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Recent strides in treatment and side-effect management are making it possible for more and more people with cancer to enjoy a quality of life that allows them to continue working during treatment. The workplace can be a supportive environment for people facing a cancer diagnosis; it can contribute to a sense of normalcy and provide a feeling of community from colleagues, not to mention financial stability and health insurance benefits.

Many working-age adults who are cancer patients shoulder the tremendous financial strain of their treatment; they have no choice but to continue working or go back to work when they end treatment, regardless of whether or not they feel ready to return to their jobs. An important discussion to have with your patients is about their employment status, whether or not to disclose their diagnosis to their employers, and what rights they are entitled to.

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For many adults who choose to continue to work during and after treatment, the issue of disclosure looms large in their minds. Some may worry that they will be seen as a liability to their employer and perhaps be terminated from their position if they disclose their diagnosis. Others, even those who describe themselves having a good relationship with their supervisor and colleagues, may fear that they will encounter subtle discrimination.

Encourage those patients who decide to tell their employers about their cancer to learn as much as possible about their diagnosis and treatment schedule before discussing it. Presenting a plan of action to their supervisor will not only help your patients feel more in control of their situation, it may help ease the supervisor’s or coworkers’ concerns about how work will keep moving forward as the patient copes with his or her illness.

While the decision to disclose a cancer diagnosis is a personal one, employees need to inform their employer of their status in order to be protected by the Americans with Disabilities Act (ADA) and the Family and Medical Leave Act of 1993 (FMLA). The Americans with Disabilities Act prohibits discrimination in the workplace related to a disability or a perceived disability, and requires employers to provide “reasonable accommodations” for qualified employees with a disability. Organizations with 15 or more employees must adhere to ADA guidelines. You and your patients can learn more about this act by visiting www.ada.gov.

Americans with Disabilities Act In order to be protected under the Americans with Disabilities Act, patients must meet the ADA’s definition of a disabled person, be able to perform the job’s essential functions, and not pose a risk to colleagues’ health and safety. Some common workplace accommodations that your patients may wish to explore include modifying their personal workspace to maximize comfort and productivity, or a temporary change in job responsibilities. Urge patients to work with their supervisor to create a schedule that accommodates their treatment schedule and energy level. Many employers create a flexible work schedule to allow their employees’ treatment schedule and doctor appointments. Your patients may propose options to their employer such as reducing the number of hours they work, telecommuting full-time or part-time, or job sharing. No matter what schedule they agree on with their employer, encourage patients to schedule periodic breaks to keep their energy up.

Family and Medical Leave Act Another key piece of legislation to inform your patients about is the Family and Medical Leave Act, which provides employees who are affected with a serious illness with job protection for up to 12 weeks of unpaid leave and continued benefits during this period of time. FMLA benefits are available to both patients and caregivers. More information about this act is available at www.dol.gov.

Perhaps the most important message to impart to your patients is that there are many available resources that can help people coping with cancer in the workplace. CancerCare (www.cancercare.org; 800-813-HOPE [4673]) provides free support services for anyone affected by cancer, including counseling, support groups, and financial assistance. Leading experts in oncology provide up-to-date information on a variety of topics during CancerCare‘s free Connect Education Workshops, including coping with cancer while continuing to work and after treatment ends. Cancer and Careers (www.cancerandcareers.org) is another excellent resource for information about coping with cancer in the workplace.

You can also refer patients to the Job Accommodation Network (askjan.org), a free service that answers patients’ questions about job accommodations, the Americans with Disabilities Act, and related legislation that protects the rights of people coping with cancer in the workplace. Patients who feel they have received unfair treatment in the workplace may wish to contact the Equal Employment Opportunity Commission (www.eeoc.gov; 800-669-4000), a governmental agency that enforces federal laws prohibiting discrimination based on a person’s race, color, religion, sex, national origin, age (40 years or older), disability or genetic information. ONA

Helen Miller is CEO of CancerCare.