Work after cancer

You and only you, will know when and if you are ready to return to work after cancer.

  1. What happens with work following a cancer diagnosis?
  2. Time off employment for cancer treatment
  3. Returning to work after cancer
  4. Cancer and discrimination at work
  5. Not going back to your career after cancer

Estimated read-time: 8 minutes

What happens with work following a cancer diagnosis?

When faced with cancer many people will need to take time away from work to deal with the many medical appointments, long treatment schedules and to cope with any side effects and emotional strain. You will also have to recover sufficiently from treatment, side effects and mental health issues before being able to resume the responsibilities you had before.

Your caregiver too will undoubtedly have to stop work or cut down their hours to be able to support you through, meaning that the impact cancer can have upon a couple can be entirely devastating.

It can be massively challenging and disappointing to give up careers and a regular salary so abruptly like this, for such a devastating reason. The emotional and financial impact this uninvited major life change can have upon the household budget can be an added form of distress.

It is advisable at this point to seek the guidance of a financial advisor who has experience with dealing with people faced with cancer. Your medical team will be able to direct you to financial support, your local cancer charity can offer financial advice or at least direct you to the recommended source of local advice.

Work after cancer

A good idea is to be open with your employer, line-manager or human resource team and let them know about your diagnosis as soon as possible as it will help maintain good communication and understanding between both parties.

There is no requirement of you to have to do this, but making your employer aware of your treatment plan, will help prevent any problems arising down the line and will protect you from discrimination. To protect yourself, it is a good idea to record any possible areas of discrimination at work as it is unlawful for anyone to be prejudiced due to cancer.

Letting work know the current situation means that reasonable adjustments can be made to your work schedule to allow you time off for appointments or to recover.

The way cancer reacts to treatment can be unpredictable, but your oncologist will help you gain an awareness of what predicated side effects your treatment plan can have and how your abilities to function will be affected. This knowledge will help you plan around the uncertainty as much as possible and by sharing your situation with your employer, it will enable them to be able to support you as best they can.

If you feel uncomfortable sharing such personal information directly with your manager, informing your occupational health adviser is the best way to preserve confidentiality and let you get on with your treatment.

Time off employment for cancer treatment

Soon after your diagnosis, there will be decisions to make about your work situation. The prospect of stopping work, especially during the initial phase after diagnosis when you may be feeling well, is perhaps a surreal prospect which you are unwilling to acknowledge.

Long treatment sessions, frequent journeys to hospital, multiple appointments for testing, treatment, counselling, complementary therapies, delays in treatment, side effect control and hosting visitors will all take time out of your days and weeks, making working just not possible.

As you start your treatment plan your ability to do your job effectively will more than likely be affected1 as treatment, side effects and emotional distress will all affect your concentration and energy levels.

In fact, the Livestrong 2012 Survey of Survivors’ Experiences with Employment reported an overall a decline in productivity of 72% of the 6383 survivors surveyed. Specifically, 67% noted the negative impact cancer had upon their abilities to perform physical requirements at work and a further 61% of survivors experienced a decline in their mental capacity needed to do their job.2

Of course, whether you continue working all depends on the type of job you do, how flexible you can be and how much continuing working means to you. Financially, many people may not be in a position not to work and the self-employed are usually the worst affected by the sudden loss in income.

Every person will have an individual response to treatment and your ability to work cannot be compared to another person who is going through the same treatment protocol with the same type and stage of cancer.

With advancements in treatments, the use of kinder anti-cancer therapies and the ability to control symptoms and side effects better than before and it is not impossible to continue some types of work through treatment.3

It is essential to have honest conversations with your employer as the job you do will need to be considered as you may have to cut back on certain responsibilities. For example; you may not be able to drive, travel on a plane, work long shifts, lift heavy loads or operate machinery.

You may feel guilty about leaving your job knowing what you should be doing or perhaps knowing the extra burden that may be placed upon your other colleagues as a result. However, your new job, the structure and focus of your days, weeks and months now is your recovery.

You need to put yourself and your physical and mental health and wellbeing first and not worry about leaving work behind.

Returning to work after cancer

At the point of diagnosis, there will be uncertainty about what treatment you face and how well your cancer will respond. It will be difficult to know when or if you will be able to return to work.

Your initial treatment could last months as many patients will have a succession of multiple treatments such as; surgery, chemotherapy and radiation etc. It could also take many more months of essential recovery for you to feel a lot better and even think about going back to work. Then, there will be your ongoing medical care of regular scans, blood tests or treatment for lasting side effects could continue for several years post the completion of your treatment.

However, as time goes on you may feel stronger and more able to get your life back, although the decision is entirely personal.

Starting work again can help re-build self-esteem, give you an opportunity to reclaim parts of your identity and provide a sense of normality which has been missing. It gives people purpose, fulfilment and achievement and can be a great way of combating the loneliness, isolation and vulnerability that illness can bring.

Working and even regaining the ability to work can restore personal confidence and give you back financial stability which in turn will improve your stress levels and quality of life.

How able you are at managing lasting or long-term side effects will also have an impact upon how able you are to work. In fact, cancer survivors are more likely to take sick leave than other workers.4

Knowing your physical limits and weighing up how important working is to you, should be part of your decision process. For example, the common side effect of fatigue can be debilitating and can linger long after treatment has stopped, affecting your physical strength as well as your ability to focus mentally.

It can be difficult for those around you to appreciate and understand or even see the impact some long-term side effects can have. For example, cancer-related fatigue is one of these so-called ‘invisible disabilities’ which your colleagues may not realise that it does not go away simply because you have had a rest.

Although, your ability to cope at work will more than likely improve with time as side effects settle and you become more accustomed as to how able you are to function with the ‘new normal’.5

Psychologically you will have to find the strength to work despite having to cope with ongoing feelings of loss, anxiety, uncertainty and the emotional side effects of changes to your confidence and body image.6 Your appearance will have likely changed, from hair loss to scars and changes in weight, it will perhaps take time to regain your body confidence, especially at work.

Other side effects such as nausea and constipation should be able to be controlled by medication but returning to work whilst suffering side effects and taking medication should be a consideration.

Pills in a hand

Your medical team are there to advise and support you in your return to work. They will be able to help you overcome or manage any physical disability or anticipated problems standing in your way.

In most jobs there will be a flexible, staged, return-to-work plan which will phase you back into work and is accessed through your occupational health department. You may be able to attend courses or seminars in order to make the transition back to work easier for everyone.

Supporting your wellbeing will help keep you able to work as much as you want to. It is important not to neglect your nutrition, sleep or exercise routines, all which help you heal, just because you would rather be at work than undergoing cancer treatment. Building rest, relaxation into your day is essential and limiting stress all must be non-negotiables in your ability to work.

To help you transition back to work you may want to meet privately with a few close colleges before returning. Or, if it is more appropriate to your work culture get in touch with your Human Resource team to discuss how best to be phased back. Some people like to send an email to announce their return using it as a chance to make clear your personal preferences as to how others should approach you.7

Cancer and discrimination at work

By 2024 there will be an estimated 19 million cancer survivors in the United States of America alone.8

Many of which are of working age, requiring work-related accommodations to allow them to continue to do their job. Many companies are now much more understanding that it will be a long time before you have recovered, long after treatment stops.

Legally, you will be protected by disability laws and regulations which prevent discrimination at work. Your employer does not have the right to access your medical records9 and any health questions must be related directly to your ability to carry out the tasks relevant to your job.10

Any potential disabilities or long-term side effects which may impact upon your ability to do your job can be anticipated by your medical team in advance to your return to work. This means that any relevant adaptations to the type of work or tasks you can perform are able to be managed before any difficulties arise.

Unfortunately, some survivors can face work-place discrimination because of chronic side effects they experience such as fatigue which can result in a slower ability to perform.11

Making sure your employer knows your current health status and how you are doing is a good idea as a positive relationship will help ease your transition back to work. Having a letter from your oncologist stating these issues may help to overcome any misconceptions about your future abilities at work and ease any concerns your employer may have.12

You may be feeling good about getting back to work and able to work at your original capacity, yet you may feel stuck in your job, or overlooked, with limited options for development. A reported 32% of workers did not pursue a promotion after going back to work from having had cancer.13

By communicating well, making clear your abilities now that you are back at work, any potential misunderstandings or bad feelings can be avoided.

Being a cancer survivor has the potential to make you feel vulnerable and unsure about changing jobs and potentially not having sick pay in a new job will be of concern. You may also be worried about having to tell prospective employers of the fact that you had cancer, but you have no legal obligation to discuss your illness unless it impacts your ability to do your new job.14

It is an idea to seek advice from a careers counsellor as to how best to re-write your C.V. and answer any direct interview questions.

Also, by seeking advice from support groups, you will be able to get firsthand knowledge about what real-life challenges survivors have faced in the world of work.

Not going back to your career after cancer

Cancer can very much feel like a before and after life situation.

Having cancer and surviving it, is such a life altering experience that often survivors will experience a profound change in themselves, affecting all aspects of their life. The post-cancer you may have different goals, desires, spiritual connection, outlook and even changes in your personality can all be experienced.

This new perspective on life may even bring you to the point that going back to your old job or area of expertise may now feel entirely irrelevant. You may even find yourself re-assessing all areas of your life from where you live and what you do, your relationships, hobbies, friendships may all change in the wake of your recovery.

You may experience a sharpened focus on what you want to achieve in your life and suddenly have the drive and passion to do what you have always wanted to do.

Some people feel that having received such positive support throughout that they now want to give back to the cancer community in some way. They turn their energies to fundraising, work for a charity or retrain in complementary therapies, counselling or become a financial advisor for cancer patients.

To not be able to go back to work is a concern for over half of cancer survivors.15

For the cancer survivor, issues such as; occupational stress,16 your work arrangements, workload, potential for discrimination, working conditions, your ability to work and job satisfaction all must be weighed up.17 For many, not going back to work at learast for now, or changing the direction you take in your career is the only option.

This will be more than likely due to the long-term side effects you must live with, the scars that are both physical and mental. You may be still suffering long-term side effects or still overcoming depression or anxiety which mean that you are no longer able to do the job you once did.

This is a personal choice and not all survivors go back, with a reported statistics range between 56% and 84% of people living beyond cancer returning to work.18 Although work can give you purpose, there are other ways of finding this, for example; focusing on your family, developing a hobby, finding a project or doing volunteer work.

By keeping a little bit of yourself back and nurturing yourself away from the trauma, which you can build resilience from in the future.19

Your decision will ultimately depend upon how financially possible this is and if you do decide to not return to work, it is wise to seek professional financial advice. There may be the possibility to take early retirement and access pensions, be entitled to benefits, health insurance claims or use any investments you may have to live off whilst you recover in the long-term.

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Recommend to others facing cancer, on support forums, social media, in person or by email. Thank you.

References

  1. Banegas, M. P. et al. (2016) ‘For Working-Age Cancer Survivors, Medical Debt And Bankruptcy Create Financial Hardships’, Health Affairs, Vol. 35(No. 1), pp. [Online]. Available at: https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.0830?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed& (Accessed: 19th May 2019).
  2. Livestrong (2013) Survivors’ Experiences with Employment, Available at: https://www.livestrong.org/sites/default/files/what-we-do/reports/2012Survey-SurvivorsExperienceWithWork_0.pdf (Accessed: 19th May 2019).
  3. Grunfeld, E.A., Low, E., Cooper, A.F. (2010) ‘Cancer survivors’ and employers’ perceptions of working following cancer treatment’, Occupational Medicine, Volume 60 (Issue 8), pp. Pages 611–617 [Online]. Available at: https://doi.org/10.1093/occmed/kqq143(Accessed: 20th July 2019).
  4. Silver, J.K. et al. (2012) ‘Cancer rehabilitation may improve function in survivors and decrease the economic burden of cancer to individuals and society ‘, Work, Vol. 46 (No. 4), pp. pp. 455-472, 2013 [Online]. Available at: https://content.iospress.com/articles/work/wor01755 (Accessed: 20th July 2019).
  5. Stone, D.S. (2017) ‘Young adult cancer survivors and work: a systematic review’, Journal of Cancer Survivorship, Volume 11 (Issue 6), pp. 765–781 [Online]. Available at: https://link.springer.com/article/10.1007/s11764-017-0614-3 (Accessed: 21st July 2019).
  6. Barnard, A. et al. (2016) ‘Returning to work: The cancer survivor’s transformational journey of adjustment and coping’, International Journal of Qualitative Studies on Health and Well-being, 11, pp. 10.3402/qhw.v11.32488. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5112348/ (Accessed: 9th September 2019).
  7. American Society of Clinical Oncology. 2018. Cancer Survivorship. [ONLINE] Available at: https://www.cancer.net/sites/cancer.net/files/cancer_survivorship.pdf. [Accessed 22 December 2018].
  8. Stone, D.S. (2017) ‘Young adult cancer survivors and work: a systematic review’, Journal of Cancer Survivorship, Volume 11 (Issue 6), pp. 765–781 [Online]. Available at: https://link.springer.com/article/10.1007/s11764-017-0614-3 (Accessed: 21st July 2019).
  9. American Society of Clinical Oncology. 2018. Cancer Survivorship. [ONLINE] Available at: https://www.cancer.net/sites/cancer.net/files/cancer_survivorship.pdf. [Accessed 22 December 2018].
  10. NHS Inform (2019) Work, Available at: https://www.nhsinform.scot/illnesses-and-conditions/cancer/practical-issues/work (Accessed: 21st July 2019).
  11. Moser, E. C. et al. (2014) ‘Cancer survivorship: A positive side-effect of more successful cancer treatment’, European Journal of Cancer Supplements, Volume 12 (Issue 1), pp. Pages 1-4 [Online]. Available at: https://doi.org/10.1016/j.ejcsup.2014.03.001 (Accessed: 26th July 2019).
  12. Grunfeld, E.A., Low, E., Cooper, A.F. (2010) ‘Cancer survivors’ and employers’ perceptions of working following cancer treatment’, Occupational Medicine, Volume 60 (Issue 8), pp. Pages 611–617 [Online]. Available at: https://doi.org/10.1093/occmed/kqq143(Accessed: 20th July 2019).
  13. Livestrong (2013) Survivors’ Experiences with Employment, Available at: https://www.livestrong.org/sites/default/files/what-we-do/reports/2012Survey-SurvivorsExperienceWithWork_0.pdf (Accessed: 19th May 2019).
  14. NCCN Guidelines for Patients (2019) Adolescents and Young Adults with Cancer, 2nd edn., United States of America: NCCN Foundation.
  15. Livestrong (2013) Survivors’ Experiences with Employment, Available at: https://www.livestrong.org/sites/default/files/what-we-do/reports/2012Survey-SurvivorsExperienceWithWork_0.pdf (Accessed: 19th May 2019).
  16. Böttcher H.M., Steimann M., Rotsch M., Zurborn K.H., Koch U., Bergelt C. (2013) ‘Occupational stress and its association with early retirement and subjective need for occupational rehabilitation in cancer patients.’, Psychooncology, 22(8), pp. 1807-14 [Online]. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23175474 (Accessed: 21st July 2019).
  17. Mehnert, A. PhD (2013) ‘Employment challenges for cancer survivors’, Cancer, Volume 119 (Issue S11), pp. Pages 2151-2159 [Online]. Available at: https://doi.org/10.1002/cncr.28067 (Accessed: 20th July 2019).
  18. Grunfeld, E.A., Low, E., Cooper, A.F. (2010) ‘Cancer survivors’ and employers’ perceptions of working following cancer treatment’, Occupational Medicine, Volume 60 (Issue 8), pp. Pages 611–617 [Online]. Available at: https://doi.org/10.1093/occmed/kqq143(Accessed: 20th July 2019).
  19. Cole, F., MacDonald, H., Carus, C., Howden-Leach, H. (2010) Overcoming Chronic Pain, 2nd edn., London, UK: Robinson.

Bibliography

American Society of Clinical Oncology. 2018. Cancer Survivorship. [ONLINE] Available at: https://www.cancer.net/sites/cancer.net/files/cancer_survivorship.pdf. [Accessed 22 December 2018].

Banegas, M. P. et al. (2016) ‘For Working-Age Cancer Survivors, Medical Debt And Bankruptcy Create Financial Hardships’, Health Affairs, Vol. 35(No. 1), pp. [Online]. Available at: https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.0830?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed& (Accessed: 19th May 2019).

Barnard, A. et al. (2016) ‘Returning to work: The cancer survivor’s transformational journey of adjustment and coping’, International Journal of Qualitative Studies on Health and Well-being, 11, pp. 10.3402/qhw.v11.32488. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5112348/ (Accessed: 9th September 2019).

Böttcher H.M., Steimann M., Rotsch M., Zurborn K.H., Koch U., Bergelt C. (2013) ‘Occupational stress and its association with early retirement and subjective need for occupational rehabilitation in cancer patients.’, Psychooncology, 22(8), pp. 1807-14 [Online]. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23175474 (Accessed: 21st July 2019).

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Livestrong (2013) Survivors’ Experiences with Employment, Available at: https://www.livestrong.org/sites/default/files/what-we-do/reports/2012Survey-SurvivorsExperienceWithWork_0.pdf (Accessed: 19th May 2019).

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Mehnert, A. PhD (2013) ‘Employment challenges for cancer survivors’, Cancer, Volume 119 (Issue S11), pp. Pages 2151-2159 [Online]. Available at: https://doi.org/10.1002/cncr.28067 (Accessed: 20th July 2019).

Moser, E. C. et al. (2014) ‘Cancer survivorship: A positive side-effect of more successful cancer treatment’, European Journal of Cancer Supplements, Volume 12 (Issue 1), pp. Pages 1-4 [Online]. Available at: https://doi.org/10.1016/j.ejcsup.2014.03.001 (Accessed: 26th July 2019).

Morgan, E. (2016) Anxiety for Beginners, 1st edn., United Kingdom: Pan Macmillan.

NCCN Guidelines for Patients (2019) Adolescents and Young Adults with Cancer, 2nd edn., United States of America: NCCN Foundation.

NHS Inform (2019) Work, Available at: https://www.nhsinform.scot/illnesses-and-conditions/cancer/practical-issues/work (Accessed: 21st July 2019).

Silver, J.K. et al. (2012) ‘Cancer rehabilitation may improve function in survivors and decrease the economic burden of cancer to individuals and society ‘, Work, Vol. 46 (No. 4), pp. pp. 455-472, 2013 [Online]. Available at: https://content.iospress.com/articles/work/wor01755 (Accessed: 20th July 2019).

Stone, D.S. (2017) ‘Young adult cancer survivors and work: a systematic review’, Journal of Cancer Survivorship, Volume 11 (Issue 6), pp. pp 765–781 [Online]. Available at: https://link.springer.com/article/10.1007/s11764-017-0614-3 (Accessed: 21st July 2019).

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Cancer Signpost

1 Comment

  1. AffiliateLabz on February 21, 2020 at 12:28 pm

    Great content! Super high-quality! Keep it up! 🙂

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