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Cancer in the workplace – Telling your story

A recent Lancet Medical Journal finding that South Africa can expect to see a 78 % increase in cancer cases by 2030 means that it is likely that cancer will affect most companies at some point in time. A cancer diagnosis can affect productivity, morale, and a company’s bottom line. Knowing how to navigate work-related issues of cancer such as informing your employer and/or colleagues, sick leave and benefit pay-outs is important.

As cancer diagnosis rates rise and cure rates improve, the number of cancer survivors in the workplace is also increasing. 3 Cancer can have significant impacts on productivity, morale, and finances for both individuals and companies. 2 Therefore it is crucial for both parties to understand how to manage this journey effectively.

Why is it important to inform your work of your diagnosis?

If your diagnosis and treatment is not going to impact your work attendance nor productivity, then there is no need to inform your employer, unless you want their moral support. However, if your diagnosis and treatment is going to result in lengthy periods of absence and/or decreased work performance, then you need to inform your employer so that they can arrange to cover your absences and decreased productivity.

When should you tell them?

According to Dr Jenny Sapire, the Clinical Standards Manager for Life Healthcare, the earlier you tell your employer, the better, for planning purposes. However, she recommends that you wait until you have a clearer idea of your treatment plan, time needed off work, possible side effects and your ability to return to work, before starting the conversation.

Who should you tell?

Initially, you may want to limit the conversation to your line manager and/or Human Resources (HR) manager. Establish your privacy boundaries during this initial meeting by stating who they may convey this information to. Be aware that other parties that may need to know about your diagnosis soon, include:

  • Colleagues who will be affected by your absenteeism, especially those that will be taking over your workload
  • Other line managers that may be impacted
  • Insurers e.g. Company group risk benefit representative (the earlier you apply for benefits, the better)
  • Employee wellness programme representative – referral for psychological support

How and what should you tell them?

Dr Sapire recommends a face-to-face conversation, if possible, rather than a telephone call, email, or Microsoft Teams meeting. Request a one-on-one meeting in a private setting at a time, when neither of you are stressed or busy. She says it is a good idea to have a doctor’s letter with you, stating your diagnosis, proposed treatment plan, and predicted recovery time/sick leave required.

Give your employer as much as information as you are comfortable with, bearing in mind that the more information the company has, the better able they are to plan for your absenteeism and decreased productivity.

Returning to work

Studies have shown that, on average, about two-thirds of cancer survivors return to work. 4 Returning to work can promote a sense of normalcy, self-worth, and control during an emotionally challenging time. 5,6 Employment also provides important financial benefits in terms of both health care benefits and income. 5 Studies have even shown that returning to work improves the prognosis and survival of cancer patients. 3

A return to work depends on many different factors:

  • Type of cancer – studies have shown that genital, skin and breast cancer have higher return to work rates than liver, lung, brain, blood or gut cancer 3
  • Staging of the cancer – a patient with a lower stage of cancer (e.g. stage 1) has a higher chance of returning to work than a patient with stage 4 cancer 3
  • Age of the patient – an older patient, close to retirement age, is less likely to return to work 3
  • Type of cancer treatment and its side effects – chemotherapy is associated with longer periods of sick leave, a delayed return to work and a greater probability of not returning to work. 7 See below example provided by a study:

Missed days of work in a woman with breast cancer treated with: 7

Surgery + radiation + chemotherapy

Surgery

Surgery + radiation

Surgery + chemotherapy

68,6 days

26,5 days

19 days

61,6 days

 

  • Job requirements – a physically taxing job may not be possible for someone who is going through chemotherapy and suffering from fatigue and weakness

 

How to manage returning to work

Fatigue after cancer treatment is often unpredictable and uncontrollable and can take time to recover from. 8 Other late effects of cancer, such as cognitive problems (concentration, learning, memory), physical problems (pain, weakness) and psychological problems (fear, anxiety, depression) may affect one’s work ability. 3,6,8 Colleagues often do not realise that late effects of cancer treatment can appear quite suddenly after many years and therefor may be less supportive and understanding as time passes. 8

Because of these long-lasting effects of cancer and its treatments, Dr Sapire recommends a phased return to work - starting with a few hours a day and slowly building up to a full workday. This requires forward planning to accommodate both parties.  Examples of how employers may need to accommodate the returning employee include:

  • Initial shorter workdays, increasing to a full day over time
  • Allowance for time off work to attend treatments and doctor’s appointments
  • Work from home situation if the employee has immune deficiencies due to cancer treatment
  • Ground floor office if the employee has any residual physical impairments
  • Redeployment to another position if their current job is too taxing

On the other hand, employees need to be honest with their line managers and colleagues about their symptoms, side effects and any physical or cognitive impairments that may affect their work ability as this can have a major impact on the company. 8

If you are an employee or employer dealing with cancer in the workplace you can obtain further educational material on this topic from Campaigning for Cancer by emailing them at admin@campaign4cancer.co.za or connecting via social media on the handle @campaign4cancer.

The information is shared on condition that readers will make their own determination, including seeking advice from a healthcare professional. E&OE. Life Healthcare Group Ltd does not accept any responsibility for any loss or damage suffered by the reader as a result of the information provided.

 

References:

  1. Sartorius K, Sartorius B, Govender PS, Sharma V, Sheriff A. The future cost of cancer in South Africa: An interdisciplinary cost management strategy. S Afr Med J 2016;106(10):949-950.
  2. Alexander Forbes Public Relations. Cancer Survivors in the Workplace. [online] [cited 2023 Feb 14]. Available from: URL: https://www.alexanderforbes.co.za/download/afo/online-services/Mobile%20documents/20190604%20-%20Myrna%20Sachs%20-%20Cancer%20survivors%20in%20the%20workplace.pdf.
  3. Chen W-L, Chen Y-Y, Wu W-T, Ho C-L, Wang C-C. Life expectancy estimations and determinants of return to work among cancer survivors over a 7-year period. Sci Rep 2022;11:12858.
  4. So SCY, Ng DWL, Liao Q, Fielding R, Soong I, Chan KKL, et al. Return to Work and Work Productivity During the First Year After Cancer Treatment. Front Phsychol 2022;13:Article 866346.
  5. Blinder VS, Gany FM. Impact of Cancer on Employment. J Clin Oncol 2019;38(4):302-310.
  6. Clur L, Barnard A, Joubert YT. Work adjustment of cancer survivors: An organisational support framework. SA J Industr Pyshcol 2017;43(0):a1468.
  7. Kamal KM, Covvey JR, Dashputre A, Ghosh S, Shah S, Bhosle M, et al. A Systematic Review of the Effect of Cancer Treatment on Work Productivity of Patients and Caregivers. J Man Care Spec Pharm 2017;23(2):136-162.
  8. Boelhouwer IG, Vermeer W, van Vuuren T. Late effects of cancer (treatment) and work ability: guidance by managers and professionals. BMC Public Health 2021;21:1255.