Financial hardship, job loss common for women diagnosed with breast cancer: Study
When Elsa Torrejon, a leasing agent at Weston Property Management in Toronto, told her supervisors she had breast cancer in January 2009 and would need time off for treatment, she was fired.
Torrejon’s story isn’t unique. Of 361 working women recently diagnosed with breast cancer, 16 per cent were terminated while undergoing treatment, according to a survey conducted by the Canadian Breast Cancer Network.
The worry and stress of a stage-two breast cancer diagnosis, combined with the loss of income, left Torrejon, a 50-year-old single mother of two, depressed and anxious.
“It still hurts to talk about it,” said Torrejon. “I couldn’t believe it. I thought they were going to support me.”
And when she first spoke with Doug and Geri McDonald, her managers at Weston Property Management, on Jan. 30, 2009, that was the impression she got. She told them of her diagnosis, her surgery scheduled for Feb. 13, 2009, and her doctor’s recommendation she take an immediate and indefinite leave of absence. She told the McDonalds she would continue working until the day before her surgery.
It was only one week later, after Torrejon changed her mind about having a mastectomy on Feb. 13 and told her managers she would keep working past Feb. 12, she found out she no longer had a job.
She said Doug McDonald told her the letter she had written, confirming her last day of work before her surgery on Feb. 12, was in fact a resignation that couldn’t be withdrawn.
“I never said ‘quit’ or ‘resign’ or anything,” said Torrejon.
Torrejon called the Ministry of Labour and was referred to the Human Rights Legal Support Centre, which helped her prepare a letter denying she had resigned and stating the discussion on Jan. 30 and the letter on Feb. 2 concerned a request for sick leave.
When she went into work on Feb. 13, Geri McDonald handed her an envelope with her last paycheque, a T4 and record of employment, and told her she was no longer allowed on the premises.
Torrejon filed a human rights complaint and on April 29, 2010, the Human Rights Tribunal of Ontario ruled Weston Property Management had discriminated against her on the basis of disability. The tribunal awarded Torrejon about $22,600 in lost wages and general damages and ordered the McDonalds to complete human rights code training.
“I want other women, or men, who go through this to have the strength or the guts to fight. It’s not right when they behave like this,” she said.
Even when women aren’t fired after a breast cancer diagnosis, the majority of them suffer financial difficulties, according to the Canadian Breast Cancer Network’s survey of 446 women, all recently diagnosed with breast cancer.
Eighty per cent of respondents had financial difficulties during their treatment, often with long-term consequences for themselves and their families, found Breast Cancer: Economic Impact and Labour Force Re-Entry.
On average, the patients’ households saw a 10-per-cent ($12,000) drop in annual income, with 44 per cent of respondents depleting their savings and retirement funds and 27 per cent taking on debt to cover treatment costs, found the survey.
Torrejon relied on her savings as well as sick and disability benefits from EI while unemployed and undergoing treatment. She also had to support her two teenaged children.
Her social worker at Toronto’s Princess Margaret Hospital also helped her find and apply for financial assistance through organizations that support people with cancer diagnoses.
“They helped me two or three times to pay my rent,” said Torrejon.
The Canadian Breast Cancer Network wants all levels of government, employers and HR departments to form a task force to look at the economic impact of chronic illness.
“We don’t need people going into debt as a secondary effect of a health crisis like this,” said Sharon Young, a Canadian Breast Cancer Network board member in Brandon, Man.
Of the 361 women who were employed at the time of their diagnosis, 17 per cent were unable to return to their previous job with the same title and salary and one-fifth had to quit their job due to the effects of treatment, often because of work-related restrictions, side effects of treatment and fatigue or pain, found the survey.
Also, one in five said they had to return to work before they were physically able due to financial pressure. Part of this is because employment insurance benefits only cover 15 weeks of treatment even though the average treatment length for respondents was 38 weeks.
Costs for a woman diagnosed with breast cancer include medications not covered by provincial health plans, childcare while receiving treatment, household maintenance, dietary changes to complement treatment and travel and accommodation for treatment, said Sandra Krueckle, manager of information and support at the British Columbia and Yukon Division of the Canadian Cancer Society.
“That can really add up for an employee who is sick,” she said. “If an employee has to take unpaid leave, they face increased financial hardship.”
Young, who was diagnosed with breast cancer 14 years ago, was one of the lucky ones. Her employer provided sick leave and income replacement.
“I was really fortunate that I had that to fall back on,” she said.
But it’s not just the women who suffer when they are fired or quit during treatment, said Young. Organizations also lose all the experience and institutional knowledge possessed by these workers, she said.
Even though Young’s employer provided good sick-leave benefits, there was little flexibility around returning to work.
“When I returned to work, it wasn’t even thought of to come back part time. It was all or nothing,” she said.
But that has changed. Her employer now stays in touch with employees who are off on leave to stay on top of medical changes or accommodation that might be needed to help them return to work, said Young. The survey found this kind of support can make a big difference in the success of an employee’s re-integration into the workplace, she said.
Respondents who were able to make a gradual return to work were more likely to report a positive experience while those who didn’t reported distress, pain, fatigue and, in some cases, having to leave their jobs.
CIBC, which sponsors breast cancer research through the Canadian Breast Cancer Foundation CIBC Run for the Cure, also has a return-to-work program for employees who take sick leave.
The program, implemented in 1999, keeps employees connected to the workplace while they are recovering from their illness, said Lynne Gutteridge, senior director of global benefits policy at CIBC.
Through facilitated meetings, the employee and manager work together to develop a return-to-work plan that considers abilities and limitations as the employee moves through the recovery process and what flexibility and accommodations will be needed.
Torrejon underwent six rounds of chemotherapy starting March 18, 2009, before having a mastectomy and lumpectomy in September 2009. The surgery was followed with five weeks of radiation treatment.
She is currently waiting for the results of a mammogram in July to see if her doctor will give her the all-clear to return to work.
“That’s what I want now, to have a job. Even if it’s part time, and then increase the hours, whatever the doctor says,” she said. “I want to feel useful again.”