I’m having difficulty performing my job after cancer treatment. Could vocational rehabilitation help?

Sean Smith, medical director of Michigan Medicine’s Cancer Rehabilitation Program in Ann Arbor

Vocational rehabilitation helps people with disabilities—including a cancer history—get back to work or, if needed, find alternative employment opportunities. People with cancer may need vocational rehabilitation if they have difficulty completing job tasks due to treatment side effects, such as fatigue, pain from surgery, lymphedema, or difficulty with concentration, focus or short-term memory. These services can be provided either during or after cancer treatment.

A patient’s first step is to share their concerns with their oncologist and ask for a referral to a rehabilitation specialist. Many comprehensive cancer centers have dedicated rehab specialists on staff. At the start of vocational rehabilitation, patients might meet with a rehabilitation specialist, such as a physical therapist or an occupational therapist. The specialist then will conduct functional movement tests to assess range of motion, strength and balance to help figure out why certain job tasks may be challenging. Based on the results, they will develop a vocational rehabilitation plan that may involve exercise, physical therapy, occupational therapy or referrals to other specialists.

Based on individual needs, therapy may aim to reduce pain, enhance focus or improve stamina. For instance, physical therapy can address shoulder discomfort after breast cancer surgery. Cancer survivors with lingering fatigue may benefit from an aerobic exercise program or strategies to improve their sleep, while an occupational therapist may assess a person’s workstation to identify ways to reduce strain.

If the issues are more complex, a patient may benefit from a multidisciplinary rehabilitation team, including doctors specializing in physical medicine and rehabilitation (PM&R). A PM&R specialist can diagnose and treat multiple different physical impairments and symptoms that prevent people from working. They may have a patient participate in a sleep study, order a neurocognitive evaluation, interpret imaging studies or refer the patient to other specialists, such as a psychologist or an orthotist. They also may prescribe medications to help alleviate pain or other symptoms. If a PM&R specialist or a dedicated team isn’t available near you, your oncologist can refer you to multiple specialists, such as a physical therapist, a psychologist, a sleep doctor or a pain physician.

Check your health insurance to see if your plan covers vocational rehabilitation services. Additionally, your employer’s human resources department may offer changes to physical workspaces. Ask your local department of health and human services about assistance available in your community or state, such as career counseling, help with job placement or training for a new job.

VOCATIONAL REHABILITATION // Triage Cancer lists different types of vocational rehabilitation services, including self-advocacy skills training. // Cancer and Careers offers a webinar on occupational therapy strategies that can increase work satisfaction after cancer treatment.

The expert’s response was edited for clarity and based on an interview with Kendall K. Morgan.