A 4-Step Guide for Working During Treatment

If you decide to work during treatment and beyond, have a well thought out and researched plan in place. Here is a step-by-step guide to help you create a plan that will work for you.

Step 1: Do Your Homework

Before you make any plans, you will want to get expert advice on what is realistic and possible, given your situation. This will include everything from talking to your doctor to learning about your company's policies regarding leaves of absence, telecommuting, flex time, and other related issues. Having a family conference— heart-to-heart talk with your loved ones—to see how they feel and to discuss such matters as finances and whether or not you can afford to take time off from work will be important, too. Another important topic to discuss with your family is how they can help you balance your family responsibilities with working during treatment.

Here's homework you need to do to help you in making decisions about working during treatment:

Have a Talk with Your Health Care Professional 

Find out as much as you can about the stage of your disease, your general health status, and the type of treatment you will be receiving. Discuss the type of work you do, and ask your doctor if he or she thinks it will be possible or realistic for you to work during treatment. In addition, talk about whether it will be possible for you to arrange treatments to fit around your work schedule. Ask about ways that could make your treatment easier, such as oral medications. Also be sure to ask what treatment side effects you might experience.

Questions to Ask Your Doctor 

• What will my weekly treatment schedule be?
• Will I be able to continue my present job, or are there considerations that may  prevent me from doing so?
• Can I schedule my treatments around my work?
• Are there ways to schedule my supportive care drugs to coincide with chemotherapy so that I can consolidate my appointments and don’t have to have separate visits to receive them?
• Will I experience any treatment side effects that could affect my energy level or my ability to work? If so, how can I prevent or manage any treatment side effects?
• How can I conserve my energy?

Find Out What Your Company's Policies Are 

Perhaps there is an employee handbook where you can read about your company's policies on leave of absence, vacation, sick leave, as well as paid and unpaid time off. Many companies have a medical leave or disability leave program. For more information about disability, see "The Long and Short of Disability." Depending on your employer, you may or may not receive wages during this period. But these leaves of absence will maintain your health insurance while you're not at work.

If your company has a human resources (HR) department, talk with a representative there, too. See what the company has done in the past and what flexibility the company offers. Be clear about what you want. Your HR department may assume that you want paid medical leave time, when all you may really want or need, for example, is to take some days off for treatment. If you belong to a union, union officials can also provide helpful information regarding working and illness. The information you disclose about your medical condition should be kept confidential by your HR department and your supervisor. It should not be shared with your co-workers or other employees.

Know Your Legal Rights 

You may have a good relationship with your employer. But it doesn't hurt to brush up on your employee rights. You may be entitled to time off and job security protections under the Family and Medical Leave Act (FMLA) or the Americans with Disabilities Act (ADA) or state laws that apply. The FMLA provides for protected job leave to employees who qualify. The ADA protects qualified employees with cancer from discrimination in the workforce. For more information about your legal rights as a cancer patient, see "Know Your Legal Rights." Also keep in mind that there are protections for getting and keeping health insurance under the Health Insurance Portability and Accountability Act of 1996.

Step 2:  Make a Plan

Once you've done your homework—talked with your loved ones and your health care professional, and looked into your company's policies—the next step is to think about your personal goals in working before you talk with your employer. Ask yourself what you want to achieve. Is your primary goal in working during treatment financial, or are you motivated more by other reasons, such as the social aspect of working, the daily interaction with co-workers, and so on. Think about the type of work that you do and what kind of flexibility you might have in terms of when and where the work gets done.

The answers to these questions, combined with the other information you've gathered, will help you decide what you need and want to suggest as a work plan to your employer while you're going through treatment. Be sure to suggest any creative ideas you have for making working during treatment easier for you, such as using paid time off that's coming to you (vacation, sick time, holidays, compensatory time), working from home, flexible work hours (reduced or part time), job sharing, or temporary shift in duties or new role in the company (flexible hours or less demanding).

Step 3: Talking to Your Employer

The next step is to decide whether or not to speak with your employer about your situation. Although recent medical visits may already have caused you to miss a considerable amount of time at work, and may even have raised questions among your co-workers or employer, you do not have to disclose that you have cancer to your employer. This is a personal choice for each person to make. You are not required to tell your employer you have cancer. If you do not need your employer to make any reasonable accommodations because of your cancer, you might choose not to disclose your medical situation. Keep in mind that if you feel you are being discriminated against because you have cancer, you may not be entitled to protection under these laws if your employer does not know of your medical condition.

If you decide to tell your employer, keep in mind that this should be a dialogue. Start by briefly describing your diagnosis and the treatment you're going to have. State your interest in keeping your job, even though you may need to take time off for treatment. You both need to understand that the plan may change, depending on your condition. Instead of waiting to hear from your employer about what you will be offered, suggest a plan based on the homework and thinking you've done; discuss some ideas that you think may work for both of you.

Questions to Ask Your Employer

• I'd like to continue to work during my treatment. Is there a way to make my workload manageable? (For instance, could I take off Friday afternoon for treatment, so I can rest over the weekend?)
• Would working part time, job sharing, or telecommuting (pick which one would be appropriate) be an option for me?
• I may have to take some time off for treatment. How long will my company hold my job if I need to take some time off? What is my company's policy on medical leaves of absence? Am I entitled to leave time under the FMLA? Will my company provide medical leave as a reasonable accommodation under the ADA or applicable state law?
• If I need to cut back on responsibilities, is there another job at the company that I could do?

Be prepared to discuss your diagnosis and show your employer written details about your condition. It's not that he or she doesn't trust you, but there may be required paperwork that actually helps protect your employer (and you) in the long run. Also be prepared to outline what expected leaves and sick days you anticipate taking.

If you need to, ask for a reasonable accommodation. (It's covered under the Americans with Disabilities Act.) Let's say you need time off on a Friday for treatment, so you can have a weekend to recover. Or, maybe you'd like to wear a headscarf during treatment, but the company has a policy prohibiting head coverings.

There are no "magic words" to use when you ask for a reasonable accommodation. All you need to do is ask. The good news is that most employers are learning to be more flexible, accommodating, and reasonable with employees with cancer.

Step 4: Adjusting to Work

Your first day back on the job may be difficult emotionally and physically. Whether you decide to tell your co-workers or not about your cancer, the important thing to keep in mind is that everyone has different ways of dealing with their concern for you. For tips on talking with your co-workers, see "Sharing the News at Work."

Remember, there is no set script or way of handling these interactions. Just know that most people, no matter how awkwardly they may express themselves, most likely have the best of intentions and really want to support you. It is also your personal choice as to whether or not you share this information with your co-workers. Your employer should not discuss this information with them.

Although it is important to try to resume your routine, be realistic. You may find yourself a bit more tired than you thought you would be. For tips on handling tiredness at work, see "Tips for Making It Through the Workday.

It's only natural that you'll have good days and bad days. But keep reminding yourself of the positive aspects of your job.