What You Should Know: Thriving in the Workplace During or After Cancer

Between appointments and follow-up visits, getting treatment and managing medicines and their side effects, cancer can feel like a job. But what happens when patients or survivors are ready to actually return into the workforce?

What are some of the most common difficulties that patients and survivors of cancer face when returning to work during or after treatment?

How can they overcome these obstacles?

CURE spoke with Rebecca Nellis, Chief Mission Officer of Cancer and Careers, on how to navigate the career world during or after cancer. Cancer and Careers is a New York City-based organization aimed at empowering and educating “people with cancer to thrive in the workplace.”Some of the most common challenges that patients and survivors face include determining whether to work through treatment or take time off, deciding whether or not to disclose a diagnosis at work — and if a person decides to disclose, to whom and how — managing treatment side effects at work, deciding that they want to make a career change after a diagnosis, looking for a job after being out of work for treatment and addressing a gap on a resume from time off for treatment. These are just a few of many issues that come up when work and cancer intersect, but they’re some of the ones that we hear about most often.We offer a wealth of resources and support to help patients and survivors determine the best path forward for themselves when it comes to balancing work and cancer. Every situation is different and creating an action plan for managing work after cancer is going to look different for everyone. We recommend that after a diagnosis, patients gather as much information as possible about their diagnosis and treatment, the various side effects and how that might impact their work as well as review their employee manual for information about what policies are in place and what benefits they have access to.

Are there any legal issues patients and survivors should be aware of?

It is also critical that they talk to their health care team about what their job entails to get general ideas about how their diagnosis, treatment and side effects could affect their ability to do their work. The best way for patients and survivors to tackle these issues is to be as informed about them as possible, know their legal rights in the workplace and work with their health care team and employer — if they choose to disclose — to create a plan that works for them.There are many legal issues that arise at the intersection of work and cancer and they are often complex, but there are laws that patients and survivors should be familiar with to protect themselves in the workplace. Specifically, cancer patients and survivors should have an understanding of the two main federal laws — the Americans with Disabilities Act and the Family and Medical Leave Act — as well as any relevant state fair employment or leave laws, which can at times be more protective than the federal options.

The Americans with Disabilities Act protects eligible cancer survivors and caregivers from discrimination in the workplace and may provide access to reasonable accommodations. These accommodations can be a fantastic tool to help people manage the impact treatment is having on their job.

The Family Medical Leave Act of 1993 gives eligible employees the ability to take time off due to illness or to care for sick dependent without losing their job. The idea of using the law can be both stressful and scary and we encourage people to instead view the law as a tool to help them figure out how to balance work and a cancer diagnosis. (Editor’s note: For more on these laws and legal rights in the workplace, click here).

Is it required that you tell your employer that you have or had cancer?

Generally, under the law, you are not required to disclose anything about your diagnosis to a current or potential employer. However, if you are trying to access protections under one of the laws we just spoke of, you may need to disclose some information about your health condition to support why you are eligible to access those protections. What is critical here is that it doesn’t mean your employer is entitled to great detail about your diagnosis, treatment or prognosis. Rather you just need to provide enough information to satisfy the request you are making. This is particularly vital for people who would prefer to disclose as little as possible. It is also important to recognize that there are a great many people who choose to share their diagnosis at work and derive great support from their employer through this experience.

There are also plenty of people who never disclose. This is enormously personal and what is critical for someone going through it is to think about their preferences, gather information on what they need and then make a decision about disclosure.

What advice can you give to a person who is on the fence about returning to work? How do you know when you are ready?

There isn’t a single way to know. Some people work through their whole treatment experience, others can’t or don’t want to. Assessing readiness to return is going to be an individual decision and needs to include conversations with all members of their health care team as well as their employer (if it is to an existing job). It will require thinking about any remaining side effects and their impact on the job and what modifications might be necessary to make it possible to work.