Advocacy Spotlight

How to Navigate the Workforce After a Cancer Diagnosis

A cancer diagnosis presents unique work-related challenges; find out how to get the support you need to work during and after cancer treatment.

By Rachael Bieschke

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In the U.S., more than 21 million adults have been diagnosed with cancer, and many of them are of working age. A cancer diagnosis brings a unique set of challenges for each individual, but workers in particular often face added stress in wondering how to navigate this new world of working with cancer. There are practical considerations, such as how to secure necessary time off, and emotional ones, including how much to share, and with whom, about your diagnosis.

You may be unsure how your treatments will affect your ability to perform your job or feel anxious about the financial strain of missing too much work. You may want to consider reaching out to your human resource (HR) department for support and direction. Your HR department will be able to tell you important details about company offerings and policies that can ease your anxiety.

Speak With HR to Determine Your Rights

In the US, the Department of Labor, federal and state law offer protections to employees under various laws such as the American with Disabilities Act, The Family and Medical Leave Act, Federal Rehabilitation Act in addition to state laws that cover employer and employee relationships. Depending on the laws where you live, some may require employers to provide “reasonable accommodation” to support you both during and after cancer treatment.

This may include offering you flexible working hours, time off for doctor’s appointments or the ability to work from home on occasion. “The key to finding out whether your workplace will accommodate your needs is to continue to provide clear, open communication regarding your situation,” says Elaine Smith, MS, LMFT, a mind-body therapist with Cancer Treatment Centers of America® (CTCA) at Southeastern Regional Medical Center in Atlanta, Georgia. As you plan your discussion with your employer, Smith suggests thinking about what your goals are for the conversation.

“Think about, ‘What do I want them to know? What do I want to bring away from the meeting?’ Discuss possible work changes and where you can seek support. Also ask if there is an EAP [employee assistance program] available. If you’re concerned about how to keep up with your duties or have fears over being let go, having a meeting with HR can help improve your confidence,” Smith adds.

“Although it is not mandatory to report on your cancer diagnosis, active treatment may become complicated, from reactions to treatment or unexpected changes, requiring such things as extra time off,” Smith says. “Having discussed these matters with HR and your direct supervisor may make it easier to get adaptations and accommodations for your well-being.

“Once you’ve discussed practical considerations, such as whether your workload could be distributed or adjustments made on site to help you — such as an extra break when needed — you can also discuss some of the emotional variables,” Smith says. “How in-depth you want to go depends on your relationship with your supervisor and co-workers, but keep in mind that most people have experience with cancer (either first hand or with a friend or relative) and may be understanding of the situation.”

Talking to Co-Workers About Cancer

Many people wonder how much to share with their co-workers about their diagnosis and treatment, and this is a very personal choice. You can talk with your supervisor and let him or her explain to co-workers why work is being redistributed or you are absent for a certain time period, or you can have the conversation yourself. As for what to say, Smith suggests:

Talk about diagnosis, treatment — not necessarily in detail but relating to work, such as, ‘I’ll be going for treatment a week at a time, and I’ll do my best to carry my weight, but there might be times when I need an extra break.’ Communication is the key — if you’re physically struggling, be open and honest about how you’re feeling. Most people will want to know how you’re doing, and if someone offers help, say yes! It’s OK to accept it.

Keep in mind that everyone has different personalities and may react to your news in different ways. “Some people are natural caregivers and may offer to bring you dinner once a week. Others may be quiet,” Smith says. “This doesn’t mean they’re rejecting you. They may be reflecting on personal experiences they’ve had with cancer.”

Other co-workers may feel uncomfortable hearing the news, often due to their own fears, while others may avoid you because they’re not sure what to say. Ultimately, however, many people find telling their co-workers provides a sense of relief and a source of support.

Your co-workers may even get involved figuring out ways to cover your schedule or help out when needed. Remember, too, that this is a process likely to change as your treatment continues. “When working through issues, be informative with co-workers,” Smith explains. “What you offer initially doesn’t necessarily have to be permanent. It will be part of a process of treatment, working and healing.”

Taking Care of Yourself at Home Will Help Your Work Life

On a practical level, there are steps you can take to minimize the interruptions to your work life, such as planning treatments just before a weekend in order to give yourself more time to recuperate. At home, you’ll want to rest as much as possible, delegating some of your responsibilities around the house to friends and family members so you can get much-needed rest.

“Pay as much attention to your sleep schedule as possible,” Smith advises, noting that fatigue is a very complicated side effect to cancer treatment. “You can rest and still feel worn out,” she says. As for things you can do outside of work to help build your physical strength and emotional resilience, Smith says getting rest that is constructive is extremely important. Utilizing relaxation exercises or meditation can enhance restorative sleep.

Listening to soothing music, nature sounds or even white noise can help you to get more peaceful rest, and you can turn to these options in the middle of the night if you wake up and find it difficult to get back to sleep. In addition, she suggests the following tips:

  • Take a 20-minute power nap when you come home from work
  • Stay hydrated
  • Ask for an extra break at work if needed
  • Practice good sleep hygiene
  • Eat well
  • Make sure you mention fatigue issues to your doctor to rule out other health issues

It may take time — or a process of trial-and-error — to figure out how to balance your health and your work life, which is why you should let your HR department or supervisor know that treatment plans or reactions to treatment may change, and flexibility with your work schedule or work load may be critically important.  Keep all lines of communication open and give your supervisor regular updates.

Deciding to Leave the Workforce

“We’re in real life when we get cancer, and we’re in the workforce,” Smith says. Your success at maintaining your work life will depend, in large part, on the organization you work for. How illness-friendly are they? How open are they to being flexible?

In some cases, you may find that, even with the best planning and intentions, you’re unable to continue working as you were before. If you decide that working is not a possibility, you should once again talk to your HR department and/or your supervisor to find out your options.

You may be able to qualify for short- or long-term disability, for instance, or take a leave of absence with plans to return when you’re feeling better. This should be a decision you make with your doctor, who will be involved in filling out part of the disability paperwork.

While many people prefer to keep working to provide a sense of purpose, routine and normalcy in their life, be honest with yourself if you need to take time off to focus on healing. The American Cancer Society advises:

Keep in mind that it can hurt you to put off going on short-term disability. Some people have had to go to great lengths to prove that they can’t do their job after they’ve spent weeks forcing themselves to go to work when they could barely get out of bed.

Don’t wait until your work performance suffers before you decide to take time away from work. If you are fired for doing a poor job, you can lose your health insurance as well as your income. And if you’re fired, you cannot collect disability benefits.

It’s a decision only you can make. In a Harris Interactive survey commissioned by Cancer and Careers, nearly 80 percent of cancer patients and survivors said continuing to work after diagnosis aided their recovery. Still, not surprisingly, 67 percent cited work/life balance as being essential to keeping their career — but many found achieving this balance difficult.

Strategies for Managing Work Life — From Cancer Survivors

No one knows better how to address some of the challenges of working with cancer than those who have gone through it. In a study of women with breast cancer who continued to work during treatment or returned to work after, the following methods were found to be helpful:

  • Making adjustments to work schedule
  • Performing fewer tasks
  • Modifying or changing the work environment
  • Reducing non-work activities at the workplace
  • Acting preemptively to make work tasks manageable

Ultimately, research suggests that more than 60 percent of cancer patients are able to work after cancer diagnosis. Support outside of work, along with co-worker and supervisor support, and taking care of one’s health, are instrumental in making this happen.

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