ORIGINAL ARTICLE Returning to work following curative chemotherapy: a qualitative study of return to work barriers and preferences for intervention Vikki Knott & Stephanie Zrim & E. Michael Shanahan & Peter Anastassiadis & Sharon Lawn & Ganessan Kichenadasse & Shawgi Sukumaran & Christos Karapetis & Bogda Koczwara Received: 30 January 2014 /Accepted: 16 June 2014 # Springer-Verlag Berlin Heidelberg 2014 Abstract Purpose This study aimed to explore barriers to return to work (RTW) and preferences for intervention and support for cancer patients treated with curative intent from the per- spectives of cancer survivors and oncology health professionals. Methods Participants attended a focus group (N =24) or an individual interview (N =14). A topic guide and a semi- structured recorded interview format were used to gather data, which were later transcribed and analysed for global themes and subthemes. Results With regard to barriers, the global theme ‘work ca- pacity’ captured an array of barriers encompassing financial pressure, preparedness for work, lack of confidence as well as other key physical, practical and psychosocial barriers. Participants expressed a preference for RTW models that focus on objective and structured assessment whilst allowing for flexibility to address individual needs. Conclusions Cancer survivors perceive multiple barriers when attempting to RTW. These barriers were perceived to impact upon work capacity, where ‘capacity’ was defined broadly to include practical, physical and psychosocial con- cerns. RTW is an important concern for cancer survivors and structured RTW interventions should be incorporated into the care of cancer survivors. Keywords Return to work (RTW) . Barriers to RTW . RTW interventions . Supportive care . Occupational rehabilitation Introduction Nearly half of patients diagnosed with a curable malignancy are employed at the time of diagnosis [1]. Following cancer, approximately one third of working cancer survivors do not return to employment [2]. Whilst this may be as a result of a patient’ s preference, research indicates that for many cancer survivors, work ability is impaired more than for workers with any other chronic disorder [3]. Approximately 20–30 % of working cancer survivors report one or more limitations in work capacity [4] underscoring the need for quality interven- tions to assist survivors return to work (RTW). Maintenance of employment, following the diagnosis of and treatment for cancer, has substantial benefits to an indi- vidual in enhancing their sense of personal worth and identity as well as providing financial security [5]. Moreover, returning to work can signify recovery [1] and provide for a sense of normality and control [6, 7] with the workplace seen as a place of support and social connections that can enhance emotional well-being and self-esteem [8, 7]. Employed survi- vors have better physical and psychosocial functioning and improved quality of life than their unemployed counterparts V. Knott (*) Epidemiology & Health Systems Division, Menzies School of Health Research, Level 1, 147 Wharf Street, Spring Hill, QLD 4000, Australia e-mail: vikki.knott@menzies.edu.au S. Zrim : G. Kichenadasse : S. Sukumaran : C. Karapetis : B. Koczwara Department of Medical Oncology, Flinders Centre for Innovation in Cancer, Flinders University and Flinders Medical Centre, Flinders Dr, Bedford Park, SA 5042, Australia E. M. Shanahan Department of Rheumatology, Southern Adelaide Local Health Network, Flinders University, Adelaide, SA, Australia P. Anastassiadis Division of Rehabilitation, Aged Care & Allied Health, Repatriation General Hospital, 216 Daws Rd, Daw Park, SA 5041, Australia S. Lawn Department of Psychiatry, Flinders University, Adelaide, SA, Australia Support Care Cancer DOI 10.1007/s00520-014-2324-y