The workforce comprises increasing numbers of people living with a cancer diagnosis. One in two of us will now face a cancer diagnosis in our lifetime with almost 340,000 people in the UK are diagnosed with cancer every year.

Furthermore, in 2012 Macmillan Cancer Support estimated that there were over 750,000 people of working age with cancer. Since then that number will have increased significantly as treatments and survival rates have improved.  Because of this, and because many of us are working longer, successfully managing an employee with cancer will become a far more common experience for line managers, and one of the most challenging.

The benefits of supporting an employee with cancer

Supporting an employee to return to work after their treatment has many benefits:

• It reduces the cost of long term absence and a timely, well-planned and executed return-to-work process will have substantial benefits for an employee’s wellbeing and rehabilitation

• It equips line managers and HR with the knowledge, skills & confidence to manage work and cancer well

• It avoids the risk of expensive/time consuming legal claims and reputational damage

• It helps companies to really be an ’employer of choice’

Many cancer survivors report negative experiences and discrimination in the workplace

The Equality Act 2010 protects all cancer survivors from discrimination inside and outside the workplace from the point of diagnosis for the rest of their lives, but a Macmillan survey in 2016 showed that despite the legislation, 1 in 5 people who return to work after cancer face discrimination. This is despite the fact that cases of discrimination can result in an organisation experiencing severe reputational damage and making costly out of court settlements [employment tribunal awards are not capped in cases of disability discrimination, and cancer is classed as a disability].

Why do things go wrong?

Problems tend to arise between employees and their line managers for a number of reasons but in particular because recovering from cancer is not a linear process and typically takes over 12 months.

Two factors are important here:  an insufficient understanding of the typical impact of cancer on an individual, and ineffective communication between the employer and employee. These two factors often impact the wider team and sometimes cause friction and a hostile work environment.

1. Insufficient understanding of the impact of cancer

Physical side effects like fatigue and ‘chemo’ brain can take many months, occasionally years, to improve. Some side effects like lymphedema may only occur several months after treatment has finished.  Most employees with cancer do not know what side effects to expect and when – and doctors often do not provide sufficient advice about this.

Emotional side effects – anxiety, depression, loss of confidence – can occur at any time. In some cases, depression may be severe and made more complex by other health, family or personal problems that pre-dated or resulted from the diagnosis. The line manager may lose confidence in their employee as a result of this, particularly if their employee is still struggling with work several months after their return to work.

2. Ineffective communication

Employers often hesitate to talk about cancer at work – they may feel awkward and concerned about upsetting their employee. Equally they may just be busy coping with a depleted team and strict deadlines and feel they are unable to make the time for individual members of staff.

For many employees there may be batteries of invasive tests before they are given a cancer diagnosis, and then during treatment a diagnosis and prognosis may change.  Because of this, many employees do not know what to tell their employees and when and may decide not to say anything at all until they are certain about their situation. During this period, an employee’s behaviour might seem erratic and unpredictable; they might seem emotional or even aggressive when asked about themselves.

Some employees fiercely guard their privacy and say very little for fear of too many people knowing about their cancer.  The apparent stigma of having cancer is still real for many people.

Employees do not want to be seen as a ‘problem’. They may fear that a cancer diagnosis will damage their career prospects and their pay, and as a result may struggle to cope with work, for example, longer hours, demanding duties, stressful situations, and reject well-meaning offers of help.

Sickness policies do not always cater for cancer survivors

An employer’s sickness policies may not cater sensitively for someone who needs a longer phased return than 12 weeks.

Given that it takes most cancer survivors up to 12 months or more to recover from their treatment, and that they are, under the Equality Act, entitled to reasonable adjustments throughout their employment, it is worth checking whether policies and processes cater for this and that line managers are aware of the implications for the way they manage employees affected by cancer.

Coaching can make a significant difference

In our experience coaching employees with cancer and at the same time providing timely, expert but practical, business-oriented advice to line managers can have a significant impact on whether an employee makes a successful, long term return to employment.

HR departments should review their policies and processes for supporting cancer survivors as a matter of urgency.

Given all of the above, it is strongly recommended that employers review their policies and processes for supporting cancer survivors in the workplace and consider some or all of the following:

1. Understand the incidence of cancer in the workplace and the percentage of people returning to work successfully. At present few employers gather this information.

2. Review sickness and absenteeism policies to ensure they cater for cancer as well as other forms of chronic disability, and are in line with the provisions of the Equality Act 2010

3. Put in place clear return to work processes and provide examples of reasonable adjustments e.g. having short breaks during the day, a temporary change of duties, flexible hours and so on.

4. Put in place coaching and counselling to support employees and their managers, ideally at the point of diagnosis but particularly a few weeks before an employee is due to return to work

5. Train line managers as well as HR advisors and business partners in how to manage work and cancer

6. Encourage the formation of voluntary peer support groups for cancer survivors within the company

In 2017 the World Health Organisation reported that cancer is one of the leading causes of morbidity and mortality worldwide, with approximately 14 million new cases in 2012.  The total annual economic cost of cancer in 2010 was estimated at approximately US$ 1.16 trillion. We simply can’t afford not to give cancer survivors the support they need to help them recover and to continue to contribute to the world of work, to their wider communities and to society as a whole.