Returning to work following cancer

Being in work has considerable benefits for workers and employers, as long as they provide safe and supportive workplaces.

Being in work has considerable benefits, not just for individuals and their families but also for employers. Helping people to remain in or quickly return to work when health conditions arise is therefore important.

Employers, occupational health and other healthcare professionals, trade unions, HR professionals, line managers and occupational safety and health practitioners must all work together, combining their respective skills and experience to create a powerful multi-disciplinary team. Within such a team, the occupational safety and health practitioner has the opportunity to use the knowledge and experience they have gained in their traditional role to help make sure that all health and safety risks are suitably identified and assessed; that reasonable adjustments are identified which are both appropriate and without risk; that they support and ensure the implementation of such adjustments; and that they monitor their ongoing impact and effectiveness.

Employers can help employees in a number of ways: protecting their health and wellbeing; wherever possible, helping them remain in work when health conditions arise by providing support and making reasonable adjustments; helping those who have been absent to return to appropriate work that they can perform without risk; and by using the workplace as an opportunity to help improve employees’ general health and wellbeing. This requires a co-ordinated approach, with the focus on producing the best outcome for the individual.

Our Return to work after cancer webinar explores the occupational safety and health considerations.

Cancer - symptoms and treatment

There are many different types of cancer and many diverse treatments, even for the same type of cancer. Many factors can cause, or increase, the risk of developing cancer. These include: genetic factors; lifestyle and diet; infection by certain viruses; exposure to carcinogens in the workplace, such as asbestos and chemicals; environmental factors, such as ultra-violet radiation from the sun; and tobacco smoke.

It can take many years for symptoms of cancer to be noticeable and these usually differ depending on the type of cancer. It’s not possible to list all the symptoms that could be caused by every type of cancer, but some common symptoms include:

  • breathlessness
  • fever
  • general weakness
  • weight loss
  • loss of appetite
  • fatigue
  • anxiety
  • muscle aches/unexplained pain
  • persistent cough or hoarseness
  • difficulty in swallowing
  • altered bowel habits
  • lump somewhere on the body
  • night sweats
  • reddish, scaly patchy skin
  • abnormal bleeding.

Treatments may include: surgery, chemotherapy, radiotherapy, hormone treatment and biological therapy or any combination of these, often with more than one type of treatment being required. All treatments can have side-effects which often persist for long after treatment has finished and may have a significant impact on people returning to work.


Supporting employees with cancer

The increasing survival rate, along with the rising retirement age, means that supporting employees with cancer and better management of side-effects are likely to become increasingly important issues for employers.

Of those working when they are diagnosed, 4 in 10 have to make changes to their working lives after successful treatment for cancer, with almost half of those changing jobs or leaving work altogether.

It is important that employers understand how cancer treatments may affect people returning to work, the problems individuals with cancer may face and how they may be affected, and how to manage workplace risk. Many employees struggle with returning to work following cancer due to problems that include fatigue, trouble with concentration and memory, loss of confidence and other physical and psychological issues as well as the impact of ongoing treatment. What is often not understood is the longer-term impact that some cancer treatments can have on those returning to work and the fluctuations these can cause in health. Most people are able to resume normal work tasks 18 to 24 months after diagnosis. However, for some people it takes longer while others may not be able to undertake the same work or role.

There is a lack of information about these problems specifically in relation to workplace risk factors such as driving, the impact of fatigue and the physical or mental demands of work.

Many factors can influence an effective return to work, including treatment and side-effects, other health issues, support from employers and their willingness to make adjustments and also support from colleagues, friends and family.

The impact of treatment on most individuals with cancer means that returning to work successfully is likely to take more than 12 months. Most long-term sickness absence policies do not cater for this and should be reviewed and revised in the light of this information and the continuing need to make reasonable adjustments as set out in the Equality Act 2010 and equivalent legislation in Northern Ireland.

IOSH has already produced a toolkit on occupational cancer containing much useful and relevant information for those returning to work.

Further information

More information about the impact that returning to work after cancer has is available in the links below.

Macmillan Cancer Support work and cancer - this has information for employees and employers.
Macmillan Cancer Support - work and cancer getting the message.

Working With Cancer has a variety of articles and blogs about managing work and cancer.

The content for this toolkit was produced as part of the IOSH-funded research undertaken by the Institute of Occupational Medicine, Loughborough University and Affinity Health at work.