Going Back to Work After Cancer

This section has been reviewed and approved by the Cancer.Net Editorial Board, 07/2014

Key Messages:

  • When and how you return to work after cancer treatment depends on a number of factors, including the type of work you do and the nature of your recovery.
  • Talk with a social worker and a member of your employer’s human resources department about your legal rights, as well as any accommodations you may need.
  • It is your decision when and how to tell coworkers about your cancer experience, if you even decide to talk about it at all.  

After finishing cancer treatment, many people look forward to returning to work. Working can provide opportunities to reconnect with colleagues and friends, focus on something other than cancer, get involved in interesting and challenging projects, and start settling back into a regular routine and lifestyle. However, every person's situation is different.

Decisions about going back to work will likely depend on your financial resources, health insurance, the type of work you do, and the nature of your recovery. Many people with cancer who took time off for treatment return to work full-time, while others may have to decrease their hours. Still others may not be able to return to work because of long-term side effects. No matter what your situation, there are a number of things you can do to make this transition a little easier.

Planning for your return

For survivors who cut back on their hours or stopped working during treatment, the first step is to talk with your doctor about when you will be ready to return to work. The timing will depend on the type of cancer and treatment you had and the type of job you perform. If your job is stressful or physically demanding, you may need to wait longer before returning to work. Ongoing treatment or side effects, such as fatigue, may also cause delays. Talk with your doctor, nurse, or social worker about any ongoing physical, emotional, or mental limitations you may have, as well as how your follow-up care may affect your work schedule.

Once you know it is okay to return to work, a good next step is to set up a telephone or in-person meeting with your human resources department to discuss your plans. Ask whether your company offers resources, such as a formal “return-to-work” or disability management program, to help you make the transition. In addition, you may have access to a free consultation with a qualified mental health professional through an Employee Assistance Program (EAP) with whom you can confidentially discuss your adjustment back to the workplace.

During this meeting, you may also want to discuss the possibility of flexible work arrangements, such as part-time hours, partial or full-time telecommuting, job sharing, reassignment to another position, leave time for doctor visits, or periodic work breaks to take medications and contact members of your health care team. These are all considered reasonable accommodations under the Americans with Disabilities Act (ADA).

Before granting a reasonable accommodation, your employer may request documentation that verifies your limitations, such as fatigue, chronic pain, and cognitive difficulties, which are classified as disabilities under the ADA. However, employers are not allowed to ask for your medical records. An employer may deny a request if the accommodation would cause an “undue hardship,” such as being too difficult or expensive to implement. However, an employer is required to determine if there is an easier or less costly accommodation that can be made to meet your needs.

Legal rights under the Family Medical Leave Act

You may have used the Family Medical Leave Act (FMLA) to cover your time away from work during treatment. Under the FMLA, an employee may take up to 12 weeks of unpaid leave per 12-month time period. To be eligible for FMLA benefits, an employee must work for an employer that has at least 50 employees within 75 miles. In addition, the employee must have worked for the employer for a total of 12 months and at least 1,250 hours over the previous 12 months.

Family medical leave does not have to be taken as 12 weeks in a row. It can be used intermittently and be used after you've returned to the workplace. For example, some people use the FMLA to go back to work part time while they are regaining strength and transitioning back to their responsibilities. Some employers will require that their employees use available sick or vacation time for part or all of the 12 weeks, so check with your human resources department for information about your workplace’s policies.

Other key points in the FMLA include:

  • Employers are required to continue your group health insurance coverage while you are on family medical leave on the same terms as if you were still working.
  • You are entitled to return to your original job or to an equivalent job with equivalent pay and benefits.

Ask your nurse, social worker, or another member of your health care team for resources and information about other federal and state laws that protect workers' rights.

Talking with coworkers

You do not have to tell your employer or coworkers that you had cancer, unless you are requesting a workplace accommodation or are unable to perform the usual responsibilities of your job. However, many people decide to give coworkers or managers at least some information about their diagnosis and treatment, especially if they have been absent for a while or their physical appearance has changed.

It is important to decide what you want to tell people in advance and how you plan to do it. You may want to have private conversations with a few close coworkers. Or you may find it easier to send an e-mail or make an announcement at a staff meeting. Consider your work culture, what feels right to you, and your need for privacy versus your need for accommodations and support. You can also ask your manager, a close coworker, or a human resources professional to help you decide if, when, and how to tell others about your cancer.

When talking to coworkers, it helps to keep your explanation simple and let people know how your return to work will affect them. For example, you might consider saying: “I’ve completed treatment for cancer, and I’m currently doing well. It’s good to be back at work. Just so you know, I will be here 20 hours per week for the next four weeks, and I will return full time after that. In the meantime, Joe Smith will be covering Projects A and B.”

Some employers and coworkers may not respond well. Their reactions usually have to do with past experiences or a lack of familiarity with cancer. However, you may find that being open will help you reconnect with coworkers and offer the opportunity to address misconceptions or rumors that may have circulated in your absence. People often take your lead; if you are comfortable talking about your experience with cancer, they will usually feel the same.

Additional tips for transitioning back to work

Consider using the following strategies to make the transition smoother once you've returned to the workplace:

  • Plan to take small breaks during the day to help you maintain your energy level.
  • If you find that you're having difficulty concentrating, use lists and reminders or set meeting and task alarms on your office e-mail system.
  • Set up frequent meetings with your manager to evaluate the transition and make any necessary accommodations, such as a temporary change in responsibilities if your job is physically demanding. You are entitled to reasonable accommodations as long as you are able to do your job, so don't hide your condition at the risk of your physical or emotional health.

Remember, as a cancer survivor, your most important job is a healthy recovery. With the right information and support, returning to the workplace can be an important and positive step for that recovery.

More Information

Cancer and Workplace Discrimination

For Young Adults: Returning to Work After Cancer

Sharing Your Story

Survivorship

ASCO Answers: Cancer Survivorship (PDF)

Additional Resources

U.S. Equal Employment Opportunity Commission: Questions and Answers About Cancer in the Workplace and the Americans with Disabilities Act

LIVESTRONG: Employment Issues