Advice for returning to work after cancer

Key takeaways

• Returning to work is complex but you are not alone in feelings of worry or anxiety. There are 750,000 people with cancer in the UK of working age and this is estimated to rise to 1.7 million by 2030 (Macmillan Cancer Support).
• Planning ahead about how you would feel most confident in your return is key (think about part-time options if financially viable) and keep in touch with work while you are going through treatment so you feel equally informed and ready for your return.
• Be kind to yourself and implement self-care in and outside of work.

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1 in 3 (or 750,000) people with cancer in the UK are of working age (Macmillan Cancer Support). That is a large number of people navigating the complexities of working life with and beyond cancer. And that number is estimated to rise to 1.7 million people by 2030 (Macmillan Cancer Support).

We spoke to Helen Addis, AKA @TheTittyGritty, about her first-hand experience of returning to work after having Grade 3 ductal invasive breast cancer in 2018. She details what she was worried about before going back to the workplace and the personal impact the disease had on her and her career.

Perci Professional Dr. Simone Ruddick follows up with insight about how to make your return to work less stressful through open and ongoing conversation, plus planning ahead.

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Helen Addis on her return to work

“Before I had my diagnosis, I was a Features Editor for the ITV Lorraine show. I have been there for 20 years now and have built incredible relationships with both my manager and team. 

When I was told I had Grade 3 ductal invasive breast cancer which had spread to my lymph nodes, everything moved very quickly, from being told I would have a mastectomy in a week’s time, followed by chemotherapy treatment the one after. 

I’d told my boss before my diagnosis, “Boss, I’m going to be late tomorrow, I’ve had a biopsy done on a lump which I need to pick up the results for. So I’ll be late in”. I then didn’t go back. My next phone conversation with her was telling her I had breast cancer, which was just the strangest thing.

I was off work for about 18 months in total. I’m really aware that I was very lucky to work for a company which could afford to pay me my salary for six months and then move me on to statutory sick pay. It’s such a different situation if you are self-employed, for example. Depending on your length of treatment, the longer that you’re off the more there are financial implications and pressures on your return. You’ve got to keep afloat financially, as well as stay alive.

I didn’t have any pressure coming from my workplace, which was amazing. Something that I did do, and I would recommend, was staying in contact with work throughout treatment. I kept them updated and in return they were never on my case asking for doctor’s notes or certificates or forms. They made it overtly clear I was supported by them while giving me the space I needed to get well.

So for 18 months, my new normal had become being in the hospital; going in every week, knowing the receptionist by first name and all the porters. The hospital staff, in a weird way, became like my colleagues; my-day-to-day. And then once I finished my treatment, it felt a little like I was let go of by my support network. I can only describe the feeling as similar to falling off a cliff, because for everybody else in the real world, life hasn’t changed but people in the hospital understand and know what I’ve been through. When I started going back to work and everyone, in the nicest possible way because they’re all lovely, started high fiving me and saying “Woo! You’ve finished chemo”, it felt very alienating.

One of my biggest concerns when I first started going back to work was the constant questions from people that I hadn’t seen for a long time. It was just really hard constantly retelling my story. So I spoke to my HR in the end and said, “Look, can we just somehow let everybody know what my deal is?”. It was in no disrespect to any of my colleagues because they were just being nice, but by having HR speak to people about my situation it made things easier on me.

Even though the cancer side of things is fixed, I find it’s the mental side that you carry. I found the idea of returning to what was once ‘normal’ extremely challenging.

From a physical point of view I definitely don’t have the same energy that I had before cancer. Plus, my cognitive capacity is not what it was. Chemo brain is an actual thing, and I suffer really badly with it. I’m forever saying the same things to my team and they say to me “you told me that yesterday”. It can be frustrating and embarrassing, but I own it. And I use humour – I laugh at myself first!

I take Tamoxifen for my side-effects and that is a hard drug to be on while working. I experience menopause side-effects such as hot flashes, achy joints and feeling very, very tired and irritable. 

I liken going back to work after cancer to returning after maternity leave: my life was very different after having children and my life is very different now after cancer. I have this extra element to me, that I’m not sure people will ever understand unless they’ve been through it too. When you’ve had a baby your priorities are your baby. My priority is very much my health now as well.

The work/life juggle is now work/life/health. I chose to go back part time which has really helped me to carve myself a bit of balance. But that comes at a financial cost because I’ve had to take a pay-cut, which is frustrating because before cancer I was very career driven. The ‘old Helen’ would have been gunning for it all, but my goalposts have changed now and I try to go easy on myself”.

Perci psychologist Dr. Simone Ruddick’s advice for returning to work after cancer

How soon can I return to work after chemotherapy or treatment?

You can return to work after cancer treatment as soon as you feel ready to – recovery is important, so you should take all the time you need. Some people may want to get back to business as soon as possible, whereas others may have long term side effects that require a slower phased return to work. It’s completely normal to feel uncertain, or excited about going back.

Tips for going back to work after cancer:

Plan ahead

I recommend that people agree on a return to work plan with their employer in advance. This can be done in person, by video call or phone. You may find it helpful to have a friend or family member join the call for support and to help you remember what was discussed. The agreement should consider if you are still experiencing any side-effects from your treatment, how long these may last and detail any time outside of work for appointments that you may need. 

You may agree on a phased return to work, reduced hours or working from home. Any plans should be flexible and open to change where needed. Remember, if you need workplace adjustments by law these must be considered.

Coping with difficult conversations

Increased social interactions when you return to work can help you feel less isolated and more connected to others, which can provide valuable support. However, some people experience anxiety about talking to coworkers on their return. I encourage patients to think about how much they want others to know. Some find it helpful to meet up in advance of their return to work date with a few close colleagues. Others find it helpful to send an email outlining when they will be back, why they were off and how they would like to be treated/ not treated on their return. In doing this, if people do ask questions you don’t feel comfortable answering you can refer them back to the email.

Tackling overly sympathetic responses

Colleagues may respond in a variety of ways when you return to work. In an effort to support you people often get it wrong. If people are overly sympathetic it’s ok to feel uncomfortable or frustrated. These feelings are normal. Remember that it’s ok to let people know what is and isn’t helpful. It’s ok to say that while you appreciate their sympathy it makes you feel a little uncomfortable: think of this as signposting people in the right direction. You are helping them to help you. While you might worry about how others might respond to your requests many will be relieved to know how they can help.

Dealing with unsympathetic responses

Some colleagues may appear to be completely unsympathetic towards you. I would encourage you to think about whether this is true or not? Could you be feeling particularly sensitive and interpreting them as unsympathetic when they are actually just very busy? Or are they always this way and it’s nothing personal? Are you hyper vigilant or sensitive to how people are behaving around you or are people behaving awkwardly because they don’t know how to behave or speak to you? 

Some people report feeling guilty about the impact their absence has had on colleagues. This can affect how you imagine they think about you. If this is something that you are worried about can you discuss this together? If someone is genuinely unsympathetic towards you what would you like to do? Do you want to ignore it or challenge it? If you want to challenge it then how might you best go about this? Would it be helpful to book a meeting with this person and tell them how you are feeling? Would you want your manager to be there? 

Taking action to resolve these situations rather than avoiding them helps to reduce the worry and can give you a sense of control which may help you to feel less anxious.

Coping with the physical implications of returning to work

You don’t have to tell your employer about any medication you are on, but it is beneficial to disclose any long term side effects so that they can help you manage symptoms.

Returning to work has many health benefits but can also cause increased pain, fatigue and cognitive problems. Adapting to these limitations by making some minor changes can be helpful.

Firstly, it is important at all times to discuss any concerns with your manager. They can help you to plan breaks throughout the day to help keep your energy levels up. You can use lists, calendar reminders and alarms to help you manage meetings and tasks. These small changes can help you to feel less overwhelmed and more in control. It is important to remind yourself that asking for help and support is a strength not a weakness.

Remember, it’s ok to not feel ok

• Going back to work can be challenging and is not always easy.
• This may be a time when others think that because your cancer treatment is over that everything is ‘back to normal’ when in fact it can be a difficult period of reflection, processing what has happened and re-evaluating what is important to you.
• You may feel angry if you are struggling to carry out your normal tasks, worried about how colleagues see you, guilty that others have had to take on more work or anxious about your own financial situation.
• It is important to acknowledge and validate any difficult feelings you might have.
• Talk about them with people you trust, that might include friends, family, faith leaders or a therapist.
• Be kind to yourself and implement plenty of self-care in your work breaks and outside of work.
• It is also important to recognise that sometimes returning to work is not the best thing right now and to give yourself permission to stop and re-evaluate if needed.

Employer support makes a big difference when returning to work but if you feel like you could benefit from bespoke advice and guidance on your return to work, Perci Health is here for you. Get on-demand access to the UK’s largest collective of cancer experts by creating an account.

Find out more about Dr. Simone Ruddick and her availability.

Helen Addis has a community on Instagram under her handle @TheTittyGritty, she is also Co-Founder of The C-List which suggests skin and beauty products for people living with cancer and living beyond cancer.

While we have ensured that every article is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns, please talk to one of our healthcare professionals or your primary healthcare team.