Working During Cancer Treatment

Deciding if you can work during cancer treatment

During cancer treatment, some people are able to keep working their usual full-time or part-time schedule. Some may be able to work the same schedule under special conditions (accommodations), like being closer to the office bathroom so it’s easier to deal with side effects.  Others need a less demanding schedule, like taking extra days off or even working fewer hours for a while.

Whether or not you can work during cancer treatment can depend on:

• The stage of your cancer and type of treatment you are getting
• Your overall health and the kind of work you do
• Your cancer treatment and work schedule

Talk with your cancer care team if you plan to work during treatment. They can give you information about your specific treatment plan and possible side effects that might affect your ability to work. Some types of cancer treatments may cause specific side effects that you must watch for and know how to manage because they also can affect people around you.

Managing cancer treatment side effects while working

Working during chemo: Some chemo treatments require you to take special precautions when using the toilet to decrease toxic waste exposure from the chemo drugs.

Working during radiation therapy: If you’re getting radiation treatment, your side effects may depend on the area of your body being treated. Be sure to follow safety measures to protect yourself and others at work.

Working during other treatments: If you’re getting other cancer treatments like targeted therapy, immunotherapy, or hormone therapy, these treatments have some of the same safety precautions as chemotherapy and may change how you work.

Ask your cancer care team how you can manage their side effects at work or about any safety precautions you need to follow.

Tips for working while you are getting treatment

It’s important to plan how you will continue to work while you are being treated for cancer. These tips might help you better manage your time and work. If  you need time to recover (like rest or take a nap) after your treatment, try to plan your treatments around your needs. For example, late in the day or right before the weekend to allow time to recover.

• Explore options like working from home some days. This might help you feel less tired and allow you to easily take care of yourself if you have problems.
• Getting help at home can mean more energy for work. Ask friends and family members to divide up responsibility for certain daily chores.
• Keep your supervisor, and if you need to, your coworkers up to date on how well your schedule or other changes are working for you. Also, if you need help at work.

• Make a detailed list of job duties so you can direct others in handling things when you’re out of the office.
• If your coworkers help with some of your duties while you’re absent,   thank them for their help and support.
• Don’t be afraid to ask for help if you need it. This ensures you are taking the best care of yourself and may show your supervisors and coworkers that you’re interested in the best outcome of your job duties.

Telling your supervisor

Your success at working during treatment depends also on your workplace’s willingness and ability to accommodate special needs you might have. If you do decide to talk about your cancer, meet with your supervisor and explain your desire to continue to work while you are getting treatment.

Be honest about your treatment and the hours away from work it may require. But remember, your situation and treatment schedule might change, and you can only make an estimate at this time. Work together to set realistic goals. Keep in mind that what you tell your boss is confidential information. It will not be shared unless you say it is okay to do so.

 Under federal and state laws, some employers may be required to let you work a flexible schedule to meet your treatment needs. You can find out more from your state’s Department of Labor office.  Also see Americans With Disabilities Act: Information for People with Cancer and the Family and Medical Leave Act. Or, you can call us to learn more: 1-800-227-2345.

Telling your coworkers

Before telling your coworkers about your cancer, you might want to talk to your cancer care team about how your illness and treatment plan may affect your job/career. Learn as much as you can from your cancer care team about possible side effects and how you can manage them at work.  

Talking with your coworkers about your cancer and cancer treatment is a personal choice. You decide what and how much you want to share with them. It’s okay if you don’t want to discuss your situation with others.

You may find that your coworkers react differently when you talk about your cancer at work. People might be:

• Understanding and offer to help
• Reminded of a loved one’s time with cancer
• Uncomfortable and not know how to respond to you
• Uncomfortable and avoid you
• Frustrated if they have or had to take on extra duties because you need to be off
• Curious and ask unwanted questions

It can be helpful to think ahead about how you will handle other people’s reactions and what you want to share with them. It might help you to read Telling Others About Your Cancer.

Legal protection for working people with cancer  

You have the same rights as anyone else in the workplace and should be given equal opportunities, whether or not you tell people at work about your cancer. Hiring, promotion, and how you are treated in the workplace should depend entirely on your skills and abilities. As long as you are able to fulfill your job duties, you can’t legally be fired for being sick.

You also shouldn’t have to accept a position you never would have considered before your illness. Federal laws like the Rehabilitation Act and the Americans with Disabilities Act (ADA) protect people with cancer who have job-related problems. Some people also benefit from the Family and Medical Leave Act (FMLA). This law allows many people with serious illnesses to take reasonable unpaid leave to get medical care or manage their symptoms.

Talk to someone in your Human Resources (HR) department or another workplace expert to find out what your options are.

What is a reasonable work accommodation?

Employers are not required to lower standards or provide personal-use items like glasses or hearing aids. But they must make reasonable accommodations for qualified employees or applicants with a disability, unless doing so would be a hardship for the employer.

Examples of reasonable accommodation for people with cancer might include:

• Providing or modifying equipment or devices
• Restructuring a job
• Adjusting office temperature
• Offering part-time or modified work schedules, like permission to work from home if possible
• Offering reasonable breaks to rest or take medications
• Reassigning an employee to a different position or task if they can no longer do their job
• Adjusting or modifying tests, training materials, or policies
• Providing readers and/or interpreters
• Making the workplace readily accessible to and usable by people with disabilities

A vocational rehabilitation (rehab) counselor can help with some of your job-related legal questions. But you may also want to look into laws that affect you and how you deal with any problems that may come up.

Some cancer treatment centers offer referrals to vocational rehab counselors, so ask your cancer care team. They may also have tools or people that can help you.

To find out more about job accommodations and employment of people with limitations, contact the Job Accommodation Network at 1-800-526-7234. They can talk with you about the requirements of the ADA or the Rehabilitation Act, if either one applies to you.

Workplace discrimination against people with cancer

Even though the public understanding of cancer is getting better, you may still face workplace bias and discrimination. Talk with an HR representative about any issues you might be facing. If your workplace has a union, it also can be a good source of information.

If you believe you have been discriminated against, learn as much as possible about how your company has handled grievance issues in the past. It might help you avoid a stressful situation that could be draining both financially and physically.

Keep records of your contacts with office personnel, including:

• Names of people you spoke with
• Date and place you spoke
• Information you received
• Next steps to be taken

It’s also a good idea to keep records of your job performance reviews and any other written information about your work. These can be helpful if problems come up later.

If you want to file a discrimination complaint

If you think you have been discriminated against at work based on disability, you can file a complaint with the United States Equal Employment Opportunity Commission (EEOC). You must do this within 180 days of when you think the discrimination occurred, although some state or local laws may extend up to 300 days. For more specific information about ADA requirements affecting employment, contact the EEOC at 1-800-669-4000 or 1-800-669-6820 (TTY).

Disability insurance for people with cancer

Sometimes despite planning and extra time off, you might find that it's still too much to keep working while you are getting cancer treatment. If you can't keep up with the demands of your job , talk to your supervisor. Explain that you want to keep working, but you need to take some time away from work.

Talk to someone from your HR department to find out if you qualify for short-term or long-term disability insurance benefits at your job and how you can apply for them.

In general, short-term disability pays you some portion of your income for the first few weeks to months you are unable to work. If you are out longer, some employers also carry long-term disability insurance, which usually starts after a few months of disability. Employers and insurance companies have different definitions of short-term and long-term disability. You must meet the insurance company’s definition to get this income. If your employer benefits don't include disability insurance, ask about Supplemental Security Income or Social Security Disability Insurance. 

Talk with your cancer care team if your treatment and symptoms are affecting your work to decide whether or when you should think about taking time off. Your cancer care team can help you fill out part of the disability application.

It might be a disadvantage to put off going on short-term disability. Some people have had to make a lot of effort to prove that they can’t do their job after they’ve spent weeks forcing themselves to go to work. Don’t wait until your work performance suffers before you decide to take time away from work.