Working During Breast Cancer Treatment

bald women in chemotherapy at her desk at work
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The choice to work during breast cancer treatment is a very personal decision that is different for everyone. You may feel tied to your job for income or health insurance coverage, or you may have greater flexibility in making this choice. You may also find that working is a welcome distraction during a tough time, or instead feel that you need to dedicate yourself completely to getting better.

Your wishes may not always line up with what you're able to do. Everyone's treatment experience is different, and some are surprised to find that working through breast cancer treatment is easier or harder than they thought.

Before divulging your diagnosis, take the time to research your company's policies on medical leave and flex time, and give some thought to how you want to present the information to your coworkers—whether you hope to work through treatment, take a leave, or resign.

Know What's Involved in Your Treatment Plan

Before you approach your boss or colleagues, talk to your doctor so you understand the details of your treatment plan, including how long it will take you to recover from surgery, how long you will receive follow-up treatments such as radiation or chemotherapy, and the types of side effects you are likely to experience.

Explain the kind of work you do to your doctor, including your responsibilities, work environment, and how many hours you generally put in each week. Be realistic about other commitments you may have away from the job as well. Remember that effects of treatment are cumulative and, as you near the end of treatment, you may need a block of unbroken time in which to recover.

Get Up to Speed on the ADA

Be sure you know your employer's sick leave policy and your workplace rights before you tell your manager about your diagnosis.

The Americans With Disabilities Act (ADA) protects individuals from losing their jobs due to disability and sets guidelines for employers regarding required accommodations. The U.S. Equal Employment Opportunity Commission (EEOC) enforces the ADA.

Employers are required by federal law to provide "reasonable accommodations" for anyone with a disability. Cancer qualifies as a disability when the disease or its effects on treatment hinder an individual's "major life activities."

These accommodations can vary greatly, depending on a person's needs, and may include:

  • Time off for physician appointments and to recover from treatment
  • Short breaks during the workday
  • An altered work schedule
  • Temporarily assigning some job tasks to another employee
  • Changes to the workplace environment, such as temperature changes or workstation changes to ensure comfort

According to the EEOC, the word "reasonable" is key. Employees with breast cancer can't make requests of employers that would cause them "undue hardship." How they define that varies widely, but the majority of these accommodations for individuals with any disability cost companies very little.

Understand the FMLA

The Family Medical Leave Act (FMLA) also protects the jobs of people with a cancer diagnosis. However, not everyone qualifies for FMLA protection. An employee must have worked for the employer for at least 12 months prior to the FMLA request and have worked more than 1,250 hours in that calendar year. In addition, employers who have fewer than 50 employees do not have to follow FMLA regulations.

If protected by the FMLA, you can to take up to 12 weeks of unpaid leave from work. The act allows employees with serious medical illness, such as breast cancer, to use their leave "intermittently." This means an employee could take off one day each week or take two weeks off to recover from surgery while saving the remaining weeks to use during radiation or chemotherapy treatments.

If you feel your rights have been violated or you've been dismissed from a job due to your diagnosis, you need to file a charge "within 180 days of the alleged discriminatory action," according to the EEOC. The EEOC can be reached at (800) 669-4000.

Telling Your Boss and Colleagues

Once you've got your ducks in a row, the next step is to think about how much, if anything, you want to reveal to your employer. Deciding whether to share the news is an intensely personal decision and you are not obligated to tell anyone. You may not know how your boss will react or how supportive they'll be. Perhaps you're afraid it will change the way you are treated on the job. Your company's culture, size, and your relationship with your co-workers are all things to consider as you make your decision.

Be aware, however, that if you choose not to reveal your illness, you may not be eligible for accommodations. Also, depending on the nature of your treatment and symptoms, sharing your diagnosis may become inevitable.

If you do choose to tell your supervisor and colleagues, here are some ways to make it as stress-free as possible for all concerned:

Consider Setting Up a Meeting

Arrange a meeting or a lunch date in advance, so you can be sure to have your manager's full attention. Also, remember that discussions between a boss and employee are protected. A supervisor has a legal obligation to keep the information private. However, co-workers do not have the same obligation. Ask that your private conversations with your boss be kept confidential.

Be Aware of Your Emotions

Your boss will take their cues from your behavior. You don't have to hide your feelings, but trying your best to keep tears or an otherwise emotional reaction from taking over the conversation can help it go more smoothly.

Be Prepared for Questions

If your boss asks a question about your diagnosis or treatment and you don't have an answer ready, it is OK to say you don't know yet, but you will find out and let her know.

If you are uncertain and want professional advice about how to talk to your boss, an oncology social worker, counselor, or patient advocate can offer guidance.

Asking for Accommodations

If you choose to work, it's helpful to share the load with others. This is a time in which you do not need to be the "strong one" or to show off your courage and "make it happen." Prepare a list of ways that you might compromise and still fulfill your obligations. Accommodations you might ask for include:

Working From Home

Even if you work from home only one or two days a week, telecommuting can reduce your travel time to and from work, giving you more time to rest. Plus, when you work at home, you can skip some of your normal workday routines (and even work in your pajamas, if you wish).

Sharing Your Duties

It's said that dealing with cancer takes a village, and sometimes that includes a village to help you complete your duties at work. Some people hesitate to ask others to help, fearing that people will be offended. In actuality, fellow employees may welcome the opportunity.

One of the most common complaints among family members, friends, and fellow employees is the sense of helplessness they feel when someone they know is going through treatment. They may want to do something for you, but don't know what would be useful. Assisting you in completing your tasks is a great solution.

Of course, discuss your ideas about this with your manager first. They will likely want to weigh in and may want to be the one to speak with your colleagues about this. If and when the sharing of your duties is set up, it never hurts to remind others of your gratitude as well.

Flextime 

Fatigue gradually worsens during breast cancer treatment and often becomes limited during chemotherapy and radiation therapy. Sometimes simply starting work a few hours later or shortening your work days can make a big difference.

Your flex schedule could be set. Or you and your manager could come to an agreement that you can flex your hours as long as you complete all the hours you are committed to by week's end. It's worth having that conversation.

How Common Are Accommodations?

The International Foundation of Employee Benefit Plans' survey, which focused on women working with breast cancer, found that employers were typically more than willing to provide accommodations.

With regard to scheduling, the survey reported that:

  • About 85% allowed an employee with breast cancer to reduce their hours.
  • 79% permitted a flexible schedule.
  • 47% made telecommuting an option for the employee.
  • 62% agreed to short breaks during the day for resting and recovering.

In terms of adjusting responsibilities, employers also said they also made arrangements to alter the employee's workload, including:

  • Assigning different work (58%)
  • Altering deadlines or other previously agreed upon schedules (60%)
  • Allowing for job sharing (28%)

The organization Cancer and Careers has a multitude of resources and can provide expert advice to help people thrive in the workplace during cancer treatment.

Getting It in Writing

Keep a paper trail of all documents relating to your sick leave, medical certification, and company policies, and be sure to save copies of any emails or notes that you took along the way. This will help you avoid any misunderstandings down the line.

If some accommodations were only discussed verbally, consider typing up your understanding of the arrangements and providing a copy to your manager to review and sign. You may also want to present a copy of the document to human resources.

Taking a Break From Work

Sometimes the side effects of treatment or cancer itself will get the best of your energy and health. If that happens, you may decide not to work through treatment.

Speak with your doctor about how you're feeling and ask if you qualify for disability. Talk with your supervisor and the human resources department about taking a leave or getting short-term disability insurance to tide you over for a while.

If you decide to quit work for now, look into Social Security Disability Insurance so you will still be covered for medical expenses, or ask if you can keep your employer's insurance benefits through the COBRA program.

Many of us find social support among those we work with, and what promised to be a time of peace away from the grind may instead feel lonely. Be aware of this and proactively take steps to engage yourself socially in other ways.

A Word From Verywell

Breast cancer treatment is challenging, and your most important job is to take care of yourself, in whatever way needed, throughout your treatment. No one can predict exactly how you will feel during treatment, and you may want to rethink your decision at times. Given the impact of treatment and the importance of your job, this is to be expected. Do your homework and take things one day at a time.

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