Your cancer type, treatment regime, age and pre-existing general health will all impact on your ability and readiness to return to work. Your Cancer Specialists and General Practitioner (GP) will help to guide you with your decision to return to work.
It was about 10 months after my bowel cancer surgery when I started to feel like I was ‘almost’ well enough to return to work. I had learnt how to manage the early cues of my symptoms. I could decipher which type of nausea would pass, versus the type of nausea that needed medication. I could interpret the difference between a non-sinister stomach cramp and the (stop you in your tracks) type of stomach cramp that needed urgent gastrostop!
I had learnt the importance of hydration to reduce my dizziness and I understood which foods (mostly) my bowel would tolerate without too much drama. Essentially I had come to a point where I understood my body well, knew how to prevent most of my symptoms and I felt safe that I had a ‘tool box’ of the right strategies to treat any surprise symptoms.
My biggest concern was how I was going to manage my fatigue. I wasn’t going to be able to have my nanna naps on work days! I was still mildly deconditioned and not at my pre-cancer fitness. I was worried about the physical demands of getting the boys ready for daycare, commuting in to work, actually working, and then backing it up with the evening dinner/bath/bed routine.
So I finally accepted that I didn’t have to be back to my ‘pre-cancer fitness’ to go back to work. I just had to modify what I did, conserve my energy where I could, and have the support of my workplace and my husband. I took a leap of faith! I decided that I wouldn’t know unless I tried.
I was determined not to ‘fail’ at returning to work. I didn’t want to let down my team, my boss, my GP and importantly myself. I didn’t want a stop-start return to work. Still from a place of fear I was trying to manage my recovery. The interesting thing about feeling like you were let down by your body through illness, is that you have a hard time trusting it again.
The advice that I would give today, is that there is no such thing as ‘failing at returning to work’.
Focus on your big picture recovery
So what if there is a ‘stop-start’ to your increase in hours ? So what if you have to reduce your hours or change roles? After all that you have gone through AND ACHIEVED as a cancer patient – strike this off your ‘worry list’. Honour yourself with respect, kindness and an acknowledgement of how far you have come. Allow yourself a gradual return to work. But also: do it with support and a plan!
I was lucky enough to have an office-based role. I could take breaks if I needed. I also have a fantastic GP who was supportive of my returning to work but also made sure that I increased my hours slowly. We both wanted my return to work to be a positive experience.
I knew that if I was supported I would have a much better chance of enjoying being back at work. I would also be able to increase my hours when the time was right. Most importantly, I would still have some energy at the end of the day for the most important people in my life. My husband, my two little men and of course the fur child!
I started at 2 x 4 hour days per week. A grand total of 8 hours per week! I had to let go of all expectations of where I thought I should be in my recovery. It took me 6 months of working to gradually build up to my pre-cancer work hours of 32 hours a week.
Returning to work was a significant recovery milestone for me. It felt like an amazing accomplishment. It helped me to see the light at the end of the tunnel after a very long year at home. I finally felt like I was finding my way back to me!
“All up, I had 20 days off work to ‘beat’ my cancer. Aside from the lucky benefit of having an incredibly supportive boss and staff, my tip is to be really open with people about what you’re going through. If you need to rest, do it. If you need to hand off some of the work you can’t cope with, do it. If you need extra time to complete tasks, take it. I have been completely overwhelmed by how kind and considerate my colleagues have been, and I will repay that with hard work in loyalty in spades.”
“Don’t push yourself. Don’t put pressure on yourself. Be honest with what your body can take. Ease yourself into it. I tried retuning to work 2 months after surgery whilst doing chemo – wrong idea! I was so sick, I just couldn’t do it as I was in and out of hospital with infections and severe neutropenia. I only went back 1 full day a week but it was still too much for me at that time. I ended up having 18 months off in the end. I returned to my old job 6 months ago working 4 days per week; 2 full days and 2 half days. I’m about to ask to reduce my hours as I’m utterly exhausted and my body is about to break”.
“I decided I didn’t want to go back to work so I did a beauty therapy certificate online during COVID and now own my own home business. Because I was nervous about having off days and trying to struggle with people who don’t understand. I understand that’s not always an option for people, just start slow and ease your way back in, good luck”.
“Take your time to recover, your body has been through a lot. I waited until after surgery and chemo before returning and went back to work 4 weeks after my stoma reversal surgery. I am a teacher, so this was daunting with my many bathrooms trips. Be honest with your boss, tell them exactly what is going on and what you need. I was exhausted every single day! Then the second COVID lockdown in Victoria hit after three weeks back and I got to have the rest of the term working from home. My toilet trips can be unpredictable and urgent so my advice is have a plan so you can go when you need to! Sometimes holding on for very long is not an option. Be kind to yourself and put your needs first ( not always easy!).”
(Thank-you to my beautiful cancer communities. All feedback shared generously with permission)
I knew that I was ready to go back to work when I found myself feeling bored. The majority of my symptoms had resolved. I had more energy and wanted to do more with my time. I went from wondering “when will I ever feel normal again” to researching random topics and finding energy to clean the house. A clear sign I was ready! Ha!
Remember, you do not have to be back at your pre-cancer fitness to return to work. Sure, you may need to work in a different role, team – or even a new profession. There ARE options and it is really important to be open and honest with your health care team. Also remember that you are getting stronger. So where you begin your return to work journey, is not where you will end.
Be open to new ideas and new possibilities. Sometimes there is a much better role waiting for you, that you can’t quite see right now.
When you return to work, it’s really helpful to stay in contact with your cancer psychologist or counsellor. Having an expert to talk to about any return to work challenges is really important. Some people find that as their recovery and strength improves, they have more capacity to process emotions and the head space to think about “WTAF just happened”.
For me, over two years on, I think I am probably still processing my cancer diagnosis and recovery. I am a work in progress! (Although, most of us are let’s face it).
Everyone has their own journey, and it’s not for anyone to judge or compare. You are probably your own harshest critic.
Take a moment to reflect on how far you have come in your recovery, the lessons you have learnt and your new outlook on life. That my friend takes sheer grit, strength, power, flexibility, endurance and resilience. It is something that you cannot understand to its full magnitude unless you have been there.
Initially I really struggled with learning this lesson. My bowel cancer treatment was surgical. I did not need chemotherapy or radiotherapy. But it took me almost a year to be able to return to work. My recovery was complicated by many months of constant diarrhoea, malnutrition, muscle wasting, nausea, dizziness, sleep deprivation, exhaustion, drug reactions and emergency department presentations. Oh and the emotional (cluster f*ck) catastrophe that is a cancer diagnosis with very small children.
For a long time, I felt like a bit of a ‘sook’. I was evaluating and comparing my own recovery to others. I would speak to women in my online cancer communities who were working though their treatment for Stage IV bowel cancer. And here I was, not being able to work many months after having a bowel resection.
I spent a lot of time feeling ‘less than’ and like I was doing something wrong. As a nurse of almost 20 years, I would think back to patients that I had looked after in the community after major illness. For months my functional abilities were less than some 70 year olds that I had cared for! That was quite a lot to process as a 38yo, previously fit and well mumma to two little boys.
Thankfully I had an amazing medical and support team to guide me. My medical team assured me that I was ‘normal’ and sometimes recovery (even with ‘just’ surgery) can take a long time. “It takes as long as it takes”. The wonderful people at the Cancer Council let me know that the average time for feeling ‘normalish’ after cancer is two whole years. Ah, finally some normalising of where I was…
So some people continue to work through their treatment, others are able to get back to work a few weeks after their surgery, and others may take years to be well enough to be able to return to the workforce. You will know within yourself how you are feeling and your medical team will guide you on when the time is right to return to work.
A successful return to work will be so much easier with a supportive employer and team. Keeping your employer or team up to date with your progress is key. Your team will want to know how you are progressing and eventually when you are ready to come back to work. If you are on sick leave, usually there is a minimum requirement to keep your employer up to date at regular intervals as per the company policy. This is often monthly.
I found that through keeping in regular contact with a couple of my closest work friends, my return to work was easier. I had regular phone contact and the occasional home and hospital visit when I was well enough. If you are able to go into your workplace for an informal catch-up before your return, it may help to ease some of your nervousness about seeing your colleagues again.
It took me quite a while to regain my confidence when I went back to work. I could liken it (a little) to returning to work after maternity leave: I was tired, I had been through a major life adjustment, my thought processing speed was a little slower and my body had changed… But of course it was different. I had a cancer diagnosis in the back of my mind and my body had been pushed beyond what I knew it was capable of. Now I had to manage work, medical appointments, HR appointments, and cancer surveillance protocols all while looking after a young family. It was only when I increased my hours to about three days per week and I was able to see that I was being ‘productive’, that I felt valuable again.
This is something that you will need to discuss with your GP or Cancer Specialist. Go slow!
Most people return to work at reduced hours. I really appreciated the graduated return to work that my organisation supported. It is of no benefit to you or your team if you are pushing yourself beyond your capacity. If you do find that you have increased your hours too quickly and you are unable to manage, speak to your employer and medical professional early, before your health is impacted. You have come this far, it really is not worth jeopardising the progress that you have made.
Sometimes a change in role or duties is needed, short term or longer term. Your memory and cognition may still be impacted by Cancer Fog and you may need some role adjustment. If you have a physically demanding job you may need to modify your duties while you continue to regain your strength. There may be other reasons that you may need to change your role. As I have already mentioned, communication with your employer and medical team is key. Your colleagues want your return to work to be as successful as you do.
Some people have new and special needs when they return to work. This could be needing to have medications at certain times, needing to take further time off work for treatment, or taking regular breaks to manage a stoma bag or a feeding tube, for example.
If you have special needs when you are returning to work, get specific expert advice and prepare. Talk to communities and organisations who specialise in your condition. If you can organise to link in with a ‘buddy’ with your same condition/needs who has returned to work- this is ideal. Write down all of your questions, ask for their ‘hot tips’ and don’t be afraid to ask any curly questions. A beautiful element of cancer survivorship is that so many past patients want to share their lesson’s.
It is easier to walk the road when you have a ‘mud map’!
After you have received your ‘hints and tips’ discuss your needs with your employer or team. Be honest and up-front. Ask any questions that you have, and even offer solutions or workarounds that you have considered.
As you get stronger it is tempting to max out your calendar to make up for lost time! I totally get it, you’ve had many months of not being able to do the things that you want to do. It is always good to ‘leave some fuel in the tank’. When you first go back to work, try to make work your one ‘task’ for the day. Don’t add in grocery shopping, appointments, after school park visits, etc. Your body will thank you for allowing it adequate time to recover.
Prepare a couple of responses for when people ask you “how are you”, “how many hours are you working at the moment”, “are you in the clear”? These are the type of common questions that you will be asked. You will feel emotionally prepared if you have a couple of responses ready to go.
This was an amazing tip that I received when I returned to work from a lovely colleague who had cancer a few years prior to me. I have since shared this tip with many people who are embarking on their return to work phase, with great feedback.
I was extremely lucky to work with a group of kind and caring colleagues. I had a number of staff who regularly made a special effort to come and chat to me when I was back at work. I can’t tell you how much this meant to me and helped me to quickly settle back in to the workplace.
There were some colleagues who didn’t mention my illness or recovery. And that is totally OK. It’s important to remember that everyone has different levels of ‘comfort’ when mentioning the Big C. My cancer may have brought back painful memories, or they may have felt that they weren’t quite sure what to say. Again – totally OK. As much as we don’t want to be judged in our recovery, it is important to extend that same principle to those who are around us. Remember many people have an invisible battle that they are fighting.
If you are reading this as a supportive colleague- thank-you! A simple genuine “great to see you’re back”, is brilliant. You don’t need to worry about saying the wrong thing or worry about ‘making it a thing’. After a cancer experience we really just want to get back to our new normal as soon as possible.
Just how much I enjoyed being back in the workplace. I enjoyed the mental stimulation, the feeling of contributing, and just being ‘normal’ again. It was a momentous point in my recovery where I knew that my life trajectory was definitely on the up!
Because I was happy and supported- working actually gave me energy!
I noticed that my energy began to increase after a few months and that my symptoms of nausea and lingering food intolerances were reducing rapidly. This was about 14 months after my cancer diagnosis. I had a new life focus- my new beginnings. Returning to work has been an important step of my physical and emotional recovery. Today I feel more like me then I have in a really long time!
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X The Awakened Mumma, Author of ‘A Woman’s Guide to Navigating the Invisible Cancer Load‘
