Can cancer affect my ability to work?

Yes, often. Cancer and its treatment can make the physical and mental tasks of a job harder, and you may miss time or be unable to work at all for a while.

One study cited by NCI put a number on it. Working people getting cancer treatment missed about 22 more workdays a year than people who were not in treatment. Other common effects are losing a job, switching to part-time, taking extended leave, having trouble returning, and earning less.

Losing a job matters beyond the paycheck. It can end employment-based health insurance, and NCI notes that job loss is a risk factor for debt and bankruptcy.

The law is more protective than most people expect

Under the Americans with Disabilities Act, people who have cancer now should easily be found to have a disability. The EEOC says so directly. The same holds if your cancer is in remission. The reasoning is that cancer substantially limits normal cell growth, or would if a cancer in remission came back.

People with a history of cancer are also covered. That falls under the part of the law protecting anyone with a record of an impairment. You are covered, too, if an employer acts against you because it believes you have cancer, whether or not you do.

Title I of the ADA applies to private employers with 15 or more workers. It also applies to state and local government employers. Federal employees get similar protection under Section 501 of the Rehabilitation Act. Many states have their own laws that reach smaller employers.

What you can ask for

Employers must provide reasonable accommodations unless doing so would be an undue hardship, meaning significant difficulty or expense. The EEOC notes most accommodations for cancer cost little or nothing.

Accommodations it lists include:

• Leave for appointments, or to get and recover from treatment.
• Periodic breaks, or a private space to rest or take medication.
• A modified schedule or a shift change.
• Permission to work from home.
• A change in office temperature.
• Use of a work phone to call doctors where personal calls are normally barred.
• Moving minor, non-essential tasks to another employee.
• Reassignment to a vacant position if you can no longer do your current job.

That last one has limits worth knowing. The vacant job must match your old one in pay and status, or come as close as possible. But your employer does not have to create a vacancy by displacing someone else.

You can request an accommodation at any point, even if you said nothing when you were hired.

What your employer may not do

Your employer may not tell coworkers that you have cancer. That holds even if you told colleagues yourself, and even when everyone is asking. Your employer also may not explain that an absence was cancer-related.

If coworkers ask why you get to work from home or take breaks, the employer is not allowed to say it is an accommodation, because that reveals a disability. The correct answer is a general statement about employee privacy.

Where to start

Ask your care team what to expect from your specific treatment schedule, since that determines what you actually need. Then put your accommodation request to human resources in writing. Describe the limitation and what would help, rather than your diagnosis.

NCI is careful to flag that the research here is thin. There have been no randomized trials of financial toxicity. Most studies cover survivors and certain cancers, so the findings may not apply to everyone. Our guide to how cancer can affect your work and income covers income protection, and the piece on working during cancer treatment covers day-to-day practicalities.

Sources

• https://www.cancer.gov/about-cancer/managing-care/track-care-costs/financial-toxicity-pdq
• https://www.eeoc.gov/laws/guidance/cancer-workplace-and-ada