After Treatment: Back to Work
Topics covered on this page:
How will I know if I’m ready to go back to work?
If you are thinking of going back to work, your first step should be to talk with your healthcare team. Your treating team will provide information as to how your cancer and its treatment can affect your work abilities, whether you can return to work, or if you need to look for alternative work.
The treating team will assess your ability to work based on three key factors: your physical, cognitive (thinking), and emotional health.
In making your back to work assessment, the doctor may consider the following:
- Your own view of your abilities
- An examination of your symptoms
- Specialized tests that measure physical, cognitive, and emotional functioning
- Discussions with your family and friends. Your loved ones can comment on how you perform in your daily routine
- A review of your work roles and what support may be needed to fulfil your job duties
Level of fatigue is another main factor to consider when planning your return to work. Cancer-related fatigue is common, even after your treatment is completed. In fact, it affects between 50% and 90% of cancer patients. It can include mental and physical fatigue. Unlike regular fatigue, it doesn’t go away with rest. Therefore, it can significantly affect your daily routine and all levels of your health, including physical, cognitive and emotional functioning.
For more information, see Tiredness.
Based on these assessments, your healthcare team can determine your work capabilities and expected limitations. Any barriers to fulfilling your job duties will be identified. What is needed to overcome these barriers (facilitators) will be recommended to be put in place in your workplace. Based on these recommendations, accommodation can be requested from your employer upon your return to work.
Employers often rely on the expertise of physicians and other healthcare professionals to provide guidance on whether cancer patients can return to work after their treatment. However, how you feel, both physically and emotionally, should also be at the center of your decision to return to work or not.
Think about the following questions: would full-time work be too stressful for you? Would it be too physically exhausting? It is important to make sure you save some of your energy for relaxing activities, to listen to your body and not to take on too much too soon. You can risk burnout and find yourself having to leave work again. If money or any other reason means you need to go back to work before you feel completely ready, talk to your employer or a social worker. Don’t be shy to talk about any limitations you think you may have.
Once you and your treating team agree that you are medically ready and able to return to work, your next step should be to create a back-to-work plan.
What happens if I can’t go back to work?
If your cancer prevents you from returning to work, you may feel stress, anxiety, and frustration. But it is important to remember that not working doesn’t mean you have to sit around doing nothing. Think about all the things you have wanted to do but never had the time for. Now you’ll have the time to engage in a hobby, take a course, or volunteer with a charity that is meaningful to you. You can also visit local tourist attractions that you never had the time to explore. If you are still having difficulty with thoughts about giving up work, you may find it helpful to talk with a professional counsellor.
Discussions with your healthcare team about your working abilities and limitations also provide the opportunity for you to plan interventions to improve your work readiness.
For more information about distress, see Distress.
For more information about anxiety, see Anxiety.
For more information about frustration, see Frustration.
What should be in my back to work plan?
Now that you been assessed as able to return to work, first, ask yourself if you want to return to your previous job. Consider if you want to find a new job, or if you want to use this time as an opportunity to change your career completely.
Some factors to consider when making this decision include:
- Which parts of your job do you find most rewarding?
- Are there other jobs in your current workplace that might suit you better?
- Are there other employers you would rather work for?
- Would you lose any employee benefits if you change jobs?
If you are thinking about changing employers, some additional things you should consider include:
- What are your personal and professional strengths and interests?
- What did you feel was missing at your last job?
- What skills and knowledge could you bring to a new job?
- What sort of working environment would suit your physical and emotional health?
Another key part of your back-to-work plan is making your reasonable accommodation request, if necessary. Accommodation requests are based on your identified work-related restrictions. Reasonable accommodation can include changing your hours of work or your work duties, considering a different role at your workplace, working with others to find reasonable alternatives, or obtaining resources to help accommodate you, for example tools or equipment. Note that your employer must find a job for you if you have been assessed as medically ready and able to get back to work.
Once you have decided both the nature of your job, and your required accommodations, if any, the next step of your back to work plan should be communication. This includes communication with your healthcare team, your employer, and your coworkers.
Share your plan to return to work with your healthcare team. They can help you understand what returning to work would involve. They can provide you with suggestions for:
- How your return to work could make you feel
- Any possible symptoms that you may experience on your return to work
- Symptom management strategies to better cope at work and improve your work performance
They can also help you understand what will be involved in your treatment follow-up, for example, upcoming follow-up appointments. Knowing this information will be important for you to plan around your work responsibilities.
For more information on talking with your healthcare team, see Talking to your healthcare professional about your symptoms or concerns.
Your healthcare team is also made up of other professionals such as social workers, physiotherapists and counselors that can also be helpful towards your success in returning to work. For example, they can provide the following services:
- Working on overcoming any identified barriers to work, for example, physiotherapy sessions for any physical limitations
- Counselling to help you work through any fear around return to work
- Providing vocational counselling
- Arranging for work capacity assessments to help you make the right career choice
- Referring you to resources for job searching, career planning, and job placement.
Communication with your healthcare care team should begin early and occur often to ensure your concerns are addressed and to promote a smooth transition back to work. Continue to communicate with your care team after you get back to work as to how you are functioning, and whether you need any additional support.
Keep the line of communication open with your employer while you are away from the workplace. This open communication gives your employer time to arrange for support in the workplace to allow for a smooth and successful return to work. If you have let the relationship lapse, try to reestablish it before you are ready to return to work. Find out about the company’s policies for employees returning from sick leave. Contact the human resources department to start the process and ask them about options for part-time work, working from home, or time off for medical appointments. Unless you request accommodation upon your return to work, you do not have to provide your employer with your medical information. Disclosing any information about your health is your decision.
If you do request accommodation, your employer has the right to enough information about your medical condition to properly accommodate you. This information will come from your healthcare team’s assessments and include your work capabilities and limitations. Your cancer diagnosis is not necessarily shared. In general, employers are only told what they need to know.
If you return to the place you worked at before, your coworkers will probably be concerned about you. They will want to know what you went through and how you are doing. Decide how much you want to tell your colleagues before your return. This will keep you from being caught off guard by their questions. Even if you request accommodation upon your return to work, you are not required to share any health information with anyone. This information is confidential between you and your employer. Your response to their questions could be as simple as a smile and a comment such as, “It’s great to be back!”
Rights and responsibilities in the back to work process
Outlined below are some general guidelines that can clarify what your rights and responsibilities are. Before getting back to work, it is important to connect with a human resource representative who can explain your workplace policies and answer any questions you might have. You will also find a link to some information in the “Resources” table that can answer any legal questions you may have.
It is your responsibility to:
- Request accommodation. Request accommodation in job duties if required.
- Provide documentation. Provide a letter from a qualified healthcare professional to explain your work-related restrictions. This should include the type of accommodation that would be most helpful.
- Cooperate with experts. Work with any experts, such as human resource staff or health specialists, who are asked to provide guidance in your situation. Engage in discussions to consider reasonable accommodations.
- Respond to employer requested medical exam. Respond to your employer’s reasonable request to undergo an independent medical exam. (Note: you cannot be forced to undergo such an exam, but refusing to do so may delay the accommodation requested.
- Work with accommodation provider. Work with the accommodation provider on an ongoing basis to manage your return to work
- Allow reasonable time for requests to be made.
- Achieve agreed-upon performance standards. Achieve the agreed-upon job performance standards once accommodation has been provided.
- Advise employer if changes are needed. Advise your employer if there are any changes to your needs.
Employers share the responsibility with employees and unions to help manage your return to work.
The main responsibilities of employers include:
- Ensuring that employees are aware of their right to accommodation. Explaining the company’s accommodation policy.
- Discussing the accommodation options with the employee once a request is made.
- Keeping records of all accommodation discussions with employees.
- Exploring other approaches and solutions to accommodate employees.
- Obtaining expert opinions and advice from a health specialist when necessary.
- Maintaining confidentiality of employee health information and medical records.
- Granting an employee’s reasonable accommodation request in a timely manner unless doing so would bring about unreasonable difficulties.
- Willingness to modify the accommodation agreement if the solution no longer works.
- Providing details to justify the decision when an accommodation request is denied.
- Advising employees about their right to appeal and their right to approach the Canadian Human Rights Commission.
After you return to work is planned and you begin working, an important part of your ongoing success is to keeping track of how you feel and how well you are functioning. Cancer and Work is an excellent resource that was designed to address the unique needs of cancer survivors with returning, remaining, changing work or looking for work after a cancer diagnosis.
Some helpful tools from this website are found in the table below. These tools can help you to track your workplace fatigue levels over time and identify activities that are energizing versus draining. They can help you plan and adjust to your changing needs, to ensure your successful transition back to work. Remember to keep the line of communication open with your healthcare team and your employer as to how you are feeling and whether any additional support is required.
Available services
The Quebec Cancer Foundation supports people with cancer and their loved ones throughout Quebec, through services suited to their needs and daily concerns.
Services offered
Services offered by the Quebec Cancer Foundation can be useful to help you with your return to work, such as telephone peer-matching and their Corporate Support Program. This program offers personalized services and an approach specifically designed to provide support to business leaders and employees with cancer or who wish to support a sick colleague.
The Quebec Cancer Foundation also has many documentary resources. Via the Info-cancer library, our documentalists specialized in oncology can guide you in your search for information and give you suggested readings.
Contact
1 (800) 363-0063
Juripop offers creative, rigorous, and accessible legal services to ensure that all people can assert their rights.
Juripop’s mission is to ensure access to justice through affordable lawyers and equal representation.
Services offered
Juripop offers a free consultation (single phone call) that will allow the person requesting the service to quickly obtain free legal information.
Juripop offers free legal services for people with cancer who have an income that does not exceed the threshold published on their website.
For more information on offerings and eligibility for free legal services, please consult:
Juripop – Legal assistance for people living with cancer
Contact
1-(855)-JURIPOP
or 1-(855)-587-4767
The mission of the Quebec Breast Cancer Foundation is to promote the well-being of cancer patients and their families through research and innovation, support and awareness.
It is committed to offering a range of services, including a hotline for information and resources adapted to the needs of people living with cancer.
Services offered
The Quebec Breast Cancer Foundation offers a psychosocial support service, Social workers can accompany people affected by breast cancer to help them communicate better in their professional environment or to help them think about returning to work.
For further information:
Returning to work after breast cancer – Ruban rose
Contact
1-855-561-ROSE
General information
The Canadian Cancer Society offers support for people with cancer and their family, friends and caregivers.
Their information specialists are there to answer your questions and offer up-to-date, reliable information on topics that include:
- cancer treatment and side effects
- clinical trials
- coping with cancer
- emotional support services
- prevention
- help in the community
- complementary therapies
Services Offered
Their service is available Monday to Friday in French from 8am to 6pm ET and in English. Interpreters are available for questions in other languages.
Contact
General information: https://cancer.ca/en/
Cancer Information helpline: (Toll free) number: 1-888-939-3333
To access their website and live chat: https://cancer.ca/en/living-with-cancer/how-we-can-help/talk-to-an-information-specialist
Online community: https://cancer.ca/en/living-with-cancer/how-we-can-help/connect-with-our-online-community
You can also access the CCS database below to find support services in your area.
Service locators
Below is a list of organizations that can help identify local support services for you and those that support you. The quality of the services has not been verified by e-IMPAQc. Before using these services, verify with your healthcare practitioner.
Canadian Cancer Society (National)
The Regroupement des Organisations Communautaires en Oncologie (ROCO) offers a service locator resource specific to the province of Quebec. It lists support resources available by region.
Contact
514-506-3503
The Quebec Cancer Foundation offers a resources directory of community, association and public resources by region or postal code.
The foundation also has a document lending service. Their materials (books, web resources, online articles, webcasts) cover a wide range of topics related to cancer. It is free to borrow and materials are sent by mail or email anywhere in Quebec.
Contact
1-800-363-0063 (Monday to Friday, 9 AM to 5 PM EST)
Acknowledgement of sources
The content of this document has been adapted from the following sources:
- iCanWork: Steps to support cancer survivors with return to work
- Cancer and Work, Assessing Physical Abilities
- Cancer and Work, Assessment of Work Abilities
- Cancer and Work: Assisting patients in changing work looking for work
- Canadian Human Rights Commission. A Guide for Managing the Return to Work
- Looking Forward. Chapter 5, Section 1
- Cancer and Work: Legal Questions: Canada
Healthcare professional endorsement
The content of this document has been reviewed and approved by a team of healthcare professionals and clinical experts.
Disclaimer
Please note that this fact sheet is not intended as a substitute for consultation with a healthcare professional. Rather, it was designed to complement interventions by your treating team. If you have questions about your health, or any medical issue, you should contact a healthcare professional right away. You should not delay seeking medical advice, or disregard professional medical advice, because of information in this fact sheet. Before beginning any health treatment, always consult your doctor. All care has been taken to ensure that the information contained in this document is accurate at the time of publication. e-IMPAQc is not responsible for any injury or damage to persons or property arising out of, or related to, any use of the fact sheet, or because of any errors or omissions.
Reproduction and copyright
Any reproduction or distribution, in whole or in part, of this webpage is prohibited without obtaining prior written consent of the e-IMPAQc project lead. Permission can be obtained by writing to e-impaqc.comtl@ssss.gouv.qc.ca.
