their research in the unit Biomarkers and new therapeutic targets in oncology (Unit 981 Inserm/Gustave-Roussy/Université Paris-Saclay), at the Gustave Roussy Institute in Villejuif. Agnès Dumas is a sociologist and researcher in the fieldDivision of Clinical Epidemiology and Economic Assessment for Vulnerable Populations (Unit 1123 Inserm/Paris Cité University)
Author: FD M.
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