Balancing Cancer and Work

Many patients worry about job security and maintaining their health insurance coverage, and push themselves to work through cancer-related pain and fatigue. Yet balancing cancer treatment and work is possible with a proactive plan, accommodating employers and medical advances that include less toxic treatments and medication to alleviate side effects. Almost half of all patients with cancer receive their diagnosis before age 65; up to 60% will continue to work during treatment. Of those who stop working during treatment, up to 80% might return to the workforce at some point.

How to Make it Work

Cancer stereotypes have changed dramatically, but patients, as well as employers, might still make assumptions about how a diagnosis will or will not affect work. Experts recommend having a plan in place before discussing a cancer diagnosis at work. Patients should:

• Enter into the conversation with supervisors and coworkers with as much knowledge as possible and not be afraid to suggest what would work best for them during treatment.
• Develop a communication strategy with supervisors and coworkers that includes goals, a treatment schedule, possible side effects, delegation of job duties, whether to tell anyone about the diagnosis and whom to tell about any medically related limitations.
• Explore the company’s policy on sick leave, telecommuting and flex time.
• Talk with your medical team about what would make treatment easier, such as whether oral medication is available and how to alleviate side effects.
• Explain to supervisors that the situation could change depending on how treatment goes and how it affects work performance in the long run. Be upfront about what can and cannot be expected.
• Ask to decrease the workload, work from home or take time off from the job because of treatment schedules or side effects, such as fatigue or nausea. Scheduling chemotherapy late in the week can provide a weekend to recover.

Know the Law

The rate of job discrimination against patients with cancer and survivors has decreased, partly because of protections from the Americans with Disabilities Act (ADA) and other antidiscrimination laws that keep survivors from being treated unfairly in the workplace.

Discrimination that does occur is often a result of misconceptions regarding cancer and a patient’s ability to work. Experts recommend that patients experiencing discrimination take legal action only as a last resort. Instead, they should familiarize themselves with their company’s policies and talk with the human resources department about their issues and possible solutions. Often, information from social workers or the medical team and support from coworkers can resolve a situation. If legal action is the only alternative, patients should keep written records of all actions and communications.

Although patients have the right to keep their diagnosis confidential, it is recommended they disclose their cancer history to their employer in case it affects their job performance and they want accommodations under the ADA. Patients who work for companies with at least 15 employees must be reasonably accommodated, which can include a change in job duties or flex time.

The Family and Medical Leave Act (FMLA) also protects jobs at companies with 50 or more employees for up to 12 weeks of unpaid leave and guarantees the continuation of benefits.

Caregivers can also take advantage of the FMLA. To qualify, they must have worked more than 1,250 hours for more than one year and intend to return to the job when their leave is over.