Summary: Line managers are the most influential factor in whether employees with cancer have positive workplace experiences. Yet 58% of HR managers worry about line manager capability, and only 11% of organisations provide cancer-specific training. Line managers need training that covers treatment impacts, how to have difficult conversations, and when to make adjustments. With one in two people diagnosed with cancer in their lifetime, this is a workforce reality every organisation will face.
When we talk about supporting employees with cancer, conversations often centre around HR policies, occupational health referrals and legal compliance. But research shows line managers are the single most influential factor in whether someone working with cancer has a positive or negative workplace experience.
This World Cancer Day (4 February), under the theme United by Unique, recognises that whilst we share common goals around cancer care, every person’s experience is profoundly different. This reality plays out daily in workplaces. Line managers must therefore balance the complexities of supporting individuals through their personal cancer journeys whilst maintaining team performance and meeting organisational targets.
Why line managers matter most
The Bevan Report, conducted by the Institute for Employment Studies in partnership with Working With Cancer, surveyed over 200 HR managers and found that line managers are uniquely positioned to influence return-to-work outcomes.
Line managers are the ones who:
- Have regular conversations with the employee
- Notice changes in wellbeing
- Can facilitate workload adjustments to ensure employees are not over-burdened
- Either build or erode trust through their responses
The quality of line management support can directly affect whether employees return to work after cancer, how long they stay, and whether they thrive or merely survive.
Yet the Bevan Report revealed that 58% of HR managers expressed concerns about line manager capability to support employees with cancer. This is perhaps unsurprising considering that only 11% of organisations had provided specific training, while 78% had offered no training at all.
The capability gap
Cancer brings unique challenges that generic line manager training doesn’t address. Side effects vary wildly between individuals and are unpredictable. And psychological impacts often prove more significant barriers to work than physical symptoms.
Line managers need to understand that cancer is not a linear journey to recovery. Recovery from acute treatments like chemotherapy can take years and hormone treatments for breast cancer patients continue for five to 10 years. This significantly affects people’s day-to-day lives, creating long-term support needs that traditional absence policies don’t accommodate.
Despite this complexity, the Bevan Report identified specific gaps in line manager confidence in having the right conversations with the employee. Nearly half (48%) of HR managers worried that line managers might say the wrong thing when trying to support employees with cancer, while a third (31%) lacked confidence in line managers’ ability to have difficult conversations.
What line managers need from HR
World Cancer Day’s ‘United by Unique’ theme reinforces that there is no standard approach to supporting someone with cancer. What works for one person may be entirely wrong for another. It is really important to remember that people have their own cancer journeys and different needs that can also vary for the same employee over time.
The Bevan Report makes clear that expecting line managers to navigate cancer support without proper preparation is neither fair nor effective. Line managers need training that goes beyond generic health and wellbeing content. They need to:
- Understand cancer as a fluctuating, long-term condition
- Know about treatment side effects and how these might affect work
- Practise having conversations about diagnosis, treatment and returning to work that balance compassion with operational realities
The Bevan Report found confusion about whose responsibility it is to communicate available benefits and support to employees with cancer. Only 26% of HR managers said line managers held this responsibility, whilst 63% said it belonged to HR. In reality, both need to play complementary roles.
The business case for investment
One in two people will be diagnosed with cancer in their lifetime. Almost one million people of working age in the UK are living with cancer and around 160,000 new diagnoses each year affect people of working age. This isn’t a niche issue but a workforce reality that every organisation will face repeatedly.
The costs of getting it wrong are substantial. The Bevan Report highlights that less than two thirds of people return to work or are still working a year after diagnosis and job loss affects 53% of people living with cancer.
Conversely, good line management creates retention, maintains productivity during phased returns, and builds organisational reputation.
Practical steps to help line managers with cancer support at work
Getting it right is neither expensive nor complicated. There are practical steps organisations can take to help line managers in supporting employees:
- Provide cancer-specific training. Line managers need to understand the specific challenges of cancer, including the Equality Act and reasonable adjustments, ensuring they understand their legal obligations.
- Teach how to have conversations about cancer. This includes knowing when to initiate conversations, what questions to ask, and how to create a psychologically safe environment for disclosure.
- Offer coaching, not just training. Coaching line managers through actual situations builds confidence in ways that generic training cannot.
- Clarify expectations. Develop clear guidance on what line managers should do when an employee discloses a cancer diagnosis, including when to involve HR and how to arrange occupational health referrals.
- Create protected time. Supporting someone through cancer requires regular conversations, flexibility in workload management, and patience with a non-linear recovery process.
- Support the supporters. Line managers can experience emotional strain, particularly if they have their own lived experience of cancer. Provide access to employee assistance programmes and debrief opportunities with HR.
- Make expert support accessible. Partner with organisations that provide specialist guidance. Ensure line managers know how to access this support.
World Cancer Day’s United by Unique theme offers a powerful reminder for HR. We cannot create one-size-fits-all approaches to supporting employees with cancer. We need line managers who can respond to individual needs with empathy, flexibility and competence.
