Workplace

After being diagnosed with any illness, especially a serious one such as cancer, other areas of your life are unfortunately affected as well. When your health does affect your employment, the last thing you expect is to be confronted with harassment or the threat of losing your job, income and health benefits. Despite significant gains in cancer survival rates and the passage of the ADA, people with cancer still experience barriers to equal job opportunities. One reason individuals with cancer face discrimination at work is their supervisors' and co-workers' misperceptions about their ability to work during and after cancer treatment. Even when the prognosis is excellent, some employers expect that a person diagnosed with cancer will have long absences from work or not be able to focus on duties.

Keep a detailed journal of all incidents including the date, time and what was said and by who as well as when you sought assistance from managers to resolve the matter. Ask for a meeting with our manager, human resources or union depending on you company set up. Come to the meeting organized with detailed facts and your concerns. If you have suggestions offer them as well. Under the ADA, it prohibits harassment based on disability just as other federal laws prohibit harassment based on race, sex, color, national origin, religion, or age. Harassment is actionable under the ADA when a person is subjected to offensive conduct that is sufficiently severe or pervasive to create a hostile or abusive work environment. Employees who believe that they have been harassed because of cancer may file a charge with the EEOC if you still find your personalized meetings are not resolved to your satisfaction. Keep in mind that the charge must be filed by mail or in person with the local EEOC office within 180 days from the date of the alleged violation.

Patient Advocate Foundation's publication "First My Illness, Now Job Discrimination" is a good resource as well. After being diagnosed with any illness, especially a serious one such as cancer, other areas of your life are unfortunately affected as well. When your health does affect your employment, the last thing you expect is to be confronted with harassment or the threat of losing your job, income and health benefits. Despite significant gains in cancer survival rates and the passage of the ADA, people with cancer still experience barriers to equal job opportunities. One reason individuals with cancer face discrimination at work is their supervisors' and co-workers' misperceptions about their ability to work during and after cancer treatment. Even when the prognosis is excellent, some employers expect that a person diagnosed with cancer will have long absences from work or not be able to focus on duties.

Keep a detailed journal of all incidents including the date, time and what was said and by who as well as when you sought assistance from managers to resolve the matter. Ask for a meeting with our manager, human resources or union depending on you company set up. Come to the meeting organized with detailed facts and your concerns. If you have suggestions offer them as well. Under the ADA, it prohibits harassment based on disability just as other federal laws prohibit harassment based on race, sex, color, national origin, religion, or age. Harassment is actionable under the ADA when a person is subjected to offensive conduct that is sufficiently severe or pervasive to create a hostile or abusive work environment. Employees who believe that they have been harassed because of cancer may file a charge with the EEOC if you still find your personalized meetings are not resolved to your satisfaction. Keep in mind that the charge must be filed by mail or in person with the local EEOC office within 180 days from the date of the alleged violation.

Patient Advocate Foundation's publication "First My Illness, Now Job Discrimination" is a good resource as well.

If you have worked at your new employer long enough to accumulate leave time I would utilize vacation, sick or personal days for a scheduled doctor appointment. If you find that you need more then one day or your request are frequent you should discuss with your human resources department your needs to see if accomidations are offered. Maybe you could seek a later afternoon appointment and flex. If you have been employed for at least 12 months and worked enough hours you could be eligible for Family Medical Leave assuming your employer employees the required number of employees (www.dol.gov). If you have worked at your new employer long enough to accumulate leave time I would utilize vacation, sick or personal days for a scheduled doctor appointment. If you find that you need more then one day or your request are frequent you should discuss with your human resources department your needs to see if accomidations are offered. Maybe you could seek a later afternoon appointment and flex. If you have been employed for at least 12 months and worked enough hours you could be eligible for Family Medical Leave assuming your employer employees the required number of employees (www.dol.gov).

It should not be a problem as it doesn't interfere with your ability to move/perform your job. You never have to tell your employer/future employer about your cancer status if you do not feel comfortable. You may want to mention you had a surgery that made you likely to build up fluid in your arm and you have a special sleeve you must wear. What types of questions have you been asked specifically?
Heather
www.mybreastcanceranswers.com
some helpful links for lymphedema
http://www.mybreastcanceranswers.com/the-latest-and-greatest-news/a-newtool-may-predict-lymphedema-risk-before-symptoms-appear
http://www.mybreastcanceranswers.com/lymphedema/lymphedema
It should not be a problem as it doesn't interfere with your ability to move/perform your job. You never have to tell your employer/future employer about your cancer status if you do not feel comfortable. You may want to mention you had a surgery that made you likely to build up fluid in your arm and you have a special sleeve you must wear. What types of questions have you been asked specifically?
Heather
www.mybreastcanceranswers.com
some helpful links for lymphedema
http://www.mybreastcanceranswers.com/the-latest-and-greatest-news/a-newtool-may-predict-lymphedema-risk-before-symptoms-appear
http://www.mybreastcanceranswers.com/lymphedema/lymphedema

Congrats on being done with treatment!

Your question is a tough one and a really personal one too. Everyone feels differently about this decision, my first piece of advice is for you to understand what you legally do and don't have to do so that any decision you make includes understanding that key piece, you can do some reading here http://www.cancerandcareers.org/en/at-work/Legal-and-Financial and for specific questions on your personal situation contact the Cancer Legal Resource Center at 1-866-THE-CLRC.

Next, I think it is important for you to think about the culture of the new place you are working, do they seem very tight knit and familial or is it more corporate and less intimate? Do people who have been there a long time seem to know a lot about each other outside the work realm? Other things to look for, is there another survivor on staff who has made that known to you? If so, how is he/she being treated?

Then I think you should ask yourself whether cancer being a big part of who you are also means it needs to be a big part of your work identity. Or if your experience can inform and shape the lens through which you view everything but you don't necessarily need to brand yourself with it at work. When you think this through, it is important to recognize fair or not that people have their own perceptions of what cancer means and what being a survivor looks like and you want to be sure that you are ok with how that might be received and how you might be treated once that information is out there.

It also might just be a case of waiting to see how your trajectory in this new place shapes up and choosing to tell the people who become important to you what you have been through as it organically comes up.

I hope this provides some helpful ways to think through the new environment and your decision about whether to share or not.

Best,
Rebecca

Rebecca V Nellis
Director of Programs
Cancer and Careers. Congrats on being done with treatment!

Your question is a tough one and a really personal one too. Everyone feels differently about this decision, my first piece of advice is for you to understand what you legally do and don't have to do so that any decision you make includes understanding that key piece, you can do some reading here http://www.cancerandcareers.org/en/at-work/Legal-and-Financial and for specific questions on your personal situation contact the Cancer Legal Resource Center at 1-866-THE-CLRC.

Next, I think it is important for you to think about the culture of the new place you are working, do they seem very tight knit and familial or is it more corporate and less intimate? Do people who have been there a long time seem to know a lot about each other outside the work realm? Other things to look for, is there another survivor on staff who has made that known to you? If so, how is he/she being treated?

Then I think you should ask yourself whether cancer being a big part of who you are also means it needs to be a big part of your work identity. Or if your experience can inform and shape the lens through which you view everything but you don't necessarily need to brand yourself with it at work. When you think this through, it is important to recognize fair or not that people have their own perceptions of what cancer means and what being a survivor looks like and you want to be sure that you are ok with how that might be received and how you might be treated once that information is out there.

It also might just be a case of waiting to see how your trajectory in this new place shapes up and choosing to tell the people who become important to you what you have been through as it organically comes up.

I hope this provides some helpful ways to think through the new environment and your decision about whether to share or not.

Best,
Rebecca

Rebecca V Nellis
Director of Programs
Cancer and Careers.

Hi there,

It would help to know a little bit more about the particulars of your workplace like was it close knit before you were diagnosed and so this treatment is different from how you related to them before, are the people you work with people you consider friends in the larger frame of your life, are these people who have either never been touched by cancer or been touched by cancer before, etc. In general, your options seem to me to be:

1) Try and sit down with your co-workers and prepare them for what’s coming up so they don’t start guessing the worst. Then focus the conversation on how you plan to cope and get work done, to alleviate any worries. Often, people will take their cues from you on how to handle the situation and if you seem to have it under control; your colleagues will react accordingly. This sit down might help you understand why they are treating you differently than before your cancer and make it easier to move forward with them. We have a bit of co-worker content on the site here: http://www.cancerandcareers.org/en/coworkers and this section is growing.

2) You could speak to your supervisor or HR about the situation with your co-workers and see if they have any thoughts on ways to improve the environment for you. Perhaps if it came from them it would be easier, of course the opposite is also possible.

3) You might also want to think about what it is you need from your co-workers and if it is possible to get it elsewhere and just have work be work, again this very much depends on answers to my earlier questions.

I know none of this is an exact solution, unfortunately there isn't a perfect answer for human nature. The best you can do is see if you can figure out what is causing their behavior and then decide if you have the energy/desire to work to alleviate the cause. Of course, if you feel there is something deeper going on and it verges on some sort of legal infringement then you might want to contact the Cancer Legal Resource Center to discuss your options (1-866-THE-CLRC).

Good luck!

Best,
Rebecca

Rebecca V Nellis
Director of Programs
Cancer and Careers Hi there,

It would help to know a little bit more about the particulars of your workplace like was it close knit before you were diagnosed and so this treatment is different from how you related to them before, are the people you work with people you consider friends in the larger frame of your life, are these people who have either never been touched by cancer or been touched by cancer before, etc. In general, your options seem to me to be:

1) Try and sit down with your co-workers and prepare them for what’s coming up so they don’t start guessing the worst. Then focus the conversation on how you plan to cope and get work done, to alleviate any worries. Often, people will take their cues from you on how to handle the situation and if you seem to have it under control; your colleagues will react accordingly. This sit down might help you understand why they are treating you differently than before your cancer and make it easier to move forward with them. We have a bit of co-worker content on the site here: http://www.cancerandcareers.org/en/coworkers and this section is growing.

2) You could speak to your supervisor or HR about the situation with your co-workers and see if they have any thoughts on ways to improve the environment for you. Perhaps if it came from them it would be easier, of course the opposite is also possible.

3) You might also want to think about what it is you need from your co-workers and if it is possible to get it elsewhere and just have work be work, again this very much depends on answers to my earlier questions.

I know none of this is an exact solution, unfortunately there isn't a perfect answer for human nature. The best you can do is see if you can figure out what is causing their behavior and then decide if you have the energy/desire to work to alleviate the cause. Of course, if you feel there is something deeper going on and it verges on some sort of legal infringement then you might want to contact the Cancer Legal Resource Center to discuss your options (1-866-THE-CLRC).

Good luck!

Best,
Rebecca

Rebecca V Nellis
Director of Programs
Cancer and Careers

Hi there,

This is a big one that we hear about frequently as people transition back to work. Below are some tips/suggestions that we know to be simple and effective to get you thinking about how to manage side effects at work.

First off forget about multitasking. As hard as that may be in our super connected fast paced world, for many people managing fatigue and concentration challenges during or post-treatment successful multitasking is near impossible and very frustrating. Instead, write down a list of priorities and then turn off your email, phone and instant messenger and focus on accomplishing one thing at a time. Make sure to drill big projects down into manageable tasks for that very important feeling of accomplishment that comes with ticking things off your list.

Second, literally write everything down (from meetings to in passing ideas to people you need to follow up with to groceries), so if you forget you’ll always have a record. And keep one notebook with all your "to do" things so they are all in one place and take it everywhere so you are never scrambling without it.

In terms of your actual workspace, ban clutter and clear your desk or work area so that when you are going through tasks one by one there aren't a million distractions and you don't feel overwhelmed by all that still needs to be finished.

Third, rehearse everything from presentations to work updates and even phone calls so that you feel practiced, professional and focused.

Other things to consider, is your job flexible enough to let you ease back into the work world either by starting part-time and ramping up to full time as you get your feet under you again or by telecommuting one or two days a week for a while to eliminate the commute part of your day. Obviously, for some professions (surgeons, teachers, toll booth collectors) telecommuting isn't a feasible option so you have to think through what would be possible given your particular situation. Or, if your side effects are more debilitating do you need to look into availing yourself of any legal rights you may have. To determine what you might be eligible for I recommend you review some of our articles here: http://www.cancerandcareers.org/en/at-work/Legal-and-Financial and then call the Cancer Legal Resource Center (1-866-THE-CLRC) to discuss your specific situation.

Finally, remember to take a moment for yourself in your day, no matter how busy or how stressful. Try taking a break, with a few deep breaths to refocus or take a walk either around the office or the block.

Hope this helps!

Best,
Rebecca

Rebecca V Nellis
Director of Programs
Cancer and Careers Hi there,

This is a big one that we hear about frequently as people transition back to work. Below are some tips/suggestions that we know to be simple and effective to get you thinking about how to manage side effects at work.

First off forget about multitasking. As hard as that may be in our super connected fast paced world, for many people managing fatigue and concentration challenges during or post-treatment successful multitasking is near impossible and very frustrating. Instead, write down a list of priorities and then turn off your email, phone and instant messenger and focus on accomplishing one thing at a time. Make sure to drill big projects down into manageable tasks for that very important feeling of accomplishment that comes with ticking things off your list.

Second, literally write everything down (from meetings to in passing ideas to people you need to follow up with to groceries), so if you forget you’ll always have a record. And keep one notebook with all your "to do" things so they are all in one place and take it everywhere so you are never scrambling without it.

In terms of your actual workspace, ban clutter and clear your desk or work area so that when you are going through tasks one by one there aren't a million distractions and you don't feel overwhelmed by all that still needs to be finished.

Third, rehearse everything from presentations to work updates and even phone calls so that you feel practiced, professional and focused.

Other things to consider, is your job flexible enough to let you ease back into the work world either by starting part-time and ramping up to full time as you get your feet under you again or by telecommuting one or two days a week for a while to eliminate the commute part of your day. Obviously, for some professions (surgeons, teachers, toll booth collectors) telecommuting isn't a feasible option so you have to think through what would be possible given your particular situation. Or, if your side effects are more debilitating do you need to look into availing yourself of any legal rights you may have. To determine what you might be eligible for I recommend you review some of our articles here: http://www.cancerandcareers.org/en/at-work/Legal-and-Financial and then call the Cancer Legal Resource Center (1-866-THE-CLRC) to discuss your specific situation.

Finally, remember to take a moment for yourself in your day, no matter how busy or how stressful. Try taking a break, with a few deep breaths to refocus or take a walk either around the office or the block.

Hope this helps!

Best,
Rebecca

Rebecca V Nellis
Director of Programs
Cancer and Careers

Okay, first of all, I have to say that I love this question, because it taps into so many great things (boundaries, support, self-care, etc). Next, I'll tell you that one of the reasons I put so much time and effort into making my office (and the virtual aspects of my practice) safe space for my patients is that there are plenty of times when home and work don't feel all that safe. We have all had the experience of someone asking questions that we don't feel comfortable answering (or that we're pretty sure they don't really want an honest answer to). Most of us have had the experience of receiving advice that feels unhelpful or even intrusive. Unfortunately, many people just don't know how to respond helpfully when someone we care about has been diagnosed with cancer or other serious illnesses. Finally, this list of suggestions is just a starting point. Creating safe emotional space is the result of many healthy coping habits.
1. First, start with yourself. Before you can explain what you need to family and co-workers, you need to explain it to yourself. This can be tricky, because what you need may change from day to day (or minute to minute). The more in touch you are with your needs, the better you will be able to help others work with you to meet them.
2. Practice lots of self-compassion. If you're judging yourself for feeling tired, scared, or frustrated, it will be harder to get good support for yourself.
3. Start with your most trusted family member or co-worker. Help them understand what safe space means to you. That might include not talking about your diagnosis unless you initiate the conversation. Or it might mean that they ask you so that you don't have to bring it up. The better you can define your needs, the better they'll be able to work towards them (It might help to point them toward articles like my "Five Steps for More Compassionate Listening:" http://bit.ly/nPbRgk).
4. It may help to develop a "stoplight" system. If you tell family or coworkers that it's a green day, then then can interact with you normally. If you tell them that it's yellow, they should tune in to decreasing your stress. If you tell them that it's a red day, then your key supports should focus on taking care of you.
5. Remember that you are allowed to have all of your feelings, at any time. If you are not getting the support you need, you are allowed to share less information, to create a buffer, or to look for additional support.

Fundamentally, creating a safe space starts with your own belief that you deserve that space and your ability to learn and state your own needs.

I hope that's on track for what you need. Please feel free to ask for more clarification if you need it! Okay, first of all, I have to say that I love this question, because it taps into so many great things (boundaries, support, self-care, etc). Next, I'll tell you that one of the reasons I put so much time and effort into making my office (and the virtual aspects of my practice) safe space for my patients is that there are plenty of times when home and work don't feel all that safe. We have all had the experience of someone asking questions that we don't feel comfortable answering (or that we're pretty sure they don't really want an honest answer to). Most of us have had the experience of receiving advice that feels unhelpful or even intrusive. Unfortunately, many people just don't know how to respond helpfully when someone we care about has been diagnosed with cancer or other serious illnesses. Finally, this list of suggestions is just a starting point. Creating safe emotional space is the result of many healthy coping habits.
1. First, start with yourself. Before you can explain what you need to family and co-workers, you need to explain it to yourself. This can be tricky, because what you need may change from day to day (or minute to minute). The more in touch you are with your needs, the better you will be able to help others work with you to meet them.
2. Practice lots of self-compassion. If you're judging yourself for feeling tired, scared, or frustrated, it will be harder to get good support for yourself.
3. Start with your most trusted family member or co-worker. Help them understand what safe space means to you. That might include not talking about your diagnosis unless you initiate the conversation. Or it might mean that they ask you so that you don't have to bring it up. The better you can define your needs, the better they'll be able to work towards them (It might help to point them toward articles like my "Five Steps for More Compassionate Listening:" http://bit.ly/nPbRgk).
4. It may help to develop a "stoplight" system. If you tell family or coworkers that it's a green day, then then can interact with you normally. If you tell them that it's yellow, they should tune in to decreasing your stress. If you tell them that it's a red day, then your key supports should focus on taking care of you.
5. Remember that you are allowed to have all of your feelings, at any time. If you are not getting the support you need, you are allowed to share less information, to create a buffer, or to look for additional support.

Fundamentally, creating a safe space starts with your own belief that you deserve that space and your ability to learn and state your own needs.

I hope that's on track for what you need. Please feel free to ask for more clarification if you need it!

Overall make sure you are aware of both your body and mind. Your body will have clues as to your stress level through things like heart rate, respirations, persperation, trembling, muscle tension, fidgeting, nausea, diarrhea, etc. Your mind will give you clues like difficulty concentrating or focusing, racing thoughts, obsessive thoughts, catastrophic thoughts, fear provoking thoughts, etc.

Managing stress in the workplace is the same as managing stress anywhere. Start by de-activating the Fight/Flight response by changing your breathing pattern. Make your breathing longer, slower, deeper and more regular. Get to a quieter area and stretch muscles; try to force yourself to yawn. If you have a workplace that includes a gym or workout area, burn off some of that energy (exercise actually makes the brain think and learn better anyway).

Once you have started to get your bodily reaction calmed down, focus on changing the content of your thinking. If you are fixated on deadlines and failing and getting fired, you're just scaring yourself to death. Think about what you need to accomplish and begin by prioritizing. Break big tasks into little steps and start accomplishing them. When your mind jumps back to "You have to get this done NOW!" tell yourself that's just what you are doing; getting it done, one step at a time.

If your stress involves relationships with co-workers, supervisors or clients/customers, then take a look at what is common about the people who are frustrating or stressing you out. Try to identify the trigger and see if you can innoculate yourself against it. Try to see what their purpose is in behaving the way they do and anticipate their actions in the future. Tell yourself it doesn't really matter that it happens.

Think about your work not as who you are but something you do. Disconnect your identity from your job title. Your worth as a person is not related to how much you get done or if you met a particular deadline.

Look for the things in your life for which you are grateful and keep them in your mind. Especially when those thngs are benefitted by the work that you do or the check you bring home at the end of the week.

I keep an image of the universe in my computer to pull up and stare at now and then. I put a little tiny red arrow on it with the words, "You are here." It helps me remeber how inconsequential most things that happen in life really are. After a few minutes, some deep breaths and a renewed determination, I go back to it... and git'r dun! Overall make sure you are aware of both your body and mind. Your body will have clues as to your stress level through things like heart rate, respirations, persperation, trembling, muscle tension, fidgeting, nausea, diarrhea, etc. Your mind will give you clues like difficulty concentrating or focusing, racing thoughts, obsessive thoughts, catastrophic thoughts, fear provoking thoughts, etc.

Managing stress in the workplace is the same as managing stress anywhere. Start by de-activating the Fight/Flight response by changing your breathing pattern. Make your breathing longer, slower, deeper and more regular. Get to a quieter area and stretch muscles; try to force yourself to yawn. If you have a workplace that includes a gym or workout area, burn off some of that energy (exercise actually makes the brain think and learn better anyway).

Once you have started to get your bodily reaction calmed down, focus on changing the content of your thinking. If you are fixated on deadlines and failing and getting fired, you're just scaring yourself to death. Think about what you need to accomplish and begin by prioritizing. Break big tasks into little steps and start accomplishing them. When your mind jumps back to "You have to get this done NOW!" tell yourself that's just what you are doing; getting it done, one step at a time.

If your stress involves relationships with co-workers, supervisors or clients/customers, then take a look at what is common about the people who are frustrating or stressing you out. Try to identify the trigger and see if you can innoculate yourself against it. Try to see what their purpose is in behaving the way they do and anticipate their actions in the future. Tell yourself it doesn't really matter that it happens.

Think about your work not as who you are but something you do. Disconnect your identity from your job title. Your worth as a person is not related to how much you get done or if you met a particular deadline.

Look for the things in your life for which you are grateful and keep them in your mind. Especially when those thngs are benefitted by the work that you do or the check you bring home at the end of the week.

I keep an image of the universe in my computer to pull up and stare at now and then. I put a little tiny red arrow on it with the words, "You are here." It helps me remeber how inconsequential most things that happen in life really are. After a few minutes, some deep breaths and a renewed determination, I go back to it... and git'r dun!

Remember that your worst fears are rarely ever realized. Mark Twain once said, "I am an old man and have known a great many troubles, but most of them never happened." The brain is a problem solving organ and it can latch onto an emotion and try to problem solve it until you feel a hundred times worse.

Try eliminating caffiene and stimulants. Do some early morning deep breathing, meditation, stretching/yoga or prayer. Engage in guided imagery or positive imagery where you see yourself engaging in your daily work seccussfully and without problems.

Sit down and write out some of the fears that you have before you leave the house. Just take about 10 to 15 minutes. As you do that challenge yourself as to how reasonable that fear sounds. You might reason out any power that trigger had before you even step outside your door.

Give yourself permission to disengage while you are at work in case you start to feel trapped or overly anxious. Simply say things like, "I don't have to stay here if I feel panicked, I can go but it's not that bad yet so I can stay a little longer."

Maintain awareness of your stress level and body tension throughout the day and use the breathing and stretching at your desk to continue to manage stress. Talk to yourself in a compassionate way, acknowledge your fear but reason with it. Don't let it cause you to catastrophyze into panic. Remember that your worst fears are rarely ever realized. Mark Twain once said, "I am an old man and have known a great many troubles, but most of them never happened." The brain is a problem solving organ and it can latch onto an emotion and try to problem solve it until you feel a hundred times worse.

Try eliminating caffiene and stimulants. Do some early morning deep breathing, meditation, stretching/yoga or prayer. Engage in guided imagery or positive imagery where you see yourself engaging in your daily work seccussfully and without problems.

Sit down and write out some of the fears that you have before you leave the house. Just take about 10 to 15 minutes. As you do that challenge yourself as to how reasonable that fear sounds. You might reason out any power that trigger had before you even step outside your door.

Give yourself permission to disengage while you are at work in case you start to feel trapped or overly anxious. Simply say things like, "I don't have to stay here if I feel panicked, I can go but it's not that bad yet so I can stay a little longer."

Maintain awareness of your stress level and body tension throughout the day and use the breathing and stretching at your desk to continue to manage stress. Talk to yourself in a compassionate way, acknowledge your fear but reason with it. Don't let it cause you to catastrophyze into panic.