Working during cancer treatment

From knowing your rights to getting through the day, here’s your guide to managing cancer while you’re on the job.

There’s a lot to think about when you’re diagnosed with cancer. You may have quite a few medical appointments on your calendar in the weeks and months ahead as you start treatment. One thing that’s probably top of mind: What will happen at your job, and how will you tell your boss?

You may plan to keep working as you undergo treatment. “Continuing to work can give you a sense of normalcy,” says licensed social worker Kathryn Gurland. She’s the founder and director of PEG’s Group, which helps those with cancer in the New York City area.

In fact, nearly half of all people diagnosed with cancer are in the middle of their working years, reports a recent study in the Journal of Clinical Oncology. But between treatments and side effects, working with cancer can be a challenge. For one thing, you may not be feeling your best. And you might need to take off time for treatments.

Before it gets overwhelming, have a conversation with your boss or human resources manager. Here are some steps that can help you handle treatments while on the job.

Step 1: Talk to your care team

Let them know what your job involves and which duties have you worried. Working in retail, for example, may be more challenging than sitting at a computer. Discuss ways your illness and treatment plan may affect your job, says the American Cancer Society (ACS). Find out what to expect. Then come up with a strategy.

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Step 2: Know your rights

Thanks to laws like the Americans with Disabilities Act and the Family and Medical Leave Act (FMLA), you have legal protections when you have cancer. “If you don’t know your rights, then you’re in a lone war trying to ask for things that HR can say ‘No’ to,” Gurland says. So be prepared. Here are some basics:

You can’t be fired because you’re sick, as long as you can still do your job. And you don’t have to accept a position you wouldn’t have considered before you got cancer.
Your employer must offer you “reasonable accommodation” to help you continue working. For example, they might offer breaks to take your medication or let you work from home. Find out if you qualify for disability insurance benefits. Usually, short-term disability pays part of your income for a few weeks or months when you can’t work. And if you need to be out longer, you may have long-term disability insurance.
You might qualify for Supplemental Security Income or Social Security Disability Insurance from the federal government.
If your illness keeps you from doing your job, you might be covered by FMLA, which provides certain workers with unpaid leave to get medical care or manage symptoms. To learn more, check out the Job Accommodation Network.

Step 3: Be open with your boss

Set up time to let your boss know your situation. And know that the conversation will be confidential, says the ACS. So don’t be afraid to be honest. Outline the hours away from work your treatment might require. This way, your workplace can adjust your schedule. They may divide some of your workload among your teammates.

Things may change as your treatment progresses. Side effects may get worse (or better). Or you may decide you don’t want to work after all. “It’s okay to change your mind,” Gurland says. Just keep your supervisor (and your HR department) in the loop.

Step 4: Communicate with co-workers

Would you rather not talk about it? That’s up to you. But even if you want to keep your private life separate, Gurland encourages people to tell at least one co-worker. “Have someone on the job who knows your situation and that you can trust,” she says. This person can be your ally when you need someone to talk to.

If you tell your co-workers, be prepared for their reactions. Some may be totally supportive. Some may be sad or upset. Think about what information you want to share with co-workers. (And don’t forget about clients or customers you’re often in touch with, or co-workers in other departments.) Depending on your relationships, you may decide to give more information to certain people.

Step 5: Be ready for reactions

Plan ways to handle your co-workers’ reactions and questions. For example, how will you respond when someone asks what kind of treatment you’ll be getting? One handy answer: “I’ve got a great treatment plan in place. Thanks for asking.” Or you can say: “I get tired of talking about cancer. Let’s talk about something else.” Practice your response and have it ready to use whenever you need it.

Step 6: Manage side effects

Cancer treatments often come with unwanted side effects. Pain, fatigue, nausea, and vomiting can make it difficult to work. They can also affect your skin, hair, and nails. But there are ways to manage side effects at work. Here are some ideas:

Nausea and vomiting. This is a common side effect of many treatments. Some at-work coping strategies:

Move to a work station closer the bathroom.
Drink water or sip sports drinks or ginger ale during the day to avoid dehydration, recommends the National Cancer Institute (NCI).
Avoid greasy, fried, or spicy foods.
Pack some healthy snacks for work instead of eating a big meal.

And talk to your doctor about medication or alternative therapies that can help ease nausea.

Fatigue. Cancer treatments take a lot out of you. So it’s no wonder you may feel tired at work. Exercise helps, says the NCI. Even a short walk around the parking lot or the hallways of your office can boost your energy (and mood). If you can work from home, try to make time for a short nap during the day.

Hair loss. Some treatments can make your hair fall out. Women might consider wearing a wig or a hat with a hairpiece attached. It can give you sense of normalcy at work. Most health insurance plans cover the cost of wigs for cancer patients, according to Cancer and Careers. A baseball hat is always a good option too, for men or women.

Chemo brain. It’s a real thing that can get in your way at work. You may notice your thinking, memory, and concentration take a nosedive. Write down your priorities and check them off. Try a mental run-through of each task, like presentations or phone calls. If you can, go outside. Sunshine and fresh air can boost your focus.

Step 7: Mind your mental health

Going through treatments and working can be stressful. Not only do you have to deal with a medical diagnosis, but you have to handle job-related challenges. “You absolutely need the extra emotional and psychological support to inhabit the work and cancer worlds at the same time,” Gurland says.

Ask your nurse about seeing a mental health provider, like a clinical social worker or psychologist. And learn about behavioral health care through your insurance plan. Join a support group. Talk to your team about local groups or find in-person or online meetings through CancerCare.