Cancer rehabilitation is part of comprehensive care that seeks to identify and provide the necessary services and resources to allow patients to function at their optimal best. Return to work and resumption of normal activities are important rehabilitation goals for patients.
The Role of Work in Our Lives
Work is part of our self-concept and identity. Much like our roles in our families, with our friends and in our community, our careers and jobs represent a major part of who we are.
Work represents:
- Independence and financial and economic security
- Personal fulfillment
- Control and mastery over our destinies
- Access to benefits for ourselves and our families
Going back to work means "getting back to normal."
How Employers and Co-Workers May Respond to Cancer
Some people with cancer have a negative workplace experience:
- Co-workers and employer are insensitive.
- The person experiences unfair treatment (being denied promotion, being transferred or demoted).
- The person is illegally discriminated against (fired).
Effects of Discrimination on Worker
- Anxiety about economic security
- Loss of independence
- Lowered self-esteem
What to Do
Dispel the myths: Basic misunderstandings are at the root of most workplace discrimination.
- Cancer can't be passed from one co-worker to another.
- People with cancer are productive.
- People with cancer can make modifications in their schedules to avoid missing a lot of work.
- Cancer symptoms such as nausea, fatigue and pain can often be treated with medications that cause few side effects.
- Cancer does not mean death.
Promote education: National averages indicate that more than one in four employees in the typical company will develop cancer during their work lives. Cancer education in the workplace helps promote prevention and early detection and elimination of discrimination against workers with histories of cancer. Education can take place in the form of informal conversations, brown bag lunch discussions, formal presentations and health fairs.
If discrimination does occur:
- Identify whether or not the problem is discrimination. Seek an expert opinion.
- Try to work it out through direct negotiation by discussing the issue with appropriate people (supervisor, human resources representative, etc.) at the workplace before initiating legal action.
- Have the physician write a letter to the employer about the type of cancer and the worker's ability to continue functioning effectively.
- Work with the employer to identify reasonable accommodations, such as flexible hours, change in job duties or redesign of physical space or equipment.
Know your legal rights:
- Rehab Act of 1973
- Americans with Disabilities Act
- Family and Medical Leave Act
When job seeking, employees need to know how they are going to discuss cancer if it comes up, such as if a medical exam is required. The exam must focus on the worker's ability to do the job and must be required of everyone else.
Employers’ Attitudes Toward Patients and their Families
What do co-workers experience? Shock, denial and fear – fear it could happen to them, fear of not knowing what to say or do; fear of losing a respected and valued member of a team. As a result, some workers with cancer receive unsupportive behavior from co-workers.
That's why some patients choose not to disclose their diagnosis. Many people, including co-workers and employers, tend to generalize a personal experience to include all people with cancer. A comment can imply that all people with cancer are like this: "When my uncle got cancer, he stopped working immediately."
Guidelines for Employers
- Don't participate in denial. Ask workers what benefits are needed, if changes can be made in the schedule or workload, and what resources can be identified to help (i.e., setting up an appointment with the benefits manager to discuss insurance-related concerns).
- Don't reduce responsibilities without discussing it with the employee. This sends a negative message and heightens the employee's fear of losing part of their identities, jobs, insurance, income, etc.
- If responsibilities must shift, seek the employee's help in delegating. Meet with the entire team and delegate together. Maintain team spirit.
- Be flexible about schedules. Flextime is a very reasonable accommodation to make for employees with cancer. For example, allow the employee to choose to work four longer days with a fifth day off to schedule chemotherapy treatments.
- Be alert for signs of trouble from the employee or co-workers. Are co-workers demonstrating unsupportive behavior or lack of sensitivity? Enhance communication efforts and be a compassionate employer. Watch for signs of emotional distress in the employee and problem-solve solutions.
- Be willing to assign temporary jobs on an ongoing basis.
- Inquire about whether the employee wants to work at the hospital or at home. With laptop computers and small home workstations, this is a very viable alternative.
- Provide educational opportunities for the worksite. Have seminars. As an employer, have a telephone consultation with cancer professionals to see how you can become a cancer advocate in the workplace.
Guidelines for Co-Workers
- Don't become a rescuer.
- Ask the co-worker how he or she wants to discuss the situation.
- Ask if a designated person can disseminate information to others, if preferred.
- Don't pull away.
- Offer to find resources.
- Keep conversations confidential.
- Don't feel obligated to be the "cheer-up" person.
- Don't keep telling the co-worker with cancer how courageous he or she is, because it puts a real burden on them to "overperform."
- Offer to help out when you can.
- Visit at home or at the hospital if appropriate to smooth the transition back to the office.
