Cancer in the workplace: are you ready for the tsunami?

Cancer is on the rise. Some scientists have even described it as an impending tsunami, which could overwhelm healthcare systems, and society.

In Britain, the number of people diagnosed with cancer will rise by a staggering one third by 2040, according to analysis by Cancer Research. That will take the number of annual new cases from 384,000 to 506,000 for the first time. In addition, contrary to popular opinion it’s not just the older generations which are seeing this rise in cases. The increase in cancer diagnosis for those of working age is stark.

The number of people diagnosed with cancer in Britain will rise by a third by 2040, according to Cancer Research. Photograph: iStock/FatCamera

A global study last year found that the number of under 50 year olds being diagnosed with cancer worldwide has increased by more than 80 per cent in the past three decades and is expected to increase by a further 30 per cent by 2030. 

And improvements in treatment means that people are living longer with cancer. Research has also identified that overall median survival times for cancer (the point at which half of those diagnosed have died or survived) have improved from just one year 40 years ago, to nearly six years today.

This means a cancer tsunami is also heading for the workplace, with an increase in the number of people either undergoing treatment, or caring for others with cancer.

Social enterprise Working With Cancer, which supports employers to manage cancer in the workplace and employees (including working carers) to manage work when affected by cancer, is calling for all UK organisations to establish dedicated cancer policies to support workers affected by cancer and to ensure managers and employees are trained or coached to support these individuals through what is a very difficult time of intense vulnerability for them.

Cross-industry pledge to erase the stigma of cancer at work

Some leading organisations are waking up to the issue of cancer at work. The Working with Cancer Pledge is the world’s first cross-industry coalition to erase the stigma of cancer in the workplace, initiated by Publicis and supported and partnered in the UK by Working With Cancer and Macmillan Cancer Support.

Over 1,250 organisations globally have now committed to the pledge, including Pfizer, Meta, Disney, L’Oréal, Nestlé and Toyota. Each has promised to abolish job fear and insecurity that can exist for cancer sufferers in the workplace. To complete the pledge, organisations just need the name, title and headshot of the executive taking the pledge and a description of concrete actions they will be taking to support cancer patients at work. Once signed, the coalition also shares information and advice with members.

However, this awareness of cancer in the workforce is slow to change. Research among more than 1,200 patients by Working With Cancer and the Institute of Employment Studies found that a quarter of people with cancer did not return to work after their diagnosis. More than half of those who did had no return to work conversations with their employer’s occupational health professional (51 per cent) or with their HR professional (50 per cent). Only 68 per cent even discussed return to work issues after cancer with their line managers.

We know that people having treatment, caring for others affected, or returning to work encounter a lot of fear and complex situations at work with line managers and colleagues. Common problems they might face include managers not understanding that a person with cancer is protected by the Equality Act 2010, and underestimating the need to provide a supportive phased return to work with regular check-ins.

There is clearly much to be done. Organisations need to focus on this to ensure they are ready for the increase in staff of working age with cancer, and for the increasing numbers with advanced or metastatic cancer.

This definitely does not need to be a tsunami of problems for organisations who value their workforce, and who acknowledge the issues and become prepared. Simple steps such as ensuring you have a dedicated cancer policy and have trained and coached employees and managers on how best to support a colleague affected by cancer can make a remarkable difference to staff morale and retention at a time of extreme vulnerability.

So, what can you do if you are affected by cancer, or if you want advice about how to look after your staff? According to Working with Cancer, the most important thing a manager can do is listen and for the person affected to communicate their needs. Each person’s illness and treatment will affect them in different ways and there isn’t a one-size-fits-all approach.

Tips from Working with Cancer for employers include:

Dos for employers

• Be aware of employment rights – in the UK, everyone with a cancer diagnosis is classed as disabled under the Equality Act 2010 (or in Northern Ireland, the Disability Discrimination Act 1995 (DDA) as amended) and protected against discrimination in the workplace because of cancer.
• Be responsible – employers are required to make ‘reasonable adjustments’ (also called ‘workplace adjustments’) to the workplace and working practices to support an employee’s return to work with or after cancer. Work with your employee to find the optimum working arrangements.
• Be understanding and informed – line managers can set the tone and lay the foundations for a successful return to work. Cancer and its treatment have both physical and emotional side effects, which can be long lasting and often not visible.
• Be responsible and be supportive – be empathetic and sensitive to the anxieties, stress and pressure your employee is encountering.
• Keep in touch – talk to your employee about their cancer and their progress. Give them the opportunity to tell you how they are feeling. Recovery is never a linear, straight line process.
• Be inclusive – cancer impacts everyone so, if the employee is happy for this to happen, engage the employee’s team by giving them regular updates and include them in supporting their colleague’s return.
• Protect confidentiality – ensure you respect the employee’s right to keep their cancer diagnosis confidential if that is their preference.

And Don’ts

• This is a process not an event. Don’t think of a successful return to work as one event, but a process which can take as long as 12–18 months. Arrange for regular check-ins and progress reviews with the employee.
• Make assumptions. Don’t make assumptions about the employee’s longer term career goals and direction or that everyone’s cancer experience is the same.
• Don’t have fixed views about return plans. Be as flexible as possible and be prepared to consider a staged return to work plan of at least 12 weeks, depending on the person’s individual circumstances.
• Don’t be intimidated if your employee has an advanced cancer diagnosis and assume that this means the employee can’t or won’t want to work. Listen to what they want.

And Working with Cancer tips for employees include:

• If you have cancer you are considered to have a disability and this provides you with protection under the Equality Act.
• You can control who knows about your disability. You do not have to tell your colleagues. It is your right to control who knows about your condition within your working environment.
• Your company needs to provide you with reasonable adjustments for your return and you can find out more on the UK Government website, or sign up to one of our regular free courses here.
• Don’t underestimate how much time it will take for you to adjust to work. Returning to work is a process for you as well as your company. Everything won’t return to normal the minute you’re back and you need to be ready for days or times when you will need extra support.
• Do ask for at least a 12-week phased return to work if you feel you need it. You may well need more than this.
• Do make sure you have regular meetings with your line manager or HR contact to explain how you are feeling and whether you need extra support.

Working with Cancer guidance on employers’ legal obligations

In the UK, everyone with a cancer diagnosis is classed as disabled under the Equality Act 2010 (or in Northern Ireland, the Disability Discrimination Act 1995 (DDA) (as amended)), and protected against discrimination in the workplace because of cancer. The protection is lifelong regardless of whether treatment is continuing or completed, or whether the individual is in remission or not. This legislation covers all areas of employment, including the pre-employment recruitment process and post-employment references. It also covers carers and, in many cases, people who are self-employed.

The main forms of discrimination which affect cancer survivors include:

• Direct disability discrimination applies when, because of a disability, an individual receives less favourable treatment than someone who does not have that disability. Examples are not recruiting or promoting or training someone because they have cancer.
• Indirect disability discrimination applies when a rule or policy or practice which applies to everyone puts disabled people at a disadvantage compared with those who are not disabled. Not knowing about a person’s disability is not an excuse for indirect discrimination. Examples are not being selected for a role, or promotion, or training because of a reason related to having cancer – for example, having too many days sick leave.
• Discrimination arising from disability is when someone is treated unfavourably because of something arising in consequence of their disability, rather than the disability itself. Examples include needing to have regular rest, or toilet breaks, or having difficulties in using public transport, or needing regular hospital appointments, which impact an individual’s performance, or work commitments and lead to unfavourable treatment at work.
• Harassment is when someone behaves in a way which offends another employee or makes them feel distressed or intimidated. This could be abusive comments or jokes, graffiti or insulting gestures. Examples include an employee being teased about frequent trips to the toilet, about hair loss, or about forgetting things because of ‘chemo-brain’.
• Victimisation – if an employee believes they have been treated badly because they have complained about discrimination or harassment, or because they have helped someone who has been discriminated against, this is called victimisation and is unlawful under the Equality Act. Employers can also be held vicariously liable for how their employees behave at work where this results in direct discrimination and harassment.

Getting support

Working With Cancer is a social enterprise formed in 2014 to support employers and staff to work with cancer. It supports organisations ranging from small businesses to global corporations (including banks, legal firms and retailers), and provides policy, advice and training, direct coaching of both individuals and their managers, drop-in clinics and best practice guides. The top 10 companies it is currently supporting employ more than half a million people. 

Working With Cancer’s team of 12 policy advisors, trainers and coaches, train and individually coach around 1,000 people a year in the UK and Europe as well as providing guidance and information through publishing best practice guides, podcasts, webinars, Instalive sessions and speaking at conferences.

Working With Cancer also provides free webinars on how to return to work successfully after cancer dates and details are on the website here.

Working with Cancer opinion: the steps government and employers must take to ensure better support for employees impacted by cancer

There are two areas where the UK Government and organisations need to make changes:

Employment law needs to change to reflect the increase in treatable but incurable illness. Research has identified that overall median survival times for cancer (the point at which half of those diagnosed have died or survived) have improved from just one year 40 years ago, to nearly six years today. (Source: Living after diagnosis. A research briefing paper by MacMillan.)

Barbara Wilson says: “People with advanced cancer can survive and work successfully for many years after a diagnosis if they want to, but we find they often face ignorance or prejudice at work. While British employees are protected by the Equality Act, they can still be dismissed by their employer on the grounds of capability. We don’t believe this is acceptable and call on the government to change employment law so that people with advanced cancer can no longer be dismissed.”

Barbara Wilson is founder and director of Working With Cancer. Photograph: Working With Cancer

Setting reasonable and consistent policies for cancer sufferers’ return to work

Barbara Wilson says: “I am constantly shocked by the unfairness and impractical nature of  return to work policies in organisations such as the NHS. We regularly get called by NHS staff who are being told they can only have a four-week phased return to work.

“This simply isn’t sufficient. It stops highly valuable staff from returning, or causes them problems on their return. We advocate that the NHS and indeed all organisations should set a reasonable phased return to work period of at least 12 weeks for a full-time member of staff.”

 

Barbara Wilson is founder and director of Working With Cancer

 For more information please visit or follow:

workingwithcancer.co.uk

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Join the conversation using the hashtag #workingwithcancer.

Learn more about the Cancer Pledge here:

workingwithcancer.co.uk/working-with-cancer-pledge/

workingwithcancer.co.uk/resources/videos/wwc-pledge-campaign/

Sources of information:

Cancer in 2023, tinyurl.com/y8yywu8z

Global trends in incidence, death, burden and risk factors of early-onset cancer from 1990 to 2019, BMJ Oncology, tinyurl.com/27bm88wa

Living after diagnosis. A research briefing paper by MacMillan, tinyurl.com/mrx5efb2

Cancer and Employment Survey 2022. A survey by the Institute for Employment Studies and Working With Cancer, tinyurl.com/56eefrn4