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Survivorship Series: Back to Work

annekatzBy Anne Katz, PhD, RN

This Monthly Survivorship Series, written by CKN Survivorship Editor, Anne Katz, is provided by CKN with permission from ONS.  We hope this series will become a useful resource that will help to facilitate dialogue between cancer patients, their loved ones and their physicians with a view towards improving the quality of life for cancer survivors.  

Some time after treat­ment, can­cer sur­vivors are faced with the need or desire to go back to work. Of the 12 mil­lion can­cer sur­vivors in the United States today, an esti­mated 4 mil­lion of those are adults who were employed at the time of their diag­no­sis and return to work after treat­ment; some may even have worked through­out treatment.

Con­tin­u­ing to work is impor­tant for many rea­sons, includ­ing finan­cial need, self-​​esteem, and social sup­port. Return­ing to work means that one has got­ten through treat­ment. But many can­cer sur­vivors have to work to retain health insur­ance cov­er­age. On the other hand, a life-​​altering diag­no­sis can also prompt a reeval­u­a­tion of pri­or­i­ties; some peo­ple may choose to leave a job they do not enjoy and seek more sat­is­fy­ing employ­ment or take early retirement.

It is not all smooth sail­ing, how­ever. Dis­crim­i­na­tion, both sub­tle and overt, may occur. Employ­ers may assume that some­one with can­cer is no longer capa­ble of car­ry­ing out their work as well as they did before. Can­cer sur­vivors have reported being dis­missed, passed over for pro­mo­tion, denied ben­e­fits, and expe­ri­enced hos­til­ity in the work place. All of these con­tra­vene the 1990 Amer­i­cans With Dis­abil­i­ties Act (ADA). Because can­cer is regarded as a dis­ease that impairs or lim­its a major life activ­ity, those with the dis­ease are included under this pro­tec­tion. Some courts have iden­ti­fied a weak­ness in the act: if a per­son with can­cer is well enough to work, then they are not con­sid­ered dis­abled. In addi­tion, there is not blan­ket cov­er­age with this act and whether an employee is cov­ered is decided on a case-​​by-​​case basis.

Can­cer sur­vivors who return to work may need cer­tain aspects of their job or the work­place mod­i­fied to enable them to carry out their duties. They may be pro­tected by the ADA, but only if there are more than 15 employ­ees in the work­place. Sim­i­larly, they may be pro­tected under the Fam­ily and Med­ical Leave Act (FMLA) that allows for 12 weeks of unpaid leave in a 12 month period, and the employee must be allowed to return to their same or equiv­a­lent posi­tion after the leave.

Going back to work requires advanced plan­ning and, at min­i­mum, a dis­cus­sion with the imme­di­ate super­vi­sor about any mod­i­fi­ca­tions that need to be made. What is to be shared with cowork­ers about any mod­i­fi­ca­tion is also a consideration.

Do you talk to your patients about this? Who do you refer them to for help and advice? These are impor­tant issues to dis­cuss with our patients — and I’m not sure we do this well at all.

Related:  Cancer and Careers



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One Response to Survivorship Series: Back to Work

  1. Pingback: Cancer and Careers | Cancer Knowledge Network

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