If you are self-employed during cancer treatment
For many people, the aim of cancer treatment is to cure the cancer. If the cancer is very slow-growing or if it has spread beyond its original area of the body, the aim may be to control the cancer and delay its progress.
The treatments that are most commonly used include surgery, radiotherapy and anti-cancer drugs (chemotherapy, hormonal therapy and targeted therapies). These may be given alone or in combination and are described below.
There is more detailed information about each treatment and its side effects in the cancer treatment section of the site.
Surgery may aim to remove all, or part of, a tumour. The effects of the surgery will depend on the part of your body being operated on and the type of operation you’re having.
Some operations for cancer may be carried out as day surgery, which may mean that you’ll only need to take a short time off work. Other operations are more extensive and may mean spending a few weeks, or even months, away from work.
Some cancer operations may leave you with changes to your body that could affect your ability to do your current job. The doctors and nurses at the hospital will be able to explain the likely effects of any surgery.
Radiotherapy treats cancer by using high-energy x-rays to destroy the cancer cells, while doing as little harm as possible to normal cells. Radiotherapy treatment that aims to cure the cancer will often mean that you need to go to the hospital every weekday for several weeks.
Each treatment only takes a few minutes, but travelling to and from the hospital and waiting for the treatment may take up a large part of the day.
Some people manage to continue to work during radiotherapy treatment, but you may need to reduce your hours. Other people stop working completely while they’re having radiotherapy and for a few weeks afterwards.
Side effects of radiotherapy
Radiotherapy may make you feel tired. Other side effects will depend on the part of your body that’s being treated. The side effects tend to begin a couple of weeks after the treatment starts and may slowly get worse as treatment goes on.
These effects may continue for some weeks after the treatment has ended. Then they usually improve gradually. However, the tiredness can take longer to ease and some people find it’s many months before they get their energy back.
Watch our video for an introduction to how external beam radiotherapy is given.
There are more than 100 different drugs used to treat cancer, and these fall into three main groups:
cytotoxic drugs (chemotherapy)
In most cases, you will not have to stay in hospital to receive these treatments – you may be able to have them over a few hours in the chemotherapy unit or be given treatment to take at home.
Chemotherapy (cytotoxic drugs)
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Many of these drugs have been used for more than 50 years. The drugs interfere with the process of cell division, but affect normal cells as well as cancer cells. This is why they often cause side effects. The drugs are usually given as a liquid through a drip into a vein (intravenously), so they can circulate in the bloodstream and reach the cancer cells wherever they are in the body. Some chemotherapy treatments are given as tablets or capsules to take at home.
Chemotherapy is usually given in cycles of treatment. The medication is given over a number of sessions, and then you have a break for a few weeks to allow your body to recover from the effects of the treatment. Each session of intravenous chemotherapy may take minutes, hours or a few days.
Usually, between four and six cycles of treatment are given, which takes between four and eight months. Some treatments for certain types of cancer last much longer than this, while treatment for other types of cancer may be shorter.
Chemotherapy affects people in different ways. Some people find they can’t work at all. Others can keep working or just need to take a few days off, carrying on with work between cycles.
Side effects of chemotherapy
Chemotherapy can cause unpleasant side effects. It can temporarily stop your bone marrow from making new blood cells. This means your immunity is reduced (due to a lower level of white blood cells) and you’re more prone to infections. Avoiding contact with people who have infections is a good idea if possible.
You may also become anaemic (when the number of red blood cells in your blood is low) or have bleeding problems, such as nosebleeds, or bruise easily.
If your white blood cell count is low, you may need to take antibiotics to treat an infection. Or you may need a blood transfusion if you are anaemic. You will have regular blood tests between courses of treatment to monitor its effects.
Other common side effects can include:
You can take medicines to control some of these side effects. They will gradually disappear after your treatment has finished. If you lose your hair, there are ways you can cover this up if you would like to.
Hormonal therapies are drugs that can stop or slow the growth of cancer cells. They do this by either changing the level of certain hormones in the body, or stopping the hormones from affecting the cancer cells. Most hormonal therapies are given as tablets, but some are given as injections every few weeks or months.
Side effects of hormonal therapies
Hormonal therapies can cause side effects such as weight gain, hot flushes, sweats, tiredness and lowered sex drive. These treatments are often given over a period of months or years. They usually have less of an effect on your ability to work than other cancer treatments.
These are a newer group of treatments that work by targeting the growth of cancer cells. They generally have little effect on the growth of normal cells, so they usually have fewer troublesome side effects than chemotherapy drugs.
Targeted therapies may be given as a drip (intravenous infusion) or as tablets.
Side effects of targeted therapies
Possible side effects include flu-like symptoms, chills, headaches, a temperature, low resistance to infection, skin rashes and tiredness (fatigue). Some treatments may also cause sickness and diarrhoea.
Many people are able to carry on working while taking these drugs, but tiredness and other side effects can sometimes make this difficult.
Possible long-term effects of cancer treatments
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Many people recover well and can return to a normal working life after their treatment has finished. However, other people have ongoing problems caused by their treatment. It depends on what kind of cancer and treatment you’ve had, and on your individual situation. A few examples of long-term effects from cancer treatment might be:
tiredness (fatigue) for months or sometimes yearsa swelling and discomfort in the arm (lymphoedema)
if you’ve had breast surgery
needing to eat little and often after stomach surgery
needing to go to the toilet more often after bladder or bowel cancer treatment.
If you have long-term side effects from your treatment, you may need to change the way you work or the kind of work you do. For example, you may need to think about whether
you can travel or whether you can do physical work.
It can be hard coming to terms with the fact that you may not be able to carry on with the exact work you were doing before. There may be ways that other people can help with aspects of your business. If you have a business partner, employees or use sub-contractors, they may need to take on a bigger role. You may also want to consider employing a locum or temporary replacement to take over your role in the business. This will depend on whether you can afford to and how long your absence from work may last.
If you find you’re not able to carry on with the work you were doing, you may feel it’s best to stop work or sell your business. This is a big and often hard decision to make. You’ll probably find it helpful to talk it through with your family and perhaps a financial adviser to help you make the right decision for your situation.