This article aims to answer a common question line managers may have when an employee in their team is undergoing cancer treatment.

Key takeaways

• Work can be beneficial for many people having cancer treatment, providing structure, social connection and a sense of normality. However, you should never assume this is the case for everyone. 

• Decisions about whether to work during cancer treatment, and in what capacity, rely on many factors, from medical capability to the employees preferences and workplace policies 

• The kinds of work someone can do should be guided by questions of how flexible the work is, as well as its importance. Work that’s important but not urgent could be perfect. 

When someone in your team is going through cancer treatment, there may be a question – from them, from you or from your wider team – about whether they can work during treatment. There is no straightforward answer; rather, it’s dependent on a combination of several factors. This article aims to outline those factors, share considerations when looking at working during treatment, and offer practical tips and advice for managers.

Why work during cancer treatment?

Continuing to work during cancer treatment, even in a reduced or adjusted capacity, can be genuinely beneficial for many people, providing structure, social connection and a sense of normality. Work can support mental wellbeing and help maintain a sense of identity and purpose at a time when many other things feel out of control. That said, this is not true for everyone and should never be an expectation. It’s always worth having an open and sensitive conversation about what role, if any, the employee would like work to play during their cancer treatment. 

Which factors affect whether someone in cancer treatment can work?

1. Medical capability – physical and mental

Cancer treatment affects people very differently. Two people could have the same diagnosis and the same treatment, but completely different experiences. Furthermore, neither physical and mental capability is predictable or fixed, and may fluctuate significantly, even within a single week. The side-effects of some cancer treatments can be cumulative, so for example, someone’s capability could be different after their sixth round of chemotherapy, compared to the first. 

In general, physical impacts of cancer treatment can include fatigue, pain, nausea and increased infection risk, while mental and cognitive impacts can include Cancer-Related Cognitive Impairment (CRCI), also known as ‘chemo brain’, which can involve difficulty concentrating, memory lapses and slower processing. A cancer diagnosis will almost certainly impact an individual’s mental wellbeing, and this in turn will have an impact on their capability to work.

2. Medical advice and Occupational Health

Your employee's clinical team will have the clearest picture of their cancer treatment and its likely impacts. Often, they’ll encourage the individual to retain as much of their normal life and routine as possible during treatment, and this includes work, however there may be times when this isn’t possible. Encourage the employee to share fit notes or medical guidance with you, to give you as much clarity as possible.

If your workplace or employee has access to an Occupational Health therapist, they can provide an independent expert view on fitness for work and the adjustments that might help. They can help find a way to keep someone connected to work safely, if this is what the employee wants. 

3. The employee's motivation and preferences

The employee's own wishes should sit at the centre of any decision about working during treatment. Some people will want to continue working as much as possible while others will need or want to step back entirely. Both are valid. Your role as manager is to understand what the employee wants, be honest about what is operationally possible, and find an arrangement that works for all parties, including the wider team.

It’s important to avoid assumptions in either direction. Don't assume someone is too unwell to work, and don't assume they are fine to continue as normal – many side-effects of cancer treatment are invisible, and the employee may spend a lot of energy trying to mask these for the benefit of those close to them, including you. 

4. Factors they are dealing with beyond cancer treatment

Treatment rarely happens in isolation, and the employee’s life does not stop completely at the point of diagnosis. Employees with cancer may also be managing caring responsibilities, financial pressures and family dynamics, while juggling appointments and the psychological impact of their diagnosis. All of this sits alongside the mental and physical impacts of the treatment itself. During conversations about working during treatment, a simple, ‘Is there anything else going on that would be helpful for me to know about?’ can help you understand the fuller picture and make sensible decisions about capacity to work. 

5. Your workplace policies

Your workplace policies can have a bearing on whether an employee chooses to continue working during cancer treatment, and it’s a good idea to familiarise yourself with these before any conversation with them. Your HR team and Health & Safety representative should be your first call if unsure. 

These are the key areas to ensure you have a basic understanding of:

• Absence management procedures and how long-term health conditions are handled. For example, how will the absence be handled if the employee works for a few days each fortnight, meaning multiple absences instead of one single longer absence?

• Occupational sick pay entitlements. For how long do these apply, and what happens if some work is completed on reduced hours or days during the overall treatment period?

• Income protection or critical illness cover. Does the employee have access to these? If so, how are triggers and eligibility criteria impacted by the employee doing some work during treatment?

• Health and safety obligations. These are important to consider, particularly if the role involves physical work or environments carrying infection risk. 

Summary

• Medical capability – both physical and mental – dictate whether someone can work during cancer treatment, however neither is fixed

• The employee’s medical team are best placed to advise on whether the employee can work, and fit notes and medical guidance should be shared with the employee’s permission

• The deciding factor should always be whether the employee wants to work – taking into account their wishes, preferences and anything else they are dealing with and workplace policies

What kind of work can someone in cancer treatment do?

Even if they are motivated and medically able, the nature of the work your employee can do during treatment needs to be agreed and suitable for both the employee and you as their line manager. Remember that treatment side-effects can be unpredictable and sudden changes in capability and capacity are possible. Considering work flexibility and importance can be helpful.

• Flexibility
  Consider which tasks are flexible in timing, as well as which require sustained concentration and which are more routine. What kind of work can be carried out from home or at adjusted hours, and which deadlines are truly fixed versus moveable? Build in flexibility as a default rather than an exception.

• Importance
  Prioritise meaningful, manageable work over urgent or high-pressure tasks where possible. It can be helpful to think of work tasks in the context of the Eisenhower urgent/important matrix – most roles and teams will have a list of tasks in the ‘important but not urgent’ category and these could be suitable for your team member.