Background
There are late and long-term effects cancer survivors experience that can compromise quality of life. In particular, survivors can experience challenges in returning to work. This work explored perspectives of cancer survivors (employees), employers, and insuring agencies about the challenges of returning to work.

Methods
An environmental scan identified existing programs and resources to assist survivors in their return to work. A literature review and on-line survey documented the perspectives of cancer survivors and their family caregivers about the challenges in returning to work after cancer treatment. Focus groups with employers, human resource representatives, and insuring agencies gathered their perspectives about employees returning to work after cancer.

Results
8,385 websites were scanned for relevant materials and 90 were identified with resources to support patients in their return to work. There are a range of program delivery modalities making it difficult to identify best practices. Patients (n=410) described reduction in income, a range of positive and negative experiences in returning to work, and work-related issues dealing with side-effects (fatigue and loss of energy, cognitive changes). Caregivers (n=60) described work-related challenges including reduction in income, loss of concentration and productivity, stress, and lack of support from colleagues. Employers, human resource experts, and insuring agency representatives acknowledged issues related to return to work. They reported there are few employees at any one point in time who are returning to work after cancer making it challenging for managers to know how best to support these individuals.

Conclusion
Return to work is a growing concern and individuals clearly experience challenges in making this transition. There is a need for resources to be developed to help survivors, health care professionals, and employing agencies become more aware of the challenges survivors experience and be able to deal more effectively with the situation.