Back to Work After Breast Cancer: New Research on Brain Function and Success
Getting back to work after breast cancer treatment is a huge milestone. It helps patients feel more normal and connected and provides the crucial financial stability we all need. But here's the thing - a new French study shows that about 1 in 5 women (21%) struggle to get back to work within two years of their diagnosis. A big part of this challenge? How cancer treatment affects their thinking and mental processing. Let’s break down what this research tells us about managing this journey back to work.
Key Findings at a Glance
The thinking brain matters: Returning to work was easier for women who performed better on mental tasks like quick thinking, staying focused, and juggling information in their heads. Less depression and tiredness also helped with the transition.
Treatment effects: Women who had their whole breast removed, had mastectomy (54% vs 24%) or went through chemotherapy found it harder to return, though hormone therapy didn't seem to make much difference.
Job type makes a difference: Office workers and managers returned to work more often (67%) than those running their own businesses (14%) or doing physical work (19%). This shows how different jobs can make the return journey easier or harder.
How Cognitive Health Affects Work Readiness
The study identified three key thinking skills that really affect how well women get back to work:
Quick Thinking
How fast you can take in and react to information makes a big difference - this matters right from the start, through chemotherapy, and even two years later.
Think about a nurse or a doctor who needs to understand patient notes quickly - this could be tricky if the processing speed slows down.
Memory and Focus
Women who could better manage multiple things in their heads were twice as likely to return to work successfully.
When the focus isn't quite there, even everyday tasks like working with spreadsheets or having meetings become much harder.
Believing in Your Abilities
Here's something really interesting: How confident you feel about your thinking abilities is just as important as how well you actually perform on tests. Knowing if you're worried about your mental sharpness after treatment is really valuable.
Beyond Cognition: Other Influencing Factors
Beyond thinking skills, there are a few other important things that affect getting back to work:
Physical Job Demands
People doing physical work found it hardest to return (only 19% made it back), mainly because of:
Soreness around the chest after breast surgery
Feeling really tired from chemo
Swelling in the arms making movement tricky
Treatment Types
Women who had their whole breast removed (had mastectomy) struggled more to return compared to those who kept part of their breast (54% vs 24%). We don't know how many had reconstruction, though, as that's missing from the data.
Chemo really knocked people around, making recovery take longer than those who just had radiation.
Mental Health
Depression made a big difference - for every point higher on the depression scale, people were 17% less likely to return.
Surprisingly, anxiety levels didn't seem to matter much, which goes against what some other studies have found.
Limitations & Unanswered Questions
While this research gives us some really valuable insights, there are a few important gaps we need to keep in mind when looking at the results:
Cultural Context & Healthcare Systems
The study was done in France, where they have a completely different healthcare setup than we do. Their universal system means patients get different support and sick leave compared to here in New Zealand, where things can vary quite a bit between employers and regions.
Information We're Missing
We don't know what kind of workplace adjustments were offered or tried - things like flexible hours or modified duties that could make a big difference
There's no data about how many women had breast reconstruction after mastectomy, which could affect their return to work
The researchers didn't dig into why some women chose not to return - maybe they needed to focus on caregiving, or perhaps they were receiving disability support
The Chicken or the Egg Question
Here's something really interesting to consider: We can't tell if the cognitive changes are directly caused by chemotherapy or if they're more related to the stress and exhaustion that come with treatment. It's probably a bit of both, but the study can't give us a definite answer.
Practical Takeaways for Patients
Before You Head Back: Getting Your Brain Ready
Let's talk about what to discuss with your medical team. They can help set you up for success with:
Working with an occupational therapist: They're amazing at teaching you practical tricks to work around that foggy feeling in your head. Think of them as your personal coach for getting back into the swing of things.
Workplace assessments: This is where we examine your actual job and determine how to make it work for you. Maybe you start with shorter days, or we shuffle some of your duties around until you're back at full strength.
Making Your Job Work For You
For physical jobs: We need to get creative. Can we adjust your workstation? Maybe temporarily swap some heavy lifting tasks for lighter duties? There's usually a way to make things more manageable.
For desk jobs: Sometimes, the small changes make the biggest difference. Getting things in writing instead of trying to remember verbal instructions can be a game-changer. And those task management apps? They're like having a second brain to keep you organised.
Getting the Timing Right
Here's something really interesting - how well you do on early brain function tests can actually predict how smoothly you'll transition back to work. That's why we want to catch any issues early and start working on them right away.
Looking After Your Whole Self
Let's not forget about exercise—it's pretty impressive that over half of women (55%) felt better when they followed a structured exercise program. Even a gentle walk can make a difference.
Sometimes, talking to a counsellor can help sort through all those thoughts and feelings bouncing around in your head. It's totally normal to need this kind of support.
And don't underestimate the power of connecting with other women who've been there. Support groups are fantastic for picking up tips and tricks from people who really get what you're going through.
A Note for New Zealand Patients
While this European data provides insights, local factors may influence your experience:
Indigenous Health Perspectives: Māori/Pasifika patients may face unique cultural/workplace dynamics requiring tailored support
Regional Disparities: Access to cognitive rehab services varies between DHBs – advocate for referrals early
Breast Cancer Foundation provides excellent services for New Zealand wahine, and you can find more information at www.breastcancerfoundation.org.nz
Final Thoughts
Returning to work post-cancer is deeply personal – there’s no “right” timeline. This study emphasises that cognitive health deserves equal attention to physical recovery when planning employment reintegration. By partnering with your medical team and employer, you can create a return strategy honouring both your health needs and professional goals.