Why work can matter so much right now
For many people, a job is more than a paycheck. The National Cancer Institute notes that work gives people income and a sense of routine, and helps them feel good about themselves. When so much else has been taken over by appointments and test results, a familiar desk, shift or set of colleagues can be a reminder that you are still yourself.
Other people find that cancer changes how they see their work. A job that felt central may suddenly seem less important, or a role you tolerated may feel impossible to return to. The American Cancer Society describes going back to work as a personal choice. Some people keep their usual schedule during treatment, some work reduced hours, and some step away for a while. There is no single right answer, and what fits can change from one month to the next.
Feelings that often come up on the job
- Fear that a supervisor or coworkers will see you as less capable, even when you are managing well
- Frustration with your own pace, focus or stamina, especially if you used to be the reliable one
- Guilt about colleagues covering your work, and worry that they resent it
- Tiredness from acting cheerful or "normal" so that others feel comfortable
- Relief and even pleasure at thinking about something other than cancer for a few hours
- Anxiety about money, benefits or the future of your career, which can run in the background all day
These reactions can sit side by side. It is common to feel proud of getting through a workday and discouraged by how much it cost you. If money worries are a large part of the strain, Financial Stress and Cancer looks at that side in more detail.
Energy, focus and the inner critic
The American Cancer Society notes that people returning to work after treatment may tire easily or have trouble focusing at first, and treatment itself can affect energy. Ask your oncology team what to expect from your particular treatment, because side effects are a medical question. The emotional question is often what you tell yourself about them.
Many people with cancer hold themselves to their old standard and then judge themselves harshly for missing it. It can help to plan your hardest tasks for the hours when you usually have the most energy, keep a written list of what is in progress so you do not have to hold it all in your head, and decide in advance what can wait. Noticing a limit is not the same as giving up. It is a way of protecting the energy you have.
What you share at work, and what your employer may share
Telling a supervisor or coworkers about your cancer is a personal choice, and you decide how much to say. Some people prefer to say very little; others find that being open clears up rumors and makes it easier to ask for help. How to Tell Family, Friends, and Coworkers About a Cancer Diagnosis covers those conversations.
It may ease some worry to know that, according to the U.S. Equal Employment Opportunity Commission (EEOC), an employer covered by the Americans with Disabilities Act (ADA) generally must keep medical information about an employee confidential. The EEOC lists limited exceptions, such as telling supervisors what they need to know to provide an accommodation. It also says an employer may not tell coworkers that an employee has cancer, even if the employee has chosen to tell some of them personally.
Asking for changes at work: what the EEOC describes
The EEOC has published guidance on how the ADA applies to employees who have or had cancer. This is general information, not legal advice, and whether the law applies to you depends on your situation. In broad terms, the EEOC explains that:
- Title I of the ADA covers private employers with 15 or more employees, as well as state and local government employers. Many states have their own laws, and some may reach smaller employers.
- Under the ADA as amended, people who currently have cancer, or whose cancer is in remission, should easily be found to have a disability, and a history of cancer can also be covered.
- Covered employers must provide reasonable accommodations unless doing so would cause undue hardship. Examples the EEOC gives include leave for appointments or recovery, breaks or a private place to rest, a modified schedule, and working from home.
- There are no "magic words." You only need to tell your employer that you need a change at work because of your cancer, and a family member or health professional can make the request on your behalf.
- The ADA prohibits retaliation against someone for requesting a reasonable accommodation.
For questions about your own job, your human resources office, the EEOC's guidance itself, or an employment attorney can help. Many people find that making a request early, before they are exhausted, takes some of the dread out of it.
Going back after treatment ends
The end of treatment can bring pressure to be fully "back." Coworkers may assume the hard part is over just as fatigue, fear of recurrence or the delayed emotional weight of the past months starts to show. The American Cancer Society recommends checking with your health care team before returning. The National Cancer Institute suggests planning what you will say about your cancer, keeping in touch with coworkers during recovery, and dealing with problems as soon as they come up rather than letting them grow.
If the months after treatment feel harder than you expected, you are not alone. Why Finishing Cancer Treatment Can Feel Harder Than Expected explores that transition.
Where emotional support can help
A psychologist will not give you legal or medical advice about work, but therapy can be a place to sort out what work means to you now, rehearse a hard conversation with a manager, loosen the grip of self-criticism, or think through whether to change roles. Dr. Lehmann is a licensed clinical psychologist in Franklin, Michigan, with an insight-oriented, integrative approach. Read more about cancer-related emotional support.
Practical note for working clients: the practice offers daytime appointments Monday through Thursday, with no evening or weekend hours. Telehealth sessions are available for clients physically located in Michigan at the time of the session, which some people fit around a workday or a treatment schedule.