Unfortunately, the future of our cancer care lies with very flaky politicians, fully employed in fighting Brexit. Alongside them are giant healthcare organisations that choose the path of least resistance, attempting to find favour with the individuals in office at the time. Millions gets spent every year by charities to lobby Government for whatever is their campaign at the time. Even today, we are still asking politicians to scrap hospital parking costs! A subject that was being discussed eleven years ago when I was first diagnosed. The reality of the urgent problems is being lost, maybe this is intentional? When I was approached by Dr Dianne Dowling to share her fully researched evidence I was delighted to have the difficult facts to share. This is just a small part of the realities of life after cancer for one sector of our community.
“I want to share some alarming facts about working with breast cancer. The results of my recent doctoral research seems to be saying the same thing as researchers found several decades ago. Over 55,000 new breast cancer cases are diagnosed each year and the figures are rising. Although there are many studies on Breast cancer none explore the process of how women return/don’t return to work after breast cancer.
I conducted Interviews with sixteen breast cancer respondents and HR directors from five major employers based in the South West of England. My research found women’s return to work was limited due to employers’ lack of understanding of their working [dis]ability with few or no adjustments in place to accommodate their needs. Some disabilities are hidden, for example fatigue and emotional stress may follow surgery and chemotherapy/radiotherapy treatments and lead to loss of mental and physical work ability. Studies show a return to work allows breast cancer patients to move on from their cancer diagnosis but that they struggle to overcome the barriers in the process of returning. Few breast cancer patients are able to return to their original jobs, others are forced to change career paths or retire early due to ill-health continuing long after diagnosis.
Extensive literature reviewed and my own findings show that many women suffer discrimination at work after breast cancer. For instance, Macmillan found that employee discrimination has existed for many years and they have highlighted this in their reports since 2006. Macmillan say that employers are flouting the law regarding cancer patients. But what does this mean exactly? if there is no studies of managers’ understanding and
attitudes towards women working with breast cancer and their disabilities then how are we to understand how employers are flouting the law?
Maunsell (1999) found employers ignoring disability legislation and yet the same breast cancer issues are still occurring today. 
This is commonly seen in research findings across disciplines with a lack of understanding from employers directly (through personal dialogue) or indirectly (through workplace policy and practice) about returners’ work [dis]ability. Why are women with breast cancer still experiencing workplace discrimination? It seems from the abundance of empirical research on breast cancer there is a strong focus on return to work (RTW) using medical models of health or sickness absence intervention strategies for the purposes of Insurance management but these only serve employers needs, not the women with breast cancer.
Breast Cancer is a gendered health issue which has been missing from the study of women’s occupational health and workplace wellbeing for many decades. Messing (1998, p.70) questioned the difficulties in getting funding to focus on women’s occupational health and states, that sickness absence literature “exemplifies the field’s support for the employers’ perspectives” which my data supports. Because there are few studies that exist Messing suggests “It creates an image of women’s work as safe, which in turn militates against funding to study it” (p.71). I found no literature exploring how structural relations impact a RTW after breast cancer. By this I mean, how employers put in place policies and procedures to accommodate workers’ disabilities under section 20 of The Equality Act 2010 regarding reasonable adjustment. Additionally, across the scientific literature, absenteeism is more often than not classed as a behavior problem rather than a health and safety at work issue due to poor working relations.
By linking the sociology of health and illness together with the sociology of work my research has highlighted the need to move beyond the “interchanges of frontline settings” (deVault and McCoy, 2006, p 28-29) which demands exploring institutional language and practice to investigate what actually happens to women when they return to work with breast cancer.
Also age, disability and race can further increase the chances of women suffering discrimination. Women who have higher status jobs (managers and GP’s) are more likely to have private health insurance which enables them to have a longer recovery time off work and company intervention schemes for rehabilitation. Those on zero hours contracts on the other hand, are restricted in their decisions about returning by the resources available to them.
This illustration speaks the truth about working with cancer as my data shows. Employers expect women with breast cancer to work as normal on their return to work. When they are back at their desks they are expected to work normally. Whilst some women struggle to cope others cannot cope well with busy work schedules due to fatigue from taxing treatment regimes. With little or no adjustments made to facilitate a safe return, it is not surprising that only one third of my breast cancer respondents returned to their original jobs. Why do employers expect women to be ‘more well’ living and working with cancer. We cannot just leave our sick bodies at the door of our workplace as we return back to our desks.”
Dr Dianne Dowling
The complete doctoral research thesis can be downloaded from here.
Please feel free to share your own experience below.
Chris,
What a thoughtful article.
Sadly, I found the most telling para referred
to medical professionals having private insurance. Sadly, until the majority of
Brits realise that we can’t expect the NHS to cover everything, and have to take care of our own health, there will be problems.
Europeans seem to realise this, and their combination of state health care/private insurance, where everyone chooses to pay what they think covers what they want is something we should be looking at – but don’t suppose we ever will. It is a scandal how little HR depts.in big firms actually care about employees – but it needs a few major insurance companies to go in and negotiate with employers – but first people have to pay an insurance premium.
Hi Verite,
Thanks so much, it is always good to back up my observations with hard facts. Very few want to publish these sort of findings of course, which is fine for me.
Your friends have their old ‘work and cancer’ section which of course employs people to ‘raise awareness’ but still nothing happens apart for them giving out lot’s of green cardboard tool boxes.
What a mess we are in with these guys at the helm?
Best to you as always, Chris
Too true, I’ve tried, and failed, to return to work 3 times but each time the employers ( 3 different jobs)were just not willing to compromise with me. One even refused me a stool to perch on when I was working on the entrance ticket saying that it would set a precedence to all the other staff! To my knowledge none of the other staff had cancer! Other employers made it impossible for me to work at all by insisting that instead of using my knowledge and experience to train horses and riders I was expected to do the very physical side of working on a busy yard, it made me very ill and I ended up back in hospital and without a job.
Really sorry to hear 3 experiences like that Lynne! But in truth I am not surprised. None of the big healthcare organisations wanted to even publish this report unfortunately. Several do the basics, but in reality nobody can enforce this. I believe the answer is showing employers what people with cancer can do, rather than what they can’t! As A society we will not be able to continue discarding people from the workplace. We all have a lot to offer, with or without cancer. Please let me know how things go for you? Chris
Thanks Chris, I am a founding member of The Living Tree group so at least there I can feel useful instead of discarded.
But for me a huge part of the problem is the fact that I didn’t previously work in a nice easy work setting, my knowledge is in farming, horses and driving large vehicles, so I’m not your typical ladylike lady. Because all my previous jobs have been very physical it’s hard to get back to in any capacity. I want to be able to use my knowledge and experience to find work but unfortunately I am finding that an impossible task
I get that totally Lynne! We all need to work, and share our experience with others Cancer should not be the end of your working life but hopefully provide you with a positive new challenge. We as a society are wasting tremendous resources by not looking at what we have to offer! Best of luck to you.
I had a lot to learn when I returned to work.I found it really hard.Breast cancer is a gendered health issue that needs more awareness. & understand around returning to work.There needs to be more understanding of what we’ve been through and better support back into taking up our roles & responsibilities. I’ve spoken to many other women who have had similar experiences to me.
Unfortunately Philipa this is far too common in this day and age. The reality is, very little support is available despite charity and political denial. No health org wanted to publish this report, I wonder why?
As you guys know, this is still one of the biggest issues facing people affected by #cancer Several of the larger orgs pay lip service, but it appears to be more advertising their charity than really affecting change.
Sorry to read this. We’re more than aware of the challenges that patients face returning to work and we advocate a more flexible / supportive approach to returning. We know the cancer experience doesn’t end when treatment does and more employers need to be aware of this.
As you guys know, this is still one of the biggest issues facing people affected by #cancer Several of the larger orgs pay lip service, but it appears to be more advertising their charity than really affecting change.
I am just preparing to return to work after treatment for a second cancer. So am personally very interested in how supportive my employer will be. I have requested Occupational Health involvement for my phased return and my GP is supportive. So I will see how it pans out
Wishing you the best Sandra.
I worked through the entire year of #chemotherapy + #radiation without missing a day in ‘86-‘87. Assumed that was ‘normal,’ to be expected—& needed to maintain insurance benefits anyway. Thanks to my relative youth—39–I pulled it off #foolhardy #HodgkinIIIb
You are so right Kathleen, that is exactly how it was. 11 years ago I worked through my chemo. For me it was a massive psychological challenge, but I achieved it too. Thanks so much for sharing your experience which will help so many more #cancer
Only since my retirement 4 yrs ago have I realized how impossible that was. Recovery from emergency hip replacement (treatment-related femur fracture)
+ heart attack (also treatment-related) has been my full-time job since mid-March. My failure to note impending fracture symptoms…may be due to that year of conditioning! Did not notice fracture until frmur had separated completely at hip joint #LateEffects #Survivor #rehabwarrior
Wow, Kathleen, I see what you mean. So difficult to know what to do for the best when given decisions to make. Also so many late-effects coming now. I guess we are all still learning? Hopefully things will be better for my grandchildren 🙂 Best X