Between 30 and 40% of women with breast cancer do not return to work after completing treatment, and for those who do, up to 43% report difficulty managing cancer-related symptoms in the work place. We have designed a Work and Cancer self-management intervention to enable women with breast cancer to manage post-treatment health-related difficulties in work and to provide knowledge of work-related entitlements to support women with breast cancer to manage their work activities. A feasibility study demonstrated acceptability of the intervention with 100% retention. Improvements were noted in functional ability and symptom management. Two of ten participants returned to work post-intervention. The findings of the feasibility study support progression to a definitive intervention trial to test the effectiveness of, and costs associated with, the Work and Cancer programme.
In order to test the effectiveness of the intervention, a cluster randomised trial design will be used. Two hundred and forty eight women with breast cancer, who have completed treatment and are considering returning to work within six , will be recruited through national cancer support centres. Each cancer centre will be randomised to the online Work and Cancer intervention or no intevention. A process evaluation will be carried out to examine implementation processes and mechanisms of action of the intervention. An economic evaluation will compare cost effectiveness and healthcare resource use between the intervention and control participants.
Employment related outcomes will include return-to-work rates and confidence to return to work. Secondary outcomes will include symptom management, self-efficacy and health-related quality of life. Qualitative data will examine participants’ perspectives on the impact of intervention on their return-to work. Process evaluation data will be collected through fidelity logs and interviews with key stakeholders involved in intervention delivery. Economic data will include intervention delivery costs, Quality Adjusted Life-Years and health and social care resource utilisation. Costs relating to absenteeism from work over the course of the trial will also be estimated.
If effective in supporting women with breast cancer to return to work, the Work and Cancer programme can be be offered as routine cancer survivorship care and tested with other cancer types.
