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Working Through Cancer: Career Considerations During and After Treatment

Network - Summer 2010

By Mary Brolley
When she was diagnosed with cervical cancer in 2003, Marisa Ramirez wasn’t sure how she’d balance cancer treatment and employment.

A media relations representative for Interfaith Ministries for Greater Houston, Ramirez didn’t know how chemotherapy and radiation would affect her, or how much time she’d need to recover from each treatment.

Luckily, she had an understanding boss. “I was fortunate — she was very flexible with me. As time went on, I learned that I might be OK the day of treatment, but three days later it would really hit me. She supported me all the way.”

For Ramirez, working was a constant — an anchor — when her world seemed out of control. “I really didn’t know who I was going to be as a cancer patient. But I knew how to go to work Monday through Friday, doing media relations for Interfaith Ministries.

“I put my back up against that, and it helped me be more positive.”

Of course, not all cancer patients can keep working during treatment. Certain types of cancer or treatments might require a longer recovery time. And those who can might choose to take sabbaticals from their jobs to concentrate on getting treatment, then getting healthy.

First steps for those who must work through treatment

For the many cancer patients who must work to keep their health insurance, taking a break from employment is not an option. In that case, patients must figure out how to keep their jobs while feeling tired, anxious and mentally fuzzy.

And first they might have to wrestle with the most basic choice: whether or not to tell their employer they have cancer. Factors in the decision may be their relationship with their supervisor, the culture of the workplace and the flexibility of the job itself.

To take the time for treatment appointments and to keep them informed, most patients do decide to tell their supervisor or their human resources department staff.

What and how much to reveal? This is a difficult question, because, at least at first, it may be hard to predict when appointments will be scheduled and how you’ll feel during treatment.

However, if patients can sit down with their health care team once a treatment plan has been chosen, they can find out what these medical experts predict in terms of treatment side effects, as well as the timing of necessary appointments.

Make a plan, know your rights

Then, patients might list their work duties and devise a plan for getting them done — or suggest how they should be handled. This plan will reassure their employer that cancer treatment will be manageable for both parties.

There are legal protections for employees facing cancer. The Americans With Disabilities Act (ADA) shelters employees from being fired simply because they have a disability, and cancer may be considered a disability in some cases. The Family and Medical Leave Act allows employees to take a certain amount of unpaid time off from work (for treatment or to recover from illness) without fear of being replaced by their employers.

Although these laws don’t apply in every employment situation, they are a welcome legal backing for many.

Another consideration: As prepared as you might be, there are a range of reactions to treatment and its effects. If you must return to work while still recovering, it may be possible for your employer to make reasonable accommodations through ADA for your “new normal” in terms of fatigue or need for time off for appointments. If your job allows, it might even be possible for you to telecommute for a while.

The nonprofit Cancer and Careers organization has a website that includes a good deal of practical information for patients, caregivers, employers and health care professionals about career considerations after a cancer diagnosis. 

‘They followed my lead’

Ramirez, who now works at the University of Houston, recalls that although her Interfaith Ministries coworkers were supportive, they treated her as a colleague, not a cancer patient.

“When I first told them, I experienced a momentary silence. They were worried about me and how I’d get through it,” she says.

“I sensed that if I felt it was too much to handle, they would, too.”

As she got used to the rhythm of treatments and recovery and life went on, Ramirez’s confidence and competence reassured them, and they responded with kindness but not undue worry. “They followed my lead,” she says.

Which doesn’t mean they weren’t concerned. “It was Interfaith Ministries; I had people of all faiths praying for me,” she laughs.

In the fall issue of Network, we’ll explore legal and insurance issues of working during cancer treatment. Share your story about working through cancer by e-mailing

© 2015 The University of Texas MD Anderson Cancer Center