This week has seen the publication of an important source of information and support for head and neck cancer patients about the challenge of returning to work after treatment. Chris Curtis and The Swallows, with support from others, deserve great credit for raising awareness of this issue in their Back to Work Guide. It is available here
In the last couple of decades the age profile of patients has changed, with the increasing causal involvement of HPV in head and neck cancer. With patients consequently presenting at a younger age, the wish to return to work is of even more importance.
I had a laryngectomy aged 51, which was at the lower part of the usual age range at the time. As a secondary school teacher my employment depended on my voice and I had no certainty of being able to return after the operation. As it happened, after primary surgical voice restoration, I had reasonable valve speech but it was not up to speaking several hours during a working day. Fortunately the surgery left a great sweet spot on my neck for placement of an electrolarynx (EL). Subsequently the EL has been my primary method of speech and enabled 4 more years work as a teacher, before taking early retirement in 2007.
My experience illustrates a key factor in determining the ability to return to work – the functional outcomes after cancer treatment and how the demands of the job can be met. There are many other relevant factors but some of these pose important questions about impact of equality issues on the ability to return to work.
As a teacher, I was a public sector employee. With that came many benefits, such as decent sick pay, continuing for many months. Recovering from a laryngectomy takes a long time and it was nearly a year before I returned to work full-time. Had my employment circumstances been different, with less advantageous terms of service or had I been self-employed, the outcome may not have been so positive.
This is an area where there has been little research to guide us. Abi Miller, SLT at Chesterfield Royal Hospital, and Emma Kinloch, NCRI Consumer Lead, have both been working recently to remedy this. However this is only a start. In the meantime the Back to Work Guide will be of great benefit to patients accepting the challenge of returning to work.