Changing the conversation about work and cancer

The side effects of cancer and getting back to work


Cancer drugs can have challenging side effects
Cancer drugs can have challenging side effects

You may have read a recent press release by the BCC (Breast Cancer Campaign) about the impact of Tamoxifen on cancer survivors.

In case you haven’t, in summary, around 40,000 women in the UK each year are diagnosed with hormone-positive breast cancer and around 13,000 will be prescribed a five year course of Tamoxifen, usually after surgery, radiotherapy and any necessary chemotherapy.  Findings in the British Journal of Cancer showed that more than 5,000 of these women (i.e. over 38%) may fail to complete the full course of treatment and this low adherence comes at a considerable cost to the patient, worse outcomes, in some cases early death, poorer quality of life and an increased cost to the NHS.

As Macmillan commented “Like many forms of cancer treatment, Tamoxifen can often have debilitating side effects. These include hot flushes, nausea, headaches and exhaustion which can cause many women to stop taking the drug”. Indeed I know from personal experience that Arimidex (one of the new generation of cancer drugs for post-menopausal breast cancer survivors known as aromatase inhibitors) has many of the same side effects with the additional joy of acute muscle pain and the risk of osteoporosis

As Macmillan also commented: “unfortunately suffering from severe side effects of treatment is not exclusive to breast cancer patients. Macmillan estimates that at least half a million cancer survivors in the UK currently face disability and poor health due to their illness and its treatment. This number will rise along with the increase in people being diagnosed with cancer and those who survive it.

One thing I explain to employers as well as those affected by cancer is that getting back to ‘normal’ after cancer is a long and sometimes difficult journey. Just because treatment has finished, it doesn’t mean that everything will be ‘fine’ in a few weeks’ time.  Too often line managers, HR professionals and even those affected by cancer are totally unaware that some side effects begin after cancer treatment and continue long afterwards – for many months, and sometimes years. Side effects like fatigue, depression, muscle pain, hot flushes, digestive problems, incontinence, and lymphodema.

This doesn’t mean that going back to work or trying to work is a bad idea. On the contrary, going back to work means you don’t spend day after day at home worrying about all the aches and pains and generally feeling sorry for yourself. Going back to work is generally found to aid recovery.

However, for the employee what it does mean is that however superhuman you were or indeed still are, you have to pace yourself carefully when you return to work and give yourself time to adjust. For employers it means taking just a little bit of time to learn about the impact and side effects of your employee’s form of cancer, checking in with affected employees that all is ok (or not), and being reasonably (I stress the word ‘reasonably’) flexible.  In my view this is part of any manager’s role – and for those line managers who don’t have or won’t make the time for this all I would ask is, how would you like to be treated if you were in the same position?  Unfortunately, looking at the stats, over the next ten years it seems to me that many line managers will be increasingly required to answer this question for themselves.