Employer's guide to cancer in the workplace. From someone who had cancer in the workplace.

I had just had my eyebrows tattooed on after losing them all

When I had cancer in the workplace, I was in the unusual position of being in a leadership position in the company with operational/HR responsibility. 

I was also in a position where I had relative freedom and autonomy within the company to come and go as I wanted and needed while I was ill, with the full support of the CEO and our investors. I had worked for the company about 7 years at this point, but I appreciate and fully recognise that being paid throughout and having this enormous choice was a fortunate place to be in. 

So, let's go through some of the ways you can support anyone in your team going through this. Bear in mind that there are so many different types of cancer, as well as a multitude of combinations of treatments (including IV or oral chemotherapy, radiotherapy, immunotherapy and surgery), and varying timescales. Each person's experience is different, and each person experiences things differently. Therefore, each situation should be individualised, and information between the company and employee shared and discussed based on what is happening at that point. Have a plan in mind, but it's important to know that things can change really quickly, and sometimes urgently, so being flexible here is key. 

Communication

- I found it helpful to be open with the company and investors - they knew how I was feeling, what I was up to, what I was up for and how much I could give. If I couldn't attend a meeting or finish a piece of work on time, I gave them as much notice as I could. 

- Being transparent as an employer/manager is helpful in this situation because it allows the employee to know where they stand, the deadlines that are flexible, and who is able to take some of their workload. 

- It's also essential to communicate your company’s long-term sickness/absence policies, pay and whether they will be put on SSP (financial stress is an additional factor when people are ill), what other options for pay there are, what insurance policies are available, and also what level/detail of communication is helpful to both. If the employee is off sick, decide on how much you’ll both be in touch. Check in on them, don’t check up on them.

- It's helpful to team members and other people in the company to know what's going on, in an appropriate way and with as much detail as the employee is comfortable sharing (and with their consent – not everyone wants everyone to know). It's a good way for the team to be able to fully support their colleague both professionally and personally. Only celebrate milestones if the employee wants to. 

- When the employee comes back to work, it’s best practice to do a return to work ‘interview’ to check in with them, see how they’re feeling and understand some of the ways their work life will be affected. Make sure you act on any adjustments they need.

- I hated the terminology around ‘battling’ or ‘fighting’ cancer (my dad died of cancer; does that mean I ‘fought’ harder than him – definitely not). Check in with your employee about how they want their illness communicated to the team and any investors.

 

Flexible working in this context may look like:

- Working at times during the day where they feel the best (I slept really badly while I was ill, and was really grateful for the ability to start later). It also allows them to work around appointments and treatment. 

- Extending breaks at lunch or allowing more breaks throughout the day

- If commuting, adjusting travel times to off-peak; this not only would help the employee get a seat on a train, but also reduce their risk of infection (I travelled with a mask on way before covid made it cool). 

- Working in different places. If someone is being cared for outside of their home, they may need flexibility on their place of work, and be mindful that this may change often. 

- If your company is mainly in person, flexibility to work from home would be really useful

- When they're ready to come back to work, a phased return is a good way of easing them back in to manage stress, workload and lingering fatigue (which can be for months). It was quite overwhelming for me coming back - it was so nice that everyone wanted to talk to me, but when you're given the all clear you have to step back into a world that no longer looks the same to you. You're used to constant surveillance from doctors, but after the all clear, you're just left to go back to your normal life as it was - this can be incredibly overwhelming. 

- If they're a parent, there may need to be some consideration about childcare arrangements as well

 

Workload adjustment

- Reducing pressure to meet deadlines and being aware that things can change on a day-to-day basis, sometimes urgently. For example, I spent the night in hospital once because my temperature spiked, which is a medical emergency if you have a low white blood cell count (a common side effect caused by chemotherapy). 

- Reducing the workload, and, if possible, distributing some tasks to other team members to lighten the load 

 

Health and safety adjustments

- If you are office based, knowing whether it's accessible would be good. For some people recovering from surgery, this is an important consideration. I had terrible joint pain and could barely walk up the stairs, so knowing there was a lift was important.

- I was put into a medically-induced menopause, which meant experiencing hot flushes, amongst other things; providing a fan as a way to keep cool is really helpful either in the office or at home. 

- If possible and practical, assisting with transport to and from the office would be hugely beneficial - this saves energy when you need to conserve as much as possible. 

 

Health, wellness, and financial support

This is a big one, obviously, and there are numerous ways of providing this kind of support:

- If you can, it would make SUCH a difference if you could continue to pay your employee throughout their illness. I can’t get across how much stress this alleviated from my life. I appreciate this can be very hard in most circumstances given the unknown timelines and often the need to still get the work done, but for me, this was the one thing that meant the most to me.

- It will be really important to check in on your employee’s mental health during and after treatment. It can be an extremely traumatic experience and can take a long time to recover. Lots of cancer patients look different to what they used to – chemo can do awful things to the body, body image and confidence can be affected. If someone in your organisation can be trained in Mental Health First Aid that would be great; keeping a look out for signs and symptoms of mental health issues enables you to signpost them to help and support (see private medical insurance below).

- Private medical insurance. While I didn't use my company-provided private medical insurance for any of my treatment or surgery, it was very useful for post-surgery-physiotherapy, as well as the counselling that I had afterwards. It can mean employees are able to come back to work quicker. If you have a comprehensive plan that covers cancer, it can reduce waiting times (this reduces a lot of stress - the waiting is the worst), gives you more choices about where to have treatment, what treatment to have and possibly gives you slightly nicer surroundings (and food, sorry NHS) if you do have to have surgery.

- My private medical insurance also paid me a 'cancer cash benefit', which I used to get laser eye surgery. Weird that I 'treated' myself to more surgery... 

- Having dental insurance with private medical is very helpful because the mouth can take a battering from chemo and can lead to the deterioration of gums as well as infection and ulcers. 

- Income protection insurance. If you can afford this as a startup, I'd highly recommend it – it’s not as expensive as you might think. Having cover like this is beneficial in two ways - 1) your employee can go off sick while being paid by the insurance, often for up to two years; this allows them to focus on being well and recovering and not having to worry about work. It may mean they’re not forced back to work sooner than they’re ready because of financial constraints 2) This frees up your cash to spend on an interim hire to cover the work.

- If you are a founder or work solo, personally I think it is imperative you get some kind of insurance, whether income protection (bear in mind this is often based on your salary, so if you're not paying yourself much as a founder, this is a consideration) or critical illness cover. I renewed my mortgage two weeks before I found that pesky lump and I turned down critical illness insurance. I was lucky I was paid, but use this as a warning to get some cover. 

- There are some amazing companies out there that are dedicating their business to helping people through and after cancer, as well as their employers. People live with the side effects of cancer for years, long after their treatment has finished and often need continued support – this can be related to nutrition, fatigue, post-surgery complications, menopause, mental health and some of the knock on effects of treatment (for example, my thyroid now doesn’t work because of the immunotherapy and it’s an ongoing issue to keep it on track). One such company is Perci Health; Perci is a virtual health clinic that connects patients with multi-disciplinary expert advice. Their co-founder, Kelly McCabe, has kindly shared this quote, which really gets across how individual each patient's experience is: “cancer can be thousands of different experiences to different people, different treatment types, side effects, time off work etc - there’s definitely not a one size fits all approach, which makes it hard for employers to always know how best to support. Opening up supportive conversations about cancer in the workplace and tackling the taboo can make it possible for people to get the support they need, no matter what their experience”. Perci helps employers through all of this too; it’s highly valuable to have such an empathetic and considered resource on hand to confidently support your employees.

 

Legal requirements for employers to know

-       The Equality Act considers a cancer diagnosis as a disability automatically, which means if an employee has or has had cancer, they are not allowed to be treated less favourably than someone who has not been in that position because of the cancer. An employer also must make reasonable adjustments to your work in order to support you. More here from Perci: https://www.percihealth.com/articles/guide-to-cancer-and-employment-law

- Also make sure you're aware of statutory sick pay requirements, pension requirements and holiday allowances (for example, if an employee is on long term sick leave and can't take their annual leave allowance, they're entitled to carry 4 weeks over to the following year).

-  If someone in your company has been diagnosed with cancer, it’s advisable to be fully up to date with relevant employment law and to seek professional advice as soon as you can.

This advice can come from an employment lawyer to understand your legal obligations to your employee, or from an HR professional. One of my oldest and best friends, Lauren Bradford (Assoc CIPD) is an HR leader and said the following about supporting employees:

 “Ensuring employees know they’re being supported before, during and after a period of illness is important for many reasons, including mental health. Promoting a culture where employees can keep an open dialogue about their health with their employer has many benefits; the employee feels heard, understood and supported and this provides the employer with a better understanding of the employee’s health, so they can consider how best to support them going forward. A supportive culture where employees feel safe to share health matters can show the employee that their employer genuinely cares. Offering reassurance that support will be available (whether this is from HR, line managers, senior management, EAPs or Occupational Health) to support the employee in returning to work when they are able to, reduces the psychological impact that the absence could have on their mental health and can help them to focus on their recovery.”

 

I was hoping to have space to talk about how employers can support employees when someone close to them is ill, this has turned into a bit of a beast!

 

In summary, there are so many ways to support any employee going through what will be undoubtably be one of the hardest periods of their life – for them and for their family. If work is one less thing to worry about, I can assure you it makes the world of difference. Be kind, be patient, be flexible, don’t judge, take it a week at a time, pay them as much as you can, get as much insurance as you can afford, and treat them as you would wish to be treated. 

 

I’ll leave you with this: your employee will never forget how you treated them during their illness. Let them remember it for all the right reasons.

cancer in the workplace