Can You Work With Breast Cancer

Reasonable Accommodations At Work

Employers are not required to lower standards in order to accommodate an employee, nor must they provide personal-use items like glasses or hearing aids. But an employer must accommodate a qualified applicant or employee with a disability unless the employer can show doing so would be an undue hardship. Examples of reasonable accommodations for cancer patients may include, but are not limited to:

• Providing or modifying equipment or devices
• Restructuring a job
• Offering part-time or modified work schedules, such as permission to work from home if possible
• Offering reasonable breaks for rest or to take medications
• Adjusting office temperature
• Reassigning an employee to a vacant position or assigning the employee different tasks if the employee is no longer able to do their current job
• Adjusting or modifying tests, training materials, or policies
• Providing readers and/or interpreters
• Making the workplace readily accessible to and usable by people with disabilities
• A vocational rehabilitation counselor can help with some of your job-related legal questions, but you may also want to look into laws that affect you and how you deal with any problems that may come up. Some cancer treatment centers offer referrals to vocational rehab counselors, so ask your health care team. Your health care team may also have tools or people that can help you.

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Kalasunas, 37, found the routine of work comforting amid two rounds of radiation and over a year and a half of chemotherapy treatments. When she was first diagnosed, her supervisor spoke to her about what kind of flexibility she needed, and assigned her to longer-term projects so her work wouldnt suffer if she woke up feeling too ill to work one day.

In the beginning, it was like OK, it is really important for me to be able to control work. she said. It became wildly important to be able to control something. Because everything else around me, it felt like there was nothing I could do about it.

But in the years that followed she cycled through three supervisors, and her last boss took a different approach, asking her to stick to a more regular schedule. Ayanna started to feel as though her diagnosis not her work was the reason the company kept her on. When someone says to you, I cant fire you, that lets you know that youre only really there because they dont have a choice but to put up with you, she said. At the same time, her mother had recently died and Kalasunas was going through another round of radiation. I had just been through what felt like a war zone, she said. She decided to leave her job in 2016.

They were very understanding. I know that might not be true for all employers.

Why Might I Need A Breast Ultrasound

A breast ultrasound is most often done to find out if a problem found by a mammogram or physical exam of the breast may be a cyst filled with fluid or a solid tumor.

Breast ultrasound is not usually done to screen for breast cancer. This is because it may miss some early signs of cancer. An example of early signs that may not show up on ultrasound are tiny calcium deposits called microcalcifications.

Ultrasound may be used if you:

• Have particularly dense breast tissue. A mammogram may not be able to see through the tissue.

• Are pregnant. Mammography uses radiation, but ultrasound does not. This makes it safer for the fetus.

• Are younger than age 25

Your healthcare provider may also use ultrasound to look at nearby lymph nodes, help guide a needle during a biopsy, or to remove fluid from a cyst.

Your healthcare provider may have other reasons to recommend a breast ultrasound.

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What Are My Rights

If you qualify as having a disability, any private employer with 15 or more employees must provide reasonable accommodations under the ADA.

The Family and Medical Leave Act provides up to 12 work weeks of unpaid leave during a one-year period without the threat of losing your job or health insurance benefits. You can take the leave all at once or break it up into segments over the course of a year. The FMLA only covers companies with 50 or more employees and you need to be with your company full time for at least a year to be eligible.

Keep in mind that you may be required to disclose some medical information to your employer in order to take advantage of these programs. If youre planning to apply, be sure to ask your doctor for a letter detailing your diagnosis and inability to work.

Workplace Discrimination Against People With Cancer

Even though the publics understanding of cancer is getting better, sometimes prejudices and fears are found in the workplace. You may talk with your Human Resources Department if you are worried you might face work discrimination issues. If your workplace has a union, its officials can be good sources of information about illnesses and the workplace.

If you believe you have been discriminated against, you should first learn as much as possible about how your company has handled grievance issues in the past. It might help you avoid a stressful situation that could be draining both financially and physically.

Keep notes of your contacts with office personnel, including the names of the people you spoke to, the date and place you spoke, and the information you received. Its also a good idea to keep copies of your job performance evaluations and any other written information about your work. These can be very helpful if problems come up later.

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Returning To Work After Breast Cancer Treatment At Upmc In Central Pa

Returning to work is a return to normalcy for many people. But it can come with some challenges. You may find that you have difficulty adapting to the demands of your job right away. You may also have lingering treatment-related problems such as chemo brain or neuropathy. Its important to speak with your doctor first if you are considering returning to work after treatment.

Another important step in your return to work is to set up a call or in-person meeting with your companys Human Resources department. Do this after you are cleared for work. Ask if your company has a formal return-to-work or disability management program. You may also want to discuss the possibility of a flexible work arrangement as you get used to the demands of a normal schedule. Your company may request documentation that verifies your limitations before it grants a work accommodation. If your request is denied, your employer is required to determine if theres an easier or less costly accommodation that can be made to meet your needs.

Tip: Here are some tips to help make your return to work smoother:

• Plan to take small breaks throughout the day to help maintain your energy level
• Use lists, reminders, meeting settings or task alarms
• Meet with your manager regularly to talk about the transition and any changes or adjustments you may need

Your UPMC Pinnacle Breast Care Center team can help you with other strategies to help ensure a successful return to work.

Consider Setting Up A Meeting

Arrange a meeting or a lunch date in advance, so you can be sure to have your manager’s full attention. Also, remember that discussions between a boss and employee are protected. A supervisor has a legal obligation to keep the information private. However, co-workers do not have the same obligation. Ask that your private conversations with your boss be kept confidential.

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Making Adjustments To Your Job

You may need to adjust some aspects of your job, especially during treatment and for the first months after treatment ends.

Your employer may help you find ways to balance your job with any limits you may have.

Organizations, such as Cancer and Careers, offer tips on going back to work after breast cancer treatment.

Keeping Medical Information Confidential

With limited exceptions, an employer must keep confidential any medical information it learns about an applicant or employee. Under the following circumstances, however, an employer may disclose that an employee has cancer:

• to supervisors and managers, if necessary to provide a reasonable accommodation or meet an employee’s work restrictions
• to first aid and safety personnel if an employee may need emergency treatment or require some other assistance at work
• to individuals investigating compliance with the ADA and similar state and local laws and
• where needed for workers’ compensation or insurance purposes .

8. May an employer tell employees who ask why their co-worker is allowed to do something that generally is not permitted that she is receiving a reasonable accommodation?

No. Telling co-workers that an employee is receiving a reasonable accommodation amounts to a disclosure that the employee has a disability. Rather than disclosing that the employee is receiving a reasonable accommodation, the employer shouldfocus on the importance of maintaining the privacy of all employees and emphasize that its policy is to refrain from discussing the work situation of any employee with co-workers. Employers may be able to avoid many of these kinds of questions bytraining all employees on the requirements of equal employment laws, including the ADA.

9. If an employee has lost a lot of weight or appears fatigued, may an employer explain to co-workers that the employee has cancer?

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Importance Of Work And Availability Of Support

Most participants perceived work being important due to autonomy, distraction, wellbeing, financial, love of the job, mental challenge, normalcy and social aspects. Only 8 participants reported work was not important to them compared with other life issues. While majority of survivors reported that they received sufficient support during active treatment, a few participants reported that they did not receive enough support. Participants reported that some individuals at work were not as supportive as they expected. Conversely, a small number of participants reported they received too much support at work.

How Should I Approach My Boss

At first, you dont actually have to tell anyone at work about your diagnosis unless you want to, and that includes your boss.

But if it becomes apparent that the cancer or its treatment will begin to interfere with your responsibilities at work or your schedule, you may wish to inform your boss of the situation. If you plan to make use of disability leave, youll be required to disclose some information to your employer.

Consider scheduling a meeting with your boss along with a human resources employee. If you want to keep working during treatment, you should explain to your boss that youll do everything you can to perform the required tasks of your job.

Its illegal for an employer to treat their employees differently due to health status. Youre protected from discrimination based on your health under the ADA, but only if your employer is aware of your health condition.

While undergoing breast cancer treatment, you may experience issues with memory or other cognitive effects. The added stress of living with cancer and going through treatment can make it difficult to concentrate.

Try these tips for staying focused at work:

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Longer Term Side Effects

Fatigue

Tiredness is commonly reported during treatment. This may be a direct effect of the drugs or may be due to other factors such as disrupted sleep patterns.

• Try to get adequate rest but also try to exercise regularly. Go for a walk outside each day as this can actually give you more energy.
• Find something that you actually enjoy doing and also try to incorporate exercise into your usual day, e.g. walk upstairs rather than taking the lift, park further away from where you want to go and walk the extra distance. Build this up gradually.
• Your GP, practice nurse or a physiotherapist can work with you to devise a specific exercise plan for you.
• Let others help when your energy levels are low.

If your fatigue doesnt allow you to exercise, discuss this with your GP.

Usually energy levels recover after treatment finishes but this commonly takes time. In some cases full recovery may take 12 months or more.

Cognitive changes

Some people notice they are having concentration and short-term memory problems following their chemotherapy. This is often referred to as chemo brain. The severity and duration of symptoms differ from person to person. For some people the symptoms are very mild and resolve soon after treatment stops, but others may find their daily life is noticeably affected for a much longer period, restricting their ability to return to work in their pre-treatment capacity.

Menopause/fertility

Heart conditions

Qualifying Without Meeting A Medical Listing

If youre lucky, your breast cancer will have been diagnosed at an earlier stage than III or IV. Although early stages of breast cancer are not listed in the Blue Book, you can still qualify for disability benefits.

To qualify for benefits without meeting a medical listing in the Blue Book, you will need to have doctors notes and hospital records that show that you are expected to be out of work for at least 12 months. Speak with your doctor about your treatment and whether or not youll be out of work for more than a year.

The most common way women can get approved for disability benefits without the Blue Book is through a physical Residual Functional Capacity evaluation. This is a long form filled out by your doctor about your general health and wellbeing.

Keep in mind that if you do need to file for disability benefits via an RFC, your education level will be factored into your evaluation. If you went to college and could be qualified for sedentary work, the SSA might think that although your symptoms are severe, you could find some form of desk work to do and do not qualify.

A woman who has no education and worked her entire life as a construction worker or a stay-at-home mother would have a much higher chance of qualifying via an RFC than a woman who went to college and got her degree in finance or any other major that can be applied to many jobs.

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General Information About Cancer

Cancer is a group of related diseases characterized by the out-of-control growth of abnormal cells caused by both external and internal factors, such as chemicals, radiation, immune conditions, and inherited mutations.4 In 2008, the last year for which incidence data is available, more than 12 million Americans were living with cancer.5 Some of these individuals had cancers that were not “active,” or inremission, while others still had evidence of cancer and may have been undergoing treatment.6

Cancer’s effect on an individual depends on many factors, including the primary site of the cancer, stage of the disease, age and health of the individual, and type of treatment. The most common symptoms and side effects of cancer and/ortreatment are pain, fatigue, problems related to nutrition and weight management, nausea, vomiting, hair loss, low blood counts, memory and concentration loss, depression, and respiratory problems.7

Despite significant gains in cancer survival rates, people with cancer still experience barriers to equal job opportunities. Often, employees with cancer face discrimination because of their supervisors’ and co-workers’ misperceptions about theirability to work during and after cancer treatment. Even when the prognosis is excellent, some employers expect that a person diagnosed with cancer will take long absences from work or be unable to focus on job duties.

It Will Be An Adjustment

You may be asked odd questions from co-workers too. If you still look quite healthy, someone in the workplace may challenge you as to whether you really do have stage IV breast cancer. This is because of ignorance. With the improved treatments available today, and with more and more women living for years in harmony with their metastatic disease, people are confused, because their knowledge-base of stage IV cancer, no matter what kind, is that the patient would look like death warmed over. What they envision is someone with hair loss, who is very thin, walking slowly, fatigued, and needing to be horizontal most of the time.

This requires a thoughtful dialogue, in which you educate such individuals so that they know that stage IV disease is different for each person who is unfortunate enough to be diagnosed with it. Some are very ill from the beginning and dont survive very long others may live years with the disease and be able to continue working for years. The most important person to make this information clear to will, of course, be your supervisor.

So, meet with your HR person to find out what are your benefits related to short- and long-term disability, vacation time, sick time, or PTO, as is the case in most businesses today. What reasonable accommodations you may need now, or in the future. Then, sit down with your boss for the first of a series of discussions, because your clinical situation will likely change over time.

See you at work!

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