A cancer diagnosis is many different things all at once: Scary, devastating, painful and so much more.
And yet many people — 73 per cent — with a diagnosis still want to work, according to an American survey of 913 people with cancer by Cancer + Careers.
So why do so many employees still want to put in a full day’s work while battling through what can be a tough diagnosis and treatment?
“It falls into a couple of potential reasons,” said Rebecca Nellis, chief mission officer at Cancer + Careers in New York.
“What’s at the crux of it… is what we do — our work — is at the heart of our identity. So when you’re faced with a crisis like cancer which is putting your mortality in question, to also face an identity crisis is a second stress. And so I think people want to work because it makes them feel normal and it allows them to be productive and it allows them to contribute to the world and have an identity beyond being someone who is sick,” she said.
Many people actually feel a need to keep working, whether financial or emotional, said Jan MacVinnie, manager of the Cancer Information Service at the Canadian Cancer Society in Toronto.
“What people often share with us is it could be a need to keep working — the need could be financial, where they don’t have any kind of disability or any kind of income supplementations in their job, and they’re going to be in a situation where they’re not going to be able to not work,” she said.
“And sometimes that need is more a personal one where a lot of people don’t cope well when they’ve got a lot of time to think, and if they’re at home and they’re not engaged in sort of a normal routine, then it is more stressful for them than to be trying to go to work and keep their mind occupied and be engaged in things that are more normal.”
It can also help cancer patients to maintain a feeling of control, said Sherry Hnatyshyn-Webster, director at CAREpath in Toronto.
“We do actually have some of our patients continue to work throughout their treatment because that just helps them keep some control in their life. And I believe a positive piece for them is that they still do have some control.”
For some people, it’s also about the support system and emotional benefit the workplace can provide, said Nellis.
“Of course, like everything, it’s going to depend on that person’s work environment and experience there. We spend more time at work than anywhere else, so for those people who really feel that connection to their workplace and their colleagues, it is absolutely another source of strength and hope and support and laughter, hopefully.”
Room for creativity
When it comes to accommodating an employee in the workplace during his treatment, it will very much depend on individual circumstances, said Nellis — and there’s plenty of room for creativity.
The practical challenges they may face start with the decision of whether to work through treatment or not, and whether to share their diagnosis at work or not, she said.
“And then, once you’ve sort of gotten through those big huge questions, it becomes a real day-to-day issue related to what kind of treatment side-effects are they experiencing, and how is that having an impact on their ability to do their job? So for each person, that’s going to look a little different depending on what their job requirements are,” she said.
“Are you someone who stands all day long, or has to lift heavy boxes, or sits at a desk all day long or interacts with the public? And then, conversely, are your treatment side-effects impacting your ability to lift heavy things because you’ve just had surgery or you’re struggling with concentration but your job is really detail-oriented?
“Are you experiencing neuropathy in your fingers so typing is now difficult? And then what can you do to offset those things?”
A flexible work schedule is another key piece that can really help, said Hnatyshyn-Webster.
“Definitely a flexible work schedule; the ability to work from home would always be an asset as well.”
Having that flexibility can help mitigate the effects of fatigue, said MacVinnie.
“One (common thing) when people are going through treatments is fatigue, so it might be about how to manage that fatigue. It might be a reduced work day, for example, to help them get through — they’d have a bit more time to rest, a bit more time to sleep,” she said. “Oftentimes, going through treatments, a person’s immunity is compromised, so they’re somewhat more prone to catch things.
“So if there’s the possibility of working from home for a period so that they’re not in contact with others, particularly during seasons where there’s a lot of flus and colds and people are very contagious, that might be very helpful if they can do some telework.”
There can be a range of solutions, just as there is a range of patient experiences, said Nellis.
“The way employers can be the most useful in helping someone work through treatment or come to work in the early stages of recovery is to think creatively with them about ways to mitigate those challenges. What can we all do to improve someone’s ability to continue to work?” she said.
“Is it having the person who typically changes the water cooler but can’t because they can’t lift it for a period of time, have someone else do that? Is it having them start work a little later so they miss the throes of the commute, because that makes their day longer and they’re very fatigued?
“So it’s about coming up with those unique accommodations to the circumstances — but practical solutions to the problems.”
Nothing set in stone
One of the most critical things to understand is that carefully laid plans notwithstanding, things may change — and, as an employer, it’s about being flexible, said MacVinnie.
“If people are going to be going through the traditional types of cancer therapy, they will go on for a period of time. It could be quite intense — a daily treatment, for example, if they’re having radiation therapy over a month or six weeks; if they’re having chemotherapy, it could be every other week over six months. So they’ll have an intense period where it’s hard to anticipate what kind of side effects they’ll have from their treatment, so it’s hard to know how they will feel,” she said.
“There’s a plan A — ‘Here’s what we’re going to try to do assuming that things go more or less as we anticipate’ — (but then) maybe try to explore with the person, what if? ‘What if you feel really unwell and you can’t work?’”
The more sensitive an employer can be to that and the more willing it is to work with the employee, the more successful the outcomes are for everyone, said Nellis.
“We talk to a lot to patients and survivors and employers and health-care professionals about how important it is that everyone goes into these conversations recognizing that it’s a fluid process. Because what someone’s experiencing one day one isn’t necessarily going to be the same thing they’re experiencing on day 45.”
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