Support for cancer survivors in vocational rehabilitation programs in Norway: Experiences of cancer survivors and job counselors

Background As more individuals remain in the workforce following a cancer diagnosis, many will face cancer-related late effects, including pain, fatigue, and cognitive impairments, which can hinder their return-to-work (RTW) process. Objective This study explored the RTW experiences of cancer survivors enrolled in vocational rehabilitation programs in Norway, and the experiences of job counselors supporting cancer survivors in their RTW process. Methods Qualitative interviews were conducted with five cancer survivors and five job counselors. The job counselors were employed in vocational rehabilitation enterprises operating under assignments from the public Norwegian Labor and Welfare Administration (NAV). NAV is responsible for administering social welfare benefits, providing employment services, and actively supporting individuals returning to work after illness or injury. Data were qualitatively analyzed using reflexive thematic analysis (cancer survivors) and a template organizing style analysis (job counselors). Results Three main themes emerged: Cancer-free but not healthy , Need for inclusive employment practices , and Lack of interdisciplinary collaboration . Cancer survivors frequently required workplace accommodations to address unexpected late effects, but these accommodations were not consistently provided by employers, prompting job counselors to also intervene with employers. Both cancer survivors and job counselors reported a lack of competence and interest in work inclusion among healthcare professionals. Additionally, the participants expressed frustration with NAV and perceived the follow-up of workers on long-term sick leave as inadequate, despite legal mandates. Conclusions The findings underscore the need for improved interdisciplinary collaboration to support cancer survivors in the RTW process and advocate for the integration of work inclusion into standardized cancer care pathways.