Working During Breast Cancer Treatment

bald women in chemotherapy at her desk at work
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A breast cancer diagnosis can be frightening on many levels, not the least of which is how the disease and treatment will affect your ability to work.

The choice to work is a very personal decision that will be different for everyone. Some people feel tied to their jobs for income or health insurance coverage. Others have greater flexibility in making this choice. Women also experience breast cancer differently. Some are surprised to find that working through breast cancer treatment is easier than they thought, while others, who may have thought they'd continue to work prior to their diagnosis, find it impossible to do so.

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 boss and colleagues.

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 tasks and responsibilities, and how many hours you generally work per week. Be realistic about other commitments you may have away from the job as well. Remember that effects of treatment are cumulative and that 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 boss 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 need, and may include:

  • Time off for physician appointments and to recover from treatment
  • Short breaks during the workday to rest and recover
  • 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 their employer that would cause them "undue hardship." The term "undue hardship" is different for every company. But the majority of these accommodations for individuals with any disability, not just cancer, cost companies very little.

Understanding 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, it's time to share the news that you have breast cancer with your employer. This may be difficult. 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.

Here are some things to keep in mind 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 boss' 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.

Set a positive tone for the conversation

Your boss will take her cues from your behavior. Be honest about your emotions. You don't have to hide your feelings, but try to keep your tears from taking over the conversation.

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.


Be prepared for questions

If your boss asks a question about your diagnosis or treatment and you have no ready answer, it is okay to tell her 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 do 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 suck it up. Prepare a list of ways that you might compromise and still fulfill your obligations. Accommodations you might ask for include:

Telecommuting or 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 routines and even work in your pajamas if you wish.

Sharing your work duties with other employees

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 to pick up some of the slack for you. One of the most common complaints among family members, friends, and fellow employees is the sense of helplessness they feel. By assisting you in completing your tasks, other employees will have a great way to reduce their feeling of helplessness.

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.

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 percent allowed an employee with breast cancer to reduce her hours, 79 percent permitted a flexible schedule, 47 percent made telecommuting an option for the employee, and 62 percent agreed to short breaks during the day for resting and recovering.

Employers said they also made arrangements to alter the employee's workload, including assigning different work (58 percent), altering deadlines or other previously agreed upon schedules (60 percent), and job sharing (28 percent).

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.

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 would 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.

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. You may decide that you were overzealous and that working won't work for you. In contrast, you may have taken off time, but feel bored and anxious to return to your job. 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 flexible and give yourself the benefit of being able to change your mind.

Most importantly, keep the lines of communication open between you and your colleagues. They may turn out to be among your greatest supporters.

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