Overcoming the Barriers to Living and Working with Cancer

Most of what you read about cancer on Friday 4^th February (World Cancer Day) was naturally about the search for new and better treatments, the benefits of screening and self-care and the importance of supporting patients and their families. With 50% of people born after 1960 likely to receive a cancer diagnosis at some time in their lives, each of us has a good reason to improve our awareness of its impact. But one aspect of the cancer story which gets less coverage is the impact that it has on the working lives of people living with the disease and those who care for them. On Friday we launched a report with Working With Cancer containing new data from over 1200 working age people who are living with cancer, and our findings show a distinctly mixed picture.

Of more than 200 cancers, just four (lung, bowel, breast and prostate) account for 53% of new diagnoses in the UK. Over 120,000 people of working age get a cancer diagnosis each year, adding to the total of 750,000 working-age people already living with the condition. Recent research has estimated that job loss is experienced by up to 53% of people living with cancer and unemployment can be 1.4 times more likely in people living with cancer than among people without cancer. Sadly, fewer than two-thirds of employees with cancer have returned to work (RTW) or are still working a year after getting a diagnosis.

Our survey has revealed a number of consequences of a cancer diagnosis and treatment on working age people:

The proportion of cancer patients working full time at the point they receive a diagnosis falls significantly (from 73% to 46%) once they have finished their treatment. However, the proportion who are the main income earners in their household remains very high (51%) suggesting that most want to continue to work and, for some, the financial pressure to remain at work can be significant.
Among those who have returned to work, knowledge of the 2010 Equality Act and its provisions was low at 57%. It is clear that HR and occupational health professionals are not doing enough to raise awareness of the obligation to offer reasonable adjustments and a phased return to work and wider employment rights.
1/3 of respondents did not phase their return to work and 1/4 had to take leave during their treatment.
Those with advanced or metastatic cancer reported lower levels of support for their return to work. Those with breast cancer reported more support than people with other cancers.
The frequency with which healthcare professionals discussed return to work is low. It is especially disappointing that GPs, Occupational Health professionals and clinical nurse specialists appear not to be prioritising return to work advice.
Among those who have not yet completed their treatment, more than four in five plan to go back to the same job but almost 3/4 of the remainder planned to switch employers.
Awareness of the Equality Act is higher in this group (i.e. those still in treatment) at 70% and most are aware of their entitlement to a phased return to work and workplace adjustments

Previous IES research on the ways older workers living with chronic illnesses (including cancer) coped during Covid-19 illustrated that employers can make employees feel supported and included, or they can be treated with indifference or even hostility. Our survey among cancer survivors also found that a minority of employers still have much to learn. As one respondent told us:

‘There is not a lot of support in my workplace. It is a physically & mentally demanding job, and my employer puts a lot of pressure on me. There is no understanding of my ongoing side effects following cancer treatment and no real adjustments to assist me getting through the day.’

These somewhat shocking stories are, thankfully, relatively rare and I know from my own experience of cancer treatment that even small organisations like IES can make the experience of RTW after cancer treatment a reassuring and positive one with some good communication and lots of compassion. Indeed, our survey collected some heart warming stories of organisations who get this right, more often than not. Another respondent had a more positive experience, for example:

‘I am currently having aggressive chemo – my boss is amazing – I message him if I’m having a good day and he sends me interesting things I can input to. This makes me feel so valued.’

We do think that the HR profession could be doing more, however. They need to be proactive and stay in touch with colleagues during their treatment, making it clear how sick leave, sick pay and time off for medical appointments will be managed. They should also liaise with occupational health professionals and line managers to ensure a RTW plan is in place, provide training and support for line managers and take charge of monitoring and adapting the RTW plan as the employee’s recovery improves. Some employers support and fund ‘buddy’ schemes where peer support from other colleagues living with cancer is provided.

Although the results of this survey show that many people living with cancer have positive experiences when they decide to return to work, for too many there are still preventable barriers which make the physical and psychological challenges of cancer treatment which they are trying to overcome much more difficult than they need to be. This need not be the case and our profound hope is that, with better awareness among healthcare professionals and employers, the route to a full and fulfilling working life should be open to all those cancer patients who want it.