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Are you ready to support workers affected by cancer?

06 February 2015

Are you ready to support workers affected by cancer?

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This year, World Cancer Day (4 February 2015) ran with the tagline: 'not beyond us', emphasising what already works and all the positive ways Governments, health bodies and individuals can manage the disease. But employers also need to be a part of the solution.

Of the 2.5 million people currently living with cancer in the UK, a third are estimated to be of working age. And getting back to work is really important for recovery from cancer – enabling those affected to regain confidence and purpose, to define themselves as potent, successful people, rather than just ‘that person with cancer’.

Now that survival rates for cancer are at their highest ever level in England, the benefits to the organisation from people returning to work after a cancer diagnosis are also immense; allowing employers to retain valuable skills and knowledge and demonstrate their commitment to their people. But how many employers are prepared for people returning to work following cancer, or have a policy for understanding and supporting those who want to get back to work?

Understanding workers affected by cancer

The good news on cancer survival rates is a success story for those involved in research, health services and the patients themselves. But the reality is that surviving an initial cancer diagnosis can be only the beginning of a need for long-term support both physically and psychologically.

Around a quarter of people treated for cancer in the UK continue to need particular NHS care, even after being entirely cleared of the disease. An employee returning to work may have undergone extensive medical procedures: surgery, chemotherapy, radiotherapy, mixed with prescribed drugs (like tamoxifen for breast cancer patients, testosterone suppressant drugs for prostate cancer, steroids and immunity enhancing drugs) with short, medium and long term effects on cognition and physical abilities.

Problems with memory and extreme lethargy are often cited as resulting from radiotherapy for example. The employee might look the same as they did prior to the cancer diagnosis, and be physically well, but find themselves unable to function properly, unaware of the psychological side effects of their treatment and just how long some of these effects can last.

The psychological consequences of a cancer diagnosis and the cancer treatment can be damaging and restrictive in the workplace. Even when an employee is in remission their sense of the world, its stability and security, will have been seriously shaken. This is likely to lead to a loss of self-confidence, a lower threshold of tolerance for dealing with any problems, more exasperation with colleagues and managers at work. In particular, employers are likely to see a change in values. Cancer often makes people reflect on what is important in their lives, and it's possible that working long hours, building a career, and even day-to-day work tasks can seem trivial and meaningless when you're faced by your own mortality. Post-treatment it's also fairly common for cancer survivors to be diagnosed with depression, once the focus of fighting cancer within the hospital environment is taken away and they have to start dealing with issues that have either come up during the treatment, or that they put on hold whilst recovering.

Cancer support and the need for preparation

There are a lot of spoken and unspoken emotions around cancer diagnosis and recovery, which can easily overwhelm the commonsense professional decisions that need to be made. The first rule in supporting employees with cancer is therefore not to be reactive.

HR needs to think through in advance what questions need to be asked when a diagnosis is made and prepare policies and templates for discussion with line managers for each stage of the situation, including when the employee wants to return to work.

This preparation avoids awkwardness and embarrassment, when a clear head and real support is needed. Some good stock questions to use at the basis of sensible and objective conversations include: 

”How are you feeling about work?”

“What changes have you noticed in yourself?”

“What support are you thinking you might need from the workplace?”

“How would you like the communication managed?”

How not to rehabilitate workers affected by cancer

Managers need to be briefed on the importance of listening, not getting caught up in the rush to get a valued member of the team back into work, and most of all generating a sense of normality. Make sure there are processes in place for regular and open conversations about the return, how it's going in terms of pace etc.

A recent example of how not to do things occurred where the employee wasn’t involved in decisions about her rehabilitation. All the managers involved made decisions with the best of intention, but not actually in the best interest of the employee. The employee was an Office manager in a busy operation office, and on her return the managers wanted to reduce the stress for her. Without her input, they organised for her to work at a near-by office, which was non-operational, smaller and quieter. The employee was actually looking forward to returning to her busy role, where she was well known, popular and where she could concentrate on her work, and not be defined as the ‘ill-person’. The move to the new office caused her to feel sidelined, and reinforced the feeling that she was the ill-person who needed special treatment.

After she called the Validium EAP in confidence to discuss her feelings, we were able to give her the confidence to talk to her managers about what would actually work best for her and the need for two-way communication about the decisions being made.

The importance of building resilience

The best form of preparation for your workforce when dealing with the implications of conditions such as cancer, long-term stress and chronic illness, is to develop their personal resilience.

Cases of cancer can have a ripple effect across groups and departments of employees, and building resilience is a useful way of helping everyone affected.

Key elements of resilience include:

  • the existence  and promotion of formal and informal support networks, which can include managers, mentors, coaches and peers
  • the opportunity to engage with people in a meaningful way, through discussion, learning, and off-loading
  • encouraging optimism, and positive thinking
  • developing personal authority and autonomy
  • establishing healthy routines

These tend to be very personal and need to work for each employee, but for example might be around taking regular breaks, flexible working hours, or the chance to get out of the work environment.

In the past, employee wellbeing was often seen as more of a theoretical concept, that it would be a 'good' thing to do. The increasing prevalence of cancer and its impacts on society are just another indication of why wellbeing matters more than that. There can't be an enforced split between work and the rest of people's lives without serious repercussions for employers.