Amidst the wave of shuddering changes that can come with a cancer diagnosis, one of the most fundamental is the loss of work. Around 45 per cent of Australians diagnosed with cancer are of working age, and 40 per cent of this cohort will never return to work.

Work is not only a source of income, but also provides purpose and structure. The continuation of this foundational support network can make the difference between surviving and thriving after cancer. As technological advances drive up the cancer survival rate, raising the proportion of cancer survivors who return to meaningful work is a common challenge for group insurers and their members.

Now in a global first, a lifestyle support program provided by insurer AIA Australia and developed by health technology company CancerAid–called CancerAid Coach–has been shown to massively increase the return-to-work rate of its participants.

Launched in 2018 as a pilot program from AIA Australia, CancerAid Coach is a digital health coaching program delivered via a digital health proposition. It was created with the understanding that patients who are engaged with their own healthcare – through activities like logging symptoms, engaging in exercise and undergoing appropriate rehabilitation – enjoy better health outcomes.

CancerAid Coach helps participants do the things that are scientifically proven to best help their recovery, such as managing symptoms, diet, exercise, peer support, sleep hygiene and mental wellbeing.

The pilot was so successful that it is now offered to all AIA Australia customers who lodge an income protection claim. And a growing body of research is proving its efficacy.

Over the past two years, AIA Australia and CancerAid studied a cohort of more than 100 individuals who went through the CancerAid Coach program, and compared them to an equal number of individuals who didn’t have access to the program. The individuals were matched according to common demographic traits to ensure the results were comparable.

It is the first study of its kind to demonstrate a support that improves return-to-work outcomes for cancer survivors, says Raghav Murali-Ganesh, founder and CEO of CancerAid.

“Cancer is a collection of many diseases but when someone says the C word, employers and insurers with the best intentions will say ‘Gosh, go ahead and look after yourself and call us when you’re ready,” Murali-Ganesh says.

“But work is also a form of rehabilitation in both a physical and a mental sense. It’s really important to keep functioning normally, it’s important for quality of life and also financially. We’re not pushing people back to work but having a discussion about the health benefits of returning to good work.”

The rising economic burden of cancer

Cancer is one of the world’s largest healthcare problems, and has the highest economic cost of all chronic diseases, says Murali-Ganesh. It sits alongside mental illness as the two top reasons for long-term unscheduled absence from work.

And this economic burden continues to rise as diagnosis and survival rates increase, leading to a greater number of people living long term with cancer.  Cancer Australia figures show 69 per cent of Australians diagnosed with cancer will now survive.

When a skilled and experienced individual leaves the workforce, this creates a significant flow-on cost to society and the economy.

Simonie Fox, head of shared value partnerships at AIA Australia, says improving the return-to-work rate presents an enormous shared value opportunity for insurers and their members. She defines “shared value opportunities” as solving or improving a societal problem and financially bettering a business at the same time.

“The health benefits of good work are well known,” Fox says. “You live longer if you are working, you are happier, and less likely to experience a mental health condition.

“And if insurers fix this problem, that’s not only great for society, productivity will improve, people won’t be on disability payments or stuck on an income protection claim and ultimately a Total & Permanent Disability claim.”

But reaching out to members and offering rehabilitation after treatment has finished is often too late. People are dealing with the fear of recurrence, anxiety, depression, chemo fog, cancer-related fatigue and other barriers that prevent them returning to work.

COVID-19 deepened this problem as patients dealt with social isolation and the anxiety of knowing they are at higher risk than the general population.

CancerAid began purely as an app that directed patients towards activities that best help them recover. But behavioural change is difficult to bring about, and only a very small proportion maintained sustained use in the longer term.

In response, the team introduced a human touch to increase engagement. Dedicated health coaches who are trained allied health professionals, nurses and doctors help patients through a digital curriculum that empowers them to return to healthier lives, including returning to work and regaining a sense of normalcy.

Upon enrolment and receiving their first phone call from their health coach, there is a 93 per cent program engagement rate from patients.

Helping people thrive after cancer

Maintaining an active involvement in daily life, minimising disruption to life roles, managing feelings of hopelessness and regulating the normal emotional reactions to illness are helpful strategies in reducing the risk of developing a mental illness, and the program educates customers about this.

An interactive app helps patients track their symptoms, exercise, diet, sleep and mental wellbeing. Crucially, the app also provides an online community with articles and stories that motivate patients and help reduce their feeling of isolation.

Exercise during treatment is one of the most significant factors in , but this can be a hard sell for patients who are vomiting and feeling unwell. CancerAid Coach provides the structure that makes it a little bit easier.

CancerAid Coach also incorporated an additional module after the onset of Covid-19 to deliver cancer-specific Covid-19 information to more than 10,000 individuals.

AIA Australia’s cancer recovery programs include its CaRe Movement program of exercise physiology during treatment and RESTORE CaRe which is a wellness program. In addition to these, AIA Australia has health coaching programs for its three most commonly claimed conditions–cancer, mental health and chronic pain. These conditions account for 83 per cent of its total claims.

AIA Australia and CancerAid are also developing a return-to-work coaching program to follow on from CancerAid Coach which guides members on matters like having the right conversations at work and operating differently to deal with new restrictions they may have.

Fox points out that the CancerAid Coach program is offered to customers before their claim is even assessed.

“We share with the customer that AIA Australia do not have access to any of the data which they input into the app, such as the tracking of their symptoms, so that they feel more confident to engage in the program,” Fox says.

Early support coaching programs are particularly exciting because of their low cost and easily scalable nature, Fox says.

“At AIA Australia we continuously monitor the return on investment to look for sustainable outcomes,” Fox says. “These programs are low cost and cost effective, and the CancerAid Coach program I particularly love because we offer it to everybody, even to even to customers with a poor prognosis as it will support them to live with their cancer”.

This InFocus article was published in partnership with AIA Australia.

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