Navigating work when you’re going through cancer treatment

Decisions about work during cancer treatment can be tied to big emotions and financial concerns. And everything from your treatment plan to how stressed you are at your job can make a difference as you weigh the options.

Not everyone is able to or wants to keep working. And if you do, you might decide to stop later. Whatever you choose, your work life will be different. And some preparation — mental and logistical — can help you find what’s right for you.

Making a plan

You might need to take extra days off, work from home some days or even go from full time to part time. Working with your employer to make a plan can go smoothly for some but can be difficult for others. You may have to ask for what you need more than once. Remember that the things that will make your life easier are worth fighting for.

Know your rights. Get to know the federal and state laws that affect you. It’ll give you an idea of what you can ask for. Workplace protections depend on your employer, your state, your hours per week and more. A social worker who knows the law is a good starting resource. Ask your care team to connect you.

Prep for a meeting. Once you’ve set up a meeting with your human resources rep and/or your supervisor, it’s a good idea to prepare. What do you want to share vs. keep private? What accommodations do you want to be sure to ask for? You may also want to share your treatment schedule with your employer so they’re aware of what you’ll be dealing with in the coming weeks or months.

Get it in writing. Even if you have a good relationship with your employer, documentation is important. You’ll want a record of what you requested and whether you got it. You can follow up meetings with emails that confirm what happened.

Remember, your needs might change over time. Listen to your body and your care team. And be open to changing the plan.

Telling your co-workers

Opening up about a cancer diagnosis at work can make you feel vulnerable. You might worry about intrusive questions, insensitive comments or being treated differently by co-workers. You can decide how much you want to share — and that could change from day to day.

You’re entitled to privacy, even from people who mean well. That means you might need to set some new boundaries about what you talk about at work. And the truth is that you’ll probably encounter colleagues who say the wrong thing. Most people fumble when talking about difficult topics. They may not have experience with serious illness or simply don’t know what to say.

Hearing comments like, “everything happens for a reason,” or “look at the bright side,” can feel dismissive and not true – even if the person saying them means well.

How do you respond? If it feels right to you, you can first acknowledge that the person is trying to be helpful. Then, say what you actually need. Here are some examples:

• “I know you’re worried about me, but I want to focus on something else. Can we talk about this work project?”
• “I can see how those words might be comforting for some people. But I’m OK with focusing on the reality of my situation.”
• “Thanks, but I’m tired of talking about cancer today. What’s new with you?”

While these are suggestions, keep in mind that there’s no perfect solution that works all the time.  Some days you may find you have more energy to talk. You may find one person’s advice comforting, while another person’s questions annoy you. You can be direct and honest about what you need.

Accepting help

Between taking time away from work or feeling distracted, you might need to ask for help from coworkers. You might find that people are eager to help, so ask your coworkers to catch you up on what you missed or ask them to send you an email recapping a meeting.

Try to be honest about your needs. If a coworker offers to take an assignment for you, you can say yes or no. If it’s a project you love working on, don’t be afraid to say no and counter with something that will help you more. Being clear about what you need from people at work can help you protect your time and energy — and let them show they care.

Being adaptable

Brain fog? Fatigue? Nausea? You can’t know your body’s response until you go through treatment. And it might change over time. Taking care of yourself is different for each person.

Here are some ideas from people who have been through it:

• Schedule appointments for the end of the day or over a weekend. Chemo, radiation and other treatments can leave you exhausted. Ask your healthcare team about leaving time to recover before Monday rolls around.
• Listen to your body. If your symptoms are starting to affect your work, think about taking time off. It can be hard to accept a new normal. But forcing yourself to keep working through extreme pain or exhaustion can deprive your body of the rest it needs to heal. And it could affect your disability benefits down the road.
• Get the help you need. Mental health counseling can be an immense help during cancer treatment, especially when work issues arise. A therapist can help you work through issues with co-workers, supervisors and the changes in your body that affect your work.
• Learn from other working cancer survivors. In-person and online support groups can connect you. Being the only sick person at work can feel lonely. Try talking to someone who gets it — and who may even have advice.

What happens to health insurance if you can’t work?

A common fear is that you’ll lose health insurance coverage if you can’t work due to your health condition. But rest assured that you cannot lose your health insurance because you have a health condition. Health insurance plans can’t refuse to pay for your care, decline you coverage or drop your coverage because of a diagnosis. This rule applies to plans from employers, the Affordable Care Act, and government programs like Medicaid or Medicare.

If you have insurance through an employer and need to leave your job, you might be able to stay on your health plan. A federal act called COBRA requires employers to extend benefits to former employees and their family members temporarily. You may have to pay the monthly premium yourself. An insurance broker or your company’s human resources can help.

Ask your health care team for a referral to a social worker to help navigate insurance questions and support services.

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