Coping with cancer and work

Expert reviewer Dr Jenny Lesser, Consultant Occupational Physician
Next review due August 2020

Balancing life between home and work can be a juggling act at the best of times. If you have cancer, it can be difficult to know how it will affect you at work. To some extent, this will depend on the type of work you do and the treatment you need.

You don’t have to tell your manager or human resources department about your cancer. But if you do, you can discuss any reasonable adjustments your employer could put in place to make it easier for you when you do return to work.

An image showing a woman at her desk

Taking time off

When you have cancer, you’re likely to need to take time off work for treatment, perhaps because you’re feeling unwell or to attend appointments. As someone with cancer, your employer is legally obliged to give you time off for medical appointments and for treatment. However, they don’t have to pay you for this unless this is in your employment contract. If your contract states that you don’t get sick pay, in most cases your employer should still pay you statutory sick pay. There’s more about this in our section: Money worries.

If you have been off sick for four weeks or more, your doctor may suggest referring you to Fit for Work. This is a free, national occupational health service that will help you and your employer to put together a ‘return to work plan’. The plan will give your employer an idea of when you might be fit to come back and what support you’ll need.

Once you’re with Fit for Work, you may not have to get any more sick certificates (‘fit notes’) from your doctor. Fit for Work is voluntary. You don’t have to agree to be referred. If your employer has an occupational health service, you may prefer to consult with them, although Fit for Work will also work with them.

Here are some of the issues it may be helpful to discuss.

  • Cutting down your hours, or working more flexibly, for a time when you do go back to work.
  • Rules and procedures you need to follow when you’re off sick.
  • How your entitlements and pay could be affected by time off and by new working patterns.
  • If your employer offers any support services, such as counselling or other employee assistance.
  • The kind of help and support you can expect when you return to work.

When you’re ill, work can help to take your mind off it and provide a sense of normality and routine. Cancer and treatments affect people in different ways. Some people are able to keep working while they’re having treatment. But you won’t know until your treatment starts and you see how you feel.

Money worries

If you take time off work, work fewer hours or stop working altogether, it will affect your finances. It’s a good idea to get to grips with this as early as possible. Ignoring financial issues could make your money worries worse.

You need to consider:

  • what you’re entitled to from your employer
  • unexpected costs, for example, increased travel to and from appointments, additional childcare, or higher heating bills
  • how you’ll manage on a reduced income
  • whether you have any life or health insurance policies that could help you and your loved ones now, or in the future
  • how best to manage your mortgage repayments
  • your retirement or pension plans

If your contract with your employer does not provide for paid sickness leave, your employer must pay you Statutory Sick Pay as long as you’re not classed as self-employed and you have been off sick for at least four days.

Ask someone to help you to get your paperwork in order and identify your financial needs. Friends or family can help you to get started. Then there are independent charities and financial advisers for help and advice. If you have current debts, there are organisations that provide advice. See our section: Other helpful websites for details of helpful organisations.

Below are some tips to help you plan and manage your money.

  • Check to see if you’re eligible for any financial benefits or grants. Your local Citizens’ Advice Bureau or Macmillan Cancer Support can give advice.
  • Budget your finances by calculating your income versus your total spending. From this, you can identify areas where you need to cut your spending.
  • Think about switching gas and electricity suppliers to get a better deal – the amount you use can increase when your routine changes.

Check with your mortgage and insurance providers to see if they allow payment holidays. If you can’t work because of your cancer, speak to your employer, or a benefits adviser to find out what you’re entitled to.

For information about organisations that may be able to help you with your finances, see our section: Other helpful websites below.

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If you’re self-employed

It can be particularly stressful if you are self-employed and have been diagnosed with cancer. As well as financial worries, you may have concerns about keeping your business going while you are having treatment and recovering.

There are Government benefits that you can get if you are sick and self-employed, such as Employment Support Allowance. There may also be charitable grants that you qualify for. It’s worth speaking to the Citizen’s Advice Bureau or a benefits adviser to find out more. You may also find business advice services helpful, such as the Government run Business Support Helpline. See our section: Other helpful websites for more information.

Returning to work

Returning to work after a break of a few weeks or months can be daunting. But it may also help you to feel that you’re starting to get back to normal.

It’s important to keep up contact with your employer while you’re off work. You’ll need to keep them informed about your illness and when they can realistically expect you back at work. You can make returning to work easier by:

  • keeping in touch with colleagues so you feel part of what’s going on at work
  • arranging to meet your manager or human resources department before you start back, to discuss your work and any support you may need
  • returning to work gradually – you may be able to start part time and build up your hours
  • finding out if you can change your working hours permanently if you want to
  • asking if you can have training to help get you up to speed with any changes

“After my cancer treatment I felt anxious about returning to work. Despite wanting to get back to some sort of normality, I was worried about how I was going to cope. I had developed lymphodema in my right arm as a result of my treatment, and so my arm, hand and fingers were very swollen, and a lot bigger and heavier than before. I was returning to a desk-based job that involved a lot of typing. At first, I was worried that I wouldn’t be able to type as efficiently as before and, if I did, it would make my arm ache and add to my discomfort. I approached my employer with these concerns and, after assessing my needs, they provided me with the equipment that I needed to keep my arm comfortable.” – Lorraine

Managing tiredness at work

Cancer and treatment can often cause tiredness. You may have trouble concentrating, and have less energy than usual. You may find it difficult to make decisions, feel less motivated and sleepy during the day. All of this can affect your productivity at work.

  • Drink plenty of fluids to help keep your energy levels up.
  • Plan your working days and weeks – break your workload up into small chunks and work around your treatment or appointments. Remember; always be realistic about what you can achieve at any given time.
  • Sleep as well as you can – have a regular bedtime routine and try not to nap during the day if you can manage without.
  • Make sure you get some exercise , such as walking – exercise helps to boost your energy.
  • Eat well – you need calories for energy.
  • If your commute is tiring, find out if you can change your hours so you’re travelling when it’s less busy or work from home instead if you can.
  • Take regular short breaks during the day if you need to and use them to rest and relax.
  • Ask for help. Speak to your manager who may be able to share your workload or find different tasks for you to do.

Help and support

Being diagnosed with cancer is unavoidably distressing for you and your family. An important part of your cancer treatment is having support to deal with the aspects of living with cancer. Specialist doctors and nurses, who are experts in treating cancer, can provide the support you need and may be able to visit you at home. Ask your nurse to put you in touch with support groups where you can meet people who may have had similar experiences to you.

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Related information

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    • Breast cancer and employment. Breast Cancer Care., last updated February 2016
    • Talking to your employer and colleagues. Macmillan Cancer, last updated September 2014
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    • Personal communication. Dr Jenny Lesser, Consultant Occupational Physician, August 2017
  • Reviewed by Laura Blanks, Specialist Health Editor, Bupa Health Content Team, August 2017
    Expert reviewer Dr Jenny Lesser, Consultant Occupational Physician
    Next review due August 2020

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