Don’t punish cancer patients twice - please respect their workplace rights

Reintegration into society is the best therapy for people recovering from cancer. A kind environment is one of the most helpful things an employer can provide

 

 

 

 

“If you stop my cancer treatment, I can get my job back.”

I’m surprised. My patient had told me previously that she just found a new job.

“I did, until the new boss found out I needed a morning off every third week. I was honest about the reason, and suddenly I wasn’t suitable.”

“That’s not fair”, I sympathise. Not to mention discriminatory, I think, as I wait to hear the details.

“They loved my credentials, but the truth is, no one wants to hire a cancer patient. They think we are all waiting to die.”

“You are unlucky but you’re not dying”. She looks grateful for the reminder.

She fingers her neck for the lump that had heralded a late recurrence. She had first experienced cancer in her thirties and had finally begun to get her life back on track. She had dealt with the intensive treatment, the delayed fertility and combated the existential questions that had confronted her so early in life. After recovery, she re-enrolled in her teaching course, but to her dismay her concentration was so severely affected by chemotherapy and her confidence so damaged as a result, that she left the course.

Ten years later, she was devastated by the return of her disease but by then newer and better therapies had been born, and before our eyes we watched the tumour shrink and then melt away.

For months, the gains felt tentative, even illusory. A year later, she was fine. Another year later, she was still fine. Thanks to the achievements of modern medicine, a woman who would have succumbed to her recurrence was not only alive, but well and yearning to be engaged with society.

Having put paid to her dreams of teaching, she found a cleaning job at a large organisation. She was a diligent worker whose casual stints there had garnered praise from the manager. I had seldom met a patient more excited at the prospect of a regular job, and I celebrated the purpose it introduced to her lonely days.

Then this. “Human resources says there is no opening although I had a starting date.”

I convince her that she has her story wrong and hand her a letter for her employer proclaiming her fit to work.

She returns, disappointment writ large on her face. “They took the letter but didn’t say more.”

I track down the human resources manager who bristles from the outset. He boasts of his consideration for patients but shows none in our exchange. I explain to him that cancer outcomes for some patients like mine have changed dramatically and they can expect prolonged and productive lives. I try to explain how valuable it would be for my patient and broader society to be gainfully employed. I know that my words fall on deaf ears.

And now my patient wants me to stop her cancer treatment.

I search her face and see she is serious.

“The money could help my whole family; the treatment is just for me.”

“That’s not an option for you”, I quietly say, moved by her contradictory fears.

I print information on workplace law and direct her to seek professional help, but like almost every patient in her situation, she worries that the journey will be too hard and too unpleasant. Much as I would love her to plough through the difficulties and seek redress, I tell her I completely understand.

As I sign her form for continuing welfare benefits, she shrinks in her seat. “I feel ashamed. I want to work and contribute.”

“It’s not your fault,” I assure her.

The irony of increasing cancer survival rates is being realised by many patients who face workplace challenges including unemployment, under-employment and rarely, outright discrimination. While many employers are understanding and make a genuine attempt to comprehend the many nuances of cancer treatment, patients report facing significant issues returning to work, renewing relationships and communicating about their diagnosis while maintaining some privacy and dignity.

Evidence from Australia and other countries suggests that up to a third of cancer patients don’t return to work. 40% report their experience of working and of future career prospects as having deteriorated. Smaller numbers report being overlooked for promotion, facing changes to their job without agreement, and feeling pressured to resign. Not surprisingly, financial difficulties are exceedingly common for cancer patients. These difficulties are linked to worse relationships and a decline in general wellbeing.

One of the most significant challenges patients face is cancer-related fatigue. Fatigue is ubiquitous and corrodes every aspect of life from physical fitness to emotional health. It is also invisible. Nausea and vomiting settle quickly, hair begins to return, patients reconcile to weight fluctuations but what they report being haunted by is fatigue.

Fatigue can last for months or even years after finishing treatment. It impacts the ability to travel, concentrate and even stay awake for the full day. It’s neither something patients like to disclose nor what others expect to hear but the good news is that the adverse effects of fatigue on the workplace can be significantly reduced by understanding employers who are willing to adjust working hours, support alternative arrangements, and have regular consultations about an appropriate workload. Most cancer patients don’t want to shirk their responsibility; they are eager to return to work and renew their commitment. Their distress comes from fearing that they must prove themselves fully fit as soon as they return lest they be deemed inadequate, but this is unrealistic. Many say that they don’t need specific work assistance, but kindness and empathy goes a long way to aid recovery. A kind environment is one of the most helpful things a workplace can provide to those have been ill and are feeling their way back.

‘What’s with the moping? I thought your chemo was done and you’re back to good!”, an impatient executive recently said to his thirty-year old assistant who couldn’t keep up with his rapid fire dictation and had to ask him to slow down. To her great credit, my patient responded with a printout outlining the symptoms of menopause, drawing a mortified apology and rearranged work hours. I grinned with her at her gumption, but hoped that someday her experience will be anachronistic.

An unprecedented era of modern technology and interventions has created optimism for many cancer patients who need not be punished twice. With their chances of survival furthered, it has never been more important to ensure that their workplace rights are respected. While many cancer patients are too unwell to work, there are growing numbers for whom the most beneficial therapy is reintegration into society. They won’t stop being cancer patients, but they are defined by much more. We do them and society a disservice by not recognising their worth.

We can do better. For this, we need empowered patients, an understanding society, and employers who pledge to be fair and attuned to the concerns of cancer patients that frequently lurk under the surface.

 

Dont punish cancer patients twice - please respect their workplace rights

Reintegration into society is the best therapy for people recovering from cancer. A kind environment is one of the most helpful things an employer can provide If you stop my cancer treatment, I can get my job back. Im surprised. My patient had told me previously that she just found a new job. I did, until the new boss found out I needed a morning off every third week. I was honest about the reason, and suddenly I wasnt suitable. Thats not fair, I sympathise. Not to mention discriminatory, I think, as I wait to hear the details. They loved my credentials, but the truth is, no one wants to hire a cancer patient. They think we are all waiting to die. You are unlucky but youre not dying. She looks grateful for the reminder. She fingers her neck for the lump that had heralded a late recurrence. She had first experienced cancer in her thirties and had finally begun to get her life back on track. She had dealt with the intensive treatment, the delayed fertility and combated the existential questions that had confronted her so early in life. After recovery, she re-enrolled in her teaching course, but to her dismay her concentration was so severely affected by chemotherapy and her confidence so damaged as a result, that she left the course. Ten years later, she was devastated by the return of her disease but by then newer and better therapies had been born, and before our eyes we watched the tumour shrink and then melt away. For months, the gains felt tentative, even illusory. A year later, she was fine. Another year later, she was still fine. Thanks to the achievements of modern medicine, a woman who would have succumbed to her recurrence was not only alive, but well and yearning to be engaged with society. Having put paid to her dreams of teaching, she found a cleaning job at a large organisation. She was a diligent worker whose casual stints there had garnered praise from the manager. I had seldom met a patient more excited at the prospect of a regular job, and I celebrated the purpose it introduced to her lonely days. Then this. Human resources says there is no opening although I had a starting date. I convince her that she has her story wrong and hand her a letter for her employer proclaiming her fit to work. She returns, disappointment writ large on her face. They took the letter but didnt say more. I track down the human resources manager who bristles from the outset. He boasts of his consideration for patients but shows none in our exchange. I explain to him that cancer outcomes for some patients like mine have changed dramatically and they can expect prolonged and productive lives. I try to explain how valuable it would be for my patient and broader society to be gainfully employed. I know that my words fall on deaf ears. And now my patient wants me to stop her cancer treatment. I search her face and see she is serious. The money could help my whole family; the treatment is just for me. Thats not an option for you, I quietly say, moved by her contradictory fears. I print information on workplace law and direct her to seek professional help, but like almost every patient in her situation, she worries that the journey will be too hard and too unpleasant. Much as I would love her to plough through the difficulties and seek redress, I tell her I completely understand. As I sign her form for continuing welfare benefits, she shrinks in her seat. I feel ashamed. I want to work and contribute. Its not your fault, I assure her. The irony of increasing cancer survival rates is being realised by many patients who face workplace challenges including unemployment, under-employment and rarely, outright discrimination. While many employers are understanding and make a genuine attempt to comprehend the many nuances of cancer treatment, patients report facing significant issues returning to work, renewing relationships and communicating about their diagnosis while maintaining some privacy and dignity. Evidence from Australia and other countries suggests that up to a third of cancer patients dont return to work. 40% report their experience of working and of future career prospects as having deteriorated. Smaller numbers report being overlooked for promotion, facing changes to their job without agreement, and feeling pressured to resign. Not surprisingly, financial difficulties are exceedingly common for cancer patients. These difficulties are linked to worse relationships and a decline in general wellbeing. One of the most significant challenges patients face is cancer-related fatigue. Fatigue is ubiquitous and corrodes every aspect of life from physical fitness to emotional health. It is also invisible. Nausea and vomiting settle quickly, hair begins to return, patients reconcile to weight fluctuations but what they report being haunted by is fatigue. Fatigue can last for months or even years after finishing treatment. It impacts the ability to travel, concentrate and even stay awake for the full day. Its neither something patients like to disclose nor what others expect to hear but the good news is that the adverse effects of fatigue on the workplace can be significantly reduced by understanding employers who are willing to adjust working hours, support alternative arrangements, and have regular consultations about an appropriate workload. Most cancer patients dont want to shirk their responsibility; they are eager to return to work and renew their commitment. Their distress comes from fearing that they must prove themselves fully fit as soon as they return lest they be deemed inadequate, but this is unrealistic. Many say that they dont need specific work assistance, but kindness and empathy goes a long way to aid recovery. A kind environment is one of the most helpful things a workplace can provide to those have been ill and are feeling their way back. Whats with the moping? I thought your chemo was done and youre back to good!, an impatient executive recently said to his thirty-year old assistant who couldnt keep up with his rapid fire dictation and had to ask him to slow down. To her great credit, my patient responded with a printout outlining the symptoms of menopause, drawing a mortified apology and rearranged work hours. I grinned with her at her gumption, but hoped that someday her experience will be anachronistic. An unprecedented era of modern technology and interventions has created optimism for many cancer patients who need not be punished twice. With their chances of survival furthered, it has never been more important to ensure that their workplace rights are respected. While many cancer patients are too unwell to work, there are growing numbers for whom the most beneficial therapy is reintegration into society. They wont stop being cancer patients, but they are defined by much more. We do them and society a disservice by not recognising their worth. We can do better. For this, we need empowered patients, an understanding society, and employers who pledge to be fair and attuned to the concerns of cancer patients that frequently lurk under the surface.