Working When You Have Cancer: An Expert Q&A

December 4, 2018
Nicole Franklin, MPH

Many people continue working during cancer treatment or return to work when their treatment ends. Continuing or returning to work can help provide a sense of normalcy, as well as needed financial resources.

Cancer and Careers (CAC) is an organization that empowers and educates people with cancer who work. Nicole Franklin, manager of programs at CAC, oversees patient seminars and online career coaching services. In this article, CAC addresses some of the common questions about managing cancer in the workplace.

1. Are there any laws that help people with cancer work while also managing their cancer?share on twitter

Yes. The Americans with Disabilities Act (ADA) is a federal law that requires private employers with 15 or more employees or state or local governments to make "reasonable accommodations." These accommodations allow employees to continue doing their job.

To be eligible for the ADA, an employee must have the necessary skills, experience, and/or training for their specific role. In addition, their symptoms or side effects must meet the ADA’s definition of a “disability.” Individual states also have different “fair employment” laws, many of which provide protection beyond what the ADA offers. Keep in mind that even if an employer’s description doesn’t fall into one of the above categories, they might be open to supporting their employee while still meeting their business needs. Many modifications cost the employer little to no money.

For the most part, a person diagnosed with cancer has no obligation to share health information, including a cancer diagnosis, with either a current or potential employer. That said, in order to access rights under the ADA or a state law, patients and survivors may have to provide some amount of information to show that they’re living with a serious medical condition. Learn more about this type of disclosure in this CAC webinar.

2. What kinds of accommodations are most commonly needed by people with cancer?

There is no single set of common accommodations that is right for every person with cancer, even among patients facing typical side effects from the same type of treatment. Treatment affects each person differently, and work environments vary. To start thinking about what, if any, accommodations you might need, we recommend you start by speaking with your health care team about ways to manage side effects while at your job.

Thinking through options for accommodations before speaking with an employer can help patients and survivors feel more prepared for any conversations that become necessary. It is also important to consider what the employer needs to keep business moving ahead.

Here are a couple of examples to show how job modifications might work. We once worked with a social worker who was experiencing nausea due to treatment. It was unpleasant but manageable while at home, and returning to work was really important to her. However, when she was at work, the nausea was impossible to cope with. It turned out her office was next to the cafeteria, and the smells were making her nausea worse. This was making it hard for her to go to work. Her reasonable accommodation was to switch the location of her office, so she would no longer be able to smell the cafeteria.

Another example is a school teacher who was experiencing fatigue as a side effect of his treatment. He also really wanted to keep working. But he was finding it difficult to maintain the class load, including homework grading and parent-teacher meetings. His accommodation was that another staff person took over his recess and lunchtime duties, so he had some extra time in his day to rest.

3. What should someone do if they aren't being accommodated?

Once a person has asked for a reasonable accommodation, the employer is supposed to work with their employee to determine the details of the accommodation. This conversation should continue once that accommodation has been made to evaluate whether it is working.

It is also important to remember that people might actually need multiple accommodations to address the challenges they are having. Or they might need to change accommodations over time depending on their treatment plan and side effects.

If an employer is unwilling to accommodate, you might consider consulting a legal organization. For instance, the National Cancer Legal Services Network provides a list of options that are free of charge.

4. Where can people read more about their rights in asking for workplace accommodations?

Here are a few resources to get started:

  • The Job Accommodation Network, a project that is funded by the U.S. Department of Labor, offers a searchable system that allows people to explore workplace accommodation options for people with various medical conditions in different types of jobs.

  • The U.S. Equal Employment Opportunity Commission (EEOC), which oversees the enforcement of the ADA, has various ADA-related documents in the Publications section of its website.

  • Triage Cancer is a resource for survivorship issues, including the Quick Guide to Reasonable Accommodations After a Cancer Diagnosis (PDF) and state resources directory.

  • CAC’s Manager’s Kit is designed for employers who may have never supervised an employee with cancer before. It is a useful tool for patients/survivors to have on hand when approaching the accommodations conversation. Beyond describing “need to know” laws that relate to cancer in the workplace, it outlines successful on-the-job strategies and tips on working with human resources (HR) departments.