With advances in treatment and long-term survivorship, we now talk about the ‘cancer journey’. For those living with cancer, and for those without, work plays a very important part in our life’s journey. It not only provides financial stability, but a sense of normality, routine, and self-esteem. And cancer patients often crave normality and routine wherever they can maintain it in a time that can often feel chaotic.

How does chemotherapy affect employees?

The side effects of chemotherapy and radiotherapy vary for everybody, but the common side effects are unpleasant at best. Patients can be left feeling fatigued and nauseated; they can suffer from hair loss, and a sore mouth and skin; they can bruise more easily; and be at risk of bleeding and diarrhoea to name just a few side effects.

On top of this, memory and concentration levels can be adversely affected, and this can worsen as treatment progresses. This common phenomenon is often referred to as ‘Chemo Fog’ and can lead to loss of confidence in professional ability.

All of this combined can make the workplace an uninviting environment for people going through this process. Employees can feel self-conscious if their appearance has been affected or worry about colleagues being unsupportive or over sympathetic. Dressing in formal workwear can even cause pain and discomfort for patients still recovering from surgery, or if radiotherapy has caused burning of the skin.

Work is good for your health

It is widely known that decent, satisfying work is good for our mental health. Indeed, the Royal College of Psychiatrists states that “There is good evidence that being out of work or ‘workless’ is bad for your health”, so it is important to look for ways to support employees to stay at work or return to work as soon as possible where appropriate.

The cancer journey can be a lonely struggle, but maintaining work patterns helps patients keep mentally active, maintain a sense of purpose, and provide structure and opportunities to achieve.

Many people undergoing cancer treatment are perfectly capable of carrying out at least some aspects of their role and can still be a valuable asset to your business. It also allows the individual to stay connected with colleagues and not feel so isolated, and maintains a sense of normality in a world that suddenly feels frightening.

The advantages of working from home

By allowing employees undergoing chemotherapy to work from home, it may help them perform their role better than they might at work.

Employees benefit from:

• Better ability to concentrate due to lack of distraction

• Reduced anxiety and better ability to manage embarrassing side effects in a private space

• Being able to wear comfortable clothes rather than formal workwear

• Keeping mentally active and healthy, and having purpose and structure to their day

• Not having to commute, and an ability to work around episodes of fatigue

• Using skype and conferencing facilities to connect with colleagues, attend meetings and interact without needing to physically be present in the office, which reduces the sense of isolation or disconnection

And employers benefit from:

• Retaining valuable employees and their knowledge and expertise

• Being a supportive employer and encouraging loyalty

• Reduced disruption to teams and processes

• Easier re-integration of employee when they are ready to return to the workplace

What do you need to consider?

In most cases, it is not as simple as just telling your employee to work from home until they are recovered. There are many jobs, often more manual roles, which cannot be easily transferred to the home environment, so it is necessary to consider whether alternative roles are available.

Similarly, existing roles that can be carried out from home may need to be adapted to fit in with the employee’s health and lifestyle whilst they undergo treatment. High intensity jobs may need to be scaled back to reduce the time and energy required.

The fatigue and memory loss associated with cancer and chemotherapy may well mean your employee cannot perform to their usual standard and pace. It is important that this is acknowledged and managed accordingly. It is important to have an awareness of short term cognitive changes and the effect that perception of cognitive ability can have on the individual’s confidence and perception of whether they can continue to or ever return to work.

It’s also important to look at how the employee is being affected, and what they can reasonably achieve from home whilst dealing with their combination of side effects.

Common considerations:

• Can their role be performed from home or does it need adapting or changing, and is there another suitable role available if so?

• Can the workload be reduced to accommodate periods of fatigue and time off for treatment?

• Does any special equipment need to be purchased to enable your employee to work from home?

• How will you communicate with your employee and how often?

• What pressures are associated with the role, can they be reduced, or responsibility shared with other team members?

• Do you have a home working policy in place?

• What impact will this have on the rest of your team?

• What is the expected timeframe for returning to the workplace?

How occupational health can help you

It can be daunting for employers trying to consider the needs of your employee versus the needs of your business whilst facing a number of unknowns.

An occupational health (OH) specialist can be valuable in such situations as they are experts in health and work, offering advice that takes into consideration the needs of both parties.

Being medical professionals, OH can help fill in the blanks about what to expect. They may be able to offer advice about adjustments that might facilitate home working, what you can reasonably expect from your employee, and time frames, as well as any other questions you might have.

An OH professional is able to have an in-depth discussion with the employee about their treatment and side effects, addressing their more personal issues and fears. They are also well placed to have the more difficult discussions regarding being realistic about what the employee is going to be able to achieve.

Managing expectations helps the employee to accept these normal and short term changes and aids put in place to help maintain the workload.

Managing expectations early on means you avoid the subsequent loss of self-esteem or self-doubt as both the employee and employer recognise its short term nature and are able to celebrate the achievements of the employee rather than focus on what they cannot do.

Next steps

If you have an employee who is undergoing or about to undergo cancer treatment, it is important to have an open and frank discussion with them about whether home working is an option.

If you need more advice, seek guidance from an OH specialist, and discuss with the employee what you are going to ask them. This will pave the way for a clear path forward, where both you and your employee can find a solution to help maintain balance in what will be, for your employee, probably the most challenging time of their life.