Returning to work

This entry was written by Hester Hill Schnipper, a member of our medical advisory board:

One of the challenges of living with breast cancer, especially during treatment, is finding the right balance between work and personal life.

Most women who are treated for breast cancer take some time off from work.  Depending on your course of treatment, you may need anything from a couple of weeks to six or more months of leave.  In addition to the time dictated by medical/physical necessity, there are other factors that influence this decision.

Where you work and what you do matters. If you teach kindergarten, you likely will be worried by the constant physical demands and the exposure to every possible germ and virus known to five year olds. If you work in construction, you can’t be on the job until you have completely regained full physical strength. If you work in an office, the attitudes of your supervisor and colleagues will influence your planning. A manager who is flexible, understands your need for doctors’ appointments and allows you to work shorter days when you are not feeling well may make it feasible to work through much of treatment.

Additionally, there are the financial realities. It is helpful to have someone in human resources explain the benefits available to you. Do you have short-term disability? What happens to your insurance during a leave? If you only are paid for days you work, the pressure to return is even greater. If finances will be a problem for you, speak with an oncology social worker (ask your doctor for a referral) who can tell you about possible sources of assistance.

My best advice is not to make a decision too quickly. You’ll need some time to recover from surgery. Beyond that, it is impossible to generalize and hard to predict. Waiting to see how you react to chemotherapy will make the decision easier. As a general statement, women tend to feel the worst on days 3, 4, and 5 after chemo. Think about this when you schedule your treatment.

Very important: Do not listen to everyone else’s opinions. This is a topic where there is a lot of judgment–often without consideration for your particular physical, emotional, and financial needs. Only you know whether it would be better for your psychological health to be at home, away from any professional stresses, or at work, where distractions may take your mind off other things.

Returning to work is tricky. If you have been away for a while, you will have to face questions, stories, and sidelong glances. You’ll look differently than you did the last time co-workers saw you. I have had many conversations with women who could not decide whether they should wear a wig to work or go without. It can be helpful to speak with one or two people and ask them to ease your return by telling others what you look like and how much you want to talk about your diagnosis. Would you prefer to tell your story repeatedly or would you prefer that others leave it to you to start the conversation? Everyone has different preferences, and it will help to think about it before your return. The more concrete you can be with your requests, the better. Unfortunately, you can count on being ambushed by at least one thoughtless remark. Think ahead of time about how you will handle it.

My last piece of advice? Try to negotiate a gradual re-entry. If you can work part-time for the first week or two, it will be easier. You will be surprised by your physical and emotional fatigue as you return to your job. For many women, going to work every day for less than eight hours is easier than going fewer than five days/week. Again, you know best what seems right for you.

How long after treatment did you return to work? What tips do you have to share with other women preparing to come back to work? Share your thoughts by leaving a comment below or on our Facebook page.

 Hester Hill Schnipper, LICSW, BCD, OSW-C, is chief of oncology social work at Beth Israel Deaconess Medical Center.

7 thoughts on “Returning to work

  1. I am very lucky – I had coverage for both short term and long term disability, so I didn’t have any financial pressure to return early. I had no idea how valuable those benefits really were (I’ve worked in my job for 22+ years and never had to use these before). I also have good support at home from my husband, and my two boys are old enough to be pretty independent (12 and 15). It would be much harder to go back with little ones around.

    With all that said, I am about to go back to work next week, after a full year off for treatment. And my family doctor is suggesting this may be too soon, that I’m not yet ready for the stress of my job. But I think I’m ready. I will be doing a gradual start – 4 hours a day the first week, 5 hours a day the second week, gradually working up to 8 hours a day after 4 weeks.

    I’ll be updating on my blog how its going.

  2. I returned to work two weeks after a mastectomy. Not a good idea. I had two more surgeries for reconstruction and each time I was back to work within two weeks. After the mastectomy I couldn’t drive, I couldn’t lift anything because my arm was useless and I had no energy. Somehow, despite all that I felt going back to work was the best thing. Two years later I have come to realize that I may have been wrong. I think I was trying to live up to the expectations of everyone at work of being ‘strong’, ‘positive’, ‘hopeful’. I felt obligated to get back into my routine to make things feel normal for others and myself.

    I am just approaching my first year of being surgery free and I am just recently feeling like my energy is back to a normal level. However, I find myself emotionally craving time at home and alone to, for lack of a better word, brood. I feel by not allowing myself the time early on to physically and emotionally heal I just postponed my need to recover and adjust to a new life. Despite our best efforts as survivors, our lives never go back to ‘normal’. Maybe we need time to let that sink in.

  3. I did not have disability coverage following my mastectomy and chemo, but with careful budgeting and a very understanding husband we managed to squeak by financially. My very understanding boss allowed me to work for a few hours each day during the third week of each chemo cycle, which helped with the family finances as well as helping me by getting me out of the house. Following radiation treatment I returned to full-time work, but quckly discovered that I was no longer physically capable of working 40 hours a week, and my career no longer seemed so important anyway. So I quit working entirely for nearly a year, and took the time I really needed to heal. We moved from a large home in the city to a smaller home out in the country, and that was when my physical and emotional healing REALLY took place! I learned how important it is to have “balance” in my life – to literally listen to the birds sing and watch the flowers grow! It is so important to nourish your soul as well as your body in order for healing to truly take place.

    I recently celebrated 5 years of being cancer-free; I continue to work at the same job, but in a part-time, more flexible capacity. My career is no longer all-consuming, but is a nice complement to a very balanced, happy life. I love working – I enjoy the interaction with my co-workers and my patients, and being able to contribute to my family’s finances. It is satisfying to feel that even though I have been very ill, I am still a contributing member of society. But I make sure to spend time each week doing little projects in my home, playing with my grandchildren, reading, gardening, listening to music, painting, and in spiritual meditation.

    My life will never be the same as it was before cancer; my body has changed, as well as my energy level – and my priorities are quite different now. Howevery, the balance I have achieved in my life enables me to enjoy ALL aspects of my life! I work diligently at keeping this balance, because sometimes it’s easy for one part of my life to overwhelm the others and throw everything off balance, and then my stress levels go up. My life today is drastically different from the life I had before cancer, but the balanced life I have now is by far the happiest!

  4. During my year of surgeries, chemo, radiation, infection, &blood clot, I was able to pamper myself by being stress free from the outside work environment. At first I thought it might help me keep my mind off my journey by being fully engaged at work. Instead I decided to have fun in between treatments by taking up golf with great beginners, watercoloring, volunteering to make chemo hats , joined a book club and kept in touch with friends and family. It made my recovery go smoothly and now I am ready to join the work force. It was hard on the budget last year, but I don’t care . I even had to fight for months to get my insurance company to pay for my IMRT radiation. They said it was experimental for breast cancer and would not cover the expense. After stressful appeals, they are finally going to cover this bill. After 30 years of working and the first large insurance claim, it was very disappointing to be treated this way. I did not miss working during this time. Now I have survived and am ready for the “outside world” again. God bless everyone going through this personal journey.

  5. Dear Judy,

    I could identify perfectly with what you said about being strong, positive, and hopeful…that is what I thought I would do when I had a mastectomy three months ago (almost); return to work ASAP. I soon discovered that I was unable to do so because of pain and very weepy moments that I had to experience all by myself in the privacy of my home. Even now, during treatment and many emotional ups and downs, I’m hopeful that I can continue to take at least 6 more months off of work or more!

    If I could say one thing to you, it would be that I’m so hopeful you will be gentle with yourself and know that you’re deeply loved regardless of how strong, positive, or hopeful you may seem at any given moment. I always defined myself by my athletic abilities and my upbeat personality, (and long hair!) but in God’s eyes, we are all the same and all loved completely regardless of what our outside appearances happen to be….bald, breast-less, emotional fatigue, etc! 🙂

    Please “brood” all you want and I completely understand that our lives never go back to normal…but then, what the heck is normal? I’m trying to figure that one out especially considering I’ve taught good, sound nutrition and fitness for over 20 years that would almost guarantee a person of a life free from cancer; wow…was I ever wrong!

    Blessings of health and healing to you!

  6. I thank you all for your stories. I’m going through my second occurrence with cancer. I when right back to work so I would have other things to think about. My company has been good too me. They will come and pick me up and take me home. I only work 3 hours a day. I am not aloud to drive yet. Yes some days I just want to sit at home and brood. So I start out the day with a cry and it makes me feel better.
    My supervisor let everyone know I did not want to talk about my cancer but I would give updates every now and then.

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