Madrid, February 3, 2021. The COVID-19 pandemic is having serious consequences for the mental health of the entire population, particularly so in those suffering from pathologies like cancer. For this reason, on the occasion of World Cancer Day (February 04), Cigna Spain and MD Anderson Cancer Center Madrid have drawn up guidelines - ‘A new scenario: Cancer in the company during COVID-19. Guidelines from organizations for the accompaniment of the employee with cancer’. This document was drawn up in line with the commitment of both entities to supporting companies in the implementation of a corporate culture that responds to the challenges of tackling the disease, and which is laid out in the initiative ‘Cancer and Business’.
It is made up of a series of practical advice aimed at Human Resources professionals and team leaders to support, from within the company, workers with cancer and related conditions in adapting to the current labor, social and health scenario. Because, in addition to the challenge of going through a disease of such magnitude as is cancer, these patients now face two other situations that may cause a major psychological impact - a pandemic and the need to adjust to a totally unknown situation, marked by constant change.
This context places companies in a key position as promoters and managers of health and well-being. According to the latest data from the Spanish Association Against Cancer (AECC) 1, almost 40% of the Spanish population with oncological pathologies are between 15 and 65 years old (only 3.4% are between 15 and 39 years old), so Human Resources departments or occupational health services play a central role in promoting policies and programs that support employees in this situation.
As Ana Romeo, Director of Human Resources at Cigna Spain, underlines, “The health crisis has brought about a paradigm shift marked by the rise of hybrid work environments. For that reason, we wanted to make this document more available to organizations, with the aim of providing them with the necessary guidance to be able to continue to help those employees living with cancer. From the company, our priority is to take care of the health and well-being of our employees in a comprehensive manner, and for that same reason, those going through a pathology involving specific challenges, as is the case of cancer, require our particular care".
For his part, Dr. Santiago Gonzalez, medical director of MD Anderson Cancer Center Madrid points out, “the gradual recovery of a 'new normal' at all levels for a patient who has recently undergone or is undergoing treatment for cancer is part of the treatment of the disease itself. Returning to the workplace is a fundamental part of this process and will encourage the patient to carry on, but only if we are able to adapt the work environment to their new reality. The role and awareness of organizations in this regard is key and will make a difference to the complete recovery of the patient".
This awareness-raising work by the two companies has been going on for some time. Almost two years ago, they launched the 'Cancer and Company’2 initiative with the aim of promoting a culture of support for cancer in the Spanish business community and increasing awareness of the challenges posed by the disease. Among its most significant actions are the launch at the end of 2019 of the study ‘Cancer in the company. Prospects 2020’ or ‘Cancer in business. Practical notes for Human Resources’.
What variables have an impact on the emotional well-being of cancer patients?
The starting point is to know the psychological impact of the pandemic is on people with oncological diseases and to identify what type of interventions should be undertaken from the company standpoint. Thus, to draw up the guidelines, Cigna Spain and MD Anderson Cancer Center Madrid analyzed the different challenges cancer patients are facing.
The document takes into consideration that the experience of an unprecedented health crisis makes these patients particularly prone to suffering disorders like anxiety, stress or depression, since the pandemic is occurring when the patient is going through a cancer process – which is in itself a risk factor for emotional health. This is demonstrated by the results obtained in a study carried out by the Spanish Association Against Cancer (AECC)3 in April, which showed that people with cancer pathologies were much more concerned about the pandemic than the Spanish population in general ( 67% vs 59%), and that one in three acknowledged feelings of anxiety or depression due to the lockdown.
In this sense, it is important to bear in mind that these people, in addition to having to adapt like everyone else to changes such as the increase in teleworking or the limitations on social relationships, must face a number of particular challenges directly related to their disease. Apart from the impact the pandemic has had on the health care received by these patients4, the main challenge faced by many of these people is the heightened fear of contagion, as they are a vulnerable group.
As stated by Dr. Maria Sanchez, e-Health Medical Manager at Cigna Spain, “the current situation puts additional strain on the mental health of people going through an oncological process. For that reason, we at Cigna are trying to contribute by being at the side of these patients through our Clinical Follow-up Unit and reinforcing a message that we believe is fundamental - we must not forget prevention. It is important to carry out the usual medical check-ups to be able to detect any pathology in time, as well as to consult a doctor in the event of any recent or new symptoms”.
In addition, Marta de la Fuente, head of the Psycho-Oncology Service at MD Anderson Cancer Center Madrid, says that “in these cases, 'it never rains but it pours' and the emotional impact is much greater. We must bear in mind that, right now, these people are facing three stressful life processes: cancer, a pandemic and a period of adaptation to the new situations brought about by the health crisis. Furthermore, there is a big difference between patients. The situation is not the same for someone who has just received the diagnosis and who may experience greater feelings of anger, rage, frustration and impotence as a result of the collapse of the health service as they are newcomers to the disease, as for someone who was already living with cancer and who has seen how some of their main pleasures, like going out or meeting up with family, friends or colleagues, have been limited”.
The 10 proposals of Cigna Spain and MD Anderson Cancer Center Madrid *
These variables make it necessary to create or adjust any business protocol focused on the management of these cases to adapt them to the current situation of this group and to the new work environment. What recommendations can be taken into account to do so?
- Regularly monitor the employee to know how they are and what they need
- Analyze the risks related to their health and well-being and offer the necessary resources
- Promote initiatives focused on emotional health to learn to manage uncertainty
- Pay greater attention to work-life balance and flexibility
- Keep the maximum possible communication channels open between workers
- Offer a telemedicine service in the company
- Implement specific health plans, such as ‘case management programs’
- Reinforce the professional development of these people – do not lose sight of their work goals
- Maintain or create internal actions to raise awareness about cancer
- Redefine the action protocol for the current work environment
All these actions should be regularly updated based on the changes happening in the workplace and the feedback provided by the employees themselves on the actions. For the plans and protocols to be as effective as possible, they must be adjusted to four key moments in the oncological process - pre-diagnosis (preemption), diagnosis (impact management), medical-oncological treatment (follow-up) and return to work (rehabilitation) - and take into account those employees who support dependents with the disease.
* For access to the complete document ‘A new scenario: Cancer in the company before COVID-19. Guidelines for accompanying employees with cancer from organizations', please go to the Cancer and Company website.
1Spanish Association Against Cancer (AECC). Report on the prevalence of cancer in Spain. 2020 data. Link
2 Cigna and MD Anderson Cancer Center Madrid. Website: Cancer and Business. For a culture of cancer support. Link
3 Spanish Association Against Cancer (AECC). COVID-19 Emergency in cancer. Diagnosis of the emotional impact experienced by people affected by cancer during the Covid-19 crisis. Publication: May 2020. Link
4Spanish Society of Pathological Anatomy (SEAP), the Spanish Society of Oncology Nursing (SEEO), the Spanish Society of Hematology and Hemotherapy (SEHH), the Spanish Society of Medical Oncology (SEOM), the Spanish Society of Radiation Oncology (SEOR) and the Spanish Association Against Cancer (AECC). Health Impact of the coronavirus in hospital care for oncohematological patients. Published: December 2020. Link