How cancer treatments can affect your work
The aim of cancer treatment for many people is to cure the cancer. In some very slow-growing cancers, or cancers that have spread beyond the original area of the body, the aim may be to control the cancer and delay its progress.
The main treatments for cancer are surgery, radiotherapy and chemotherapy. Other treatments such as hormonal therapy and targeted therapies may also be used for certain cancers. Often a combination of more than one type of treatment is used.
Surgery may aim to remove all or part of a tumour. The effects of the surgery will depend on the part of the body being operated on and the extent of the surgery.
Some operations for cancer may be carried out as day surgery, which may mean that you only need to take a short time off work. Other operations are much larger and may mean spending a few weeks, or even months, away from work. Some operations may mean that your ability to work is significantly affected, for example if you have to have a limb amputated.
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 working during radiotherapy treatment, but may need to reduce their 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’s ended. Then they usually improve gradually.
However, the tiredness can take longer to improve, and some people find it’s many months before they get their energy back.
We have more information about side effects of radiotherapy.
Chemotherapy drugs interfere with the process of cell division. They affect normal cells as well as cancer cells. As a result, they often cause side effects.
The drugs are often given as a liquid through a drip into a vein (intravenously). They circulate in the bloodstream and reach the cancer cells wherever they are in the body. Some chemotherapy drugs are taken as tablets or capsules, which can be taken at home.
Intravenous chemotherapy may take minutes, hours or a few days. The treatment is followed by a few weeks of rest to allow the body to recover from any side effects. Together, the treatment and the rest period are known as a cycle of chemotherapy. Sometimes a drug is given continuously into the vein by a small portable pump over a set period of time.
Your cancer doctor will explain the number of cycles you need to treat the cancer. A complete course of treatment may take several months.
Chemotherapy affects people in different ways, but there’s usually a pattern of side effects after each cycle of treatment. After your first cycle, you’ll have a better idea of how much you’re able to do.
Some people find that they can’t work at all. Others are able to keep working, or they find that they just need to take a few days off after each cycle of treatment. They can then work until the next treatment is due.
Side effects of chemotherapy
Different chemotherapy drugs have different side effects.
Side effects can include hair loss, a sore mouth, tiredness, feeling sick or being sick, and diarrhoea. A significant side effect of many chemotherapy drugs is that they can temporarily stop the bone marrow making new blood cells. This means your immunity is reduced and you’re more likely to get infections. 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 bruising easily.
If your bone marrow isn’t working properly, you may need to take antibiotics to treat infection, or have a blood transfusion if you’re anaemic. You’ll have regular blood tests between courses of treatment to monitor the effects.
Hormonal therapies are drugs that can stop or slow the growth of cancer cells by either:
changing the level of particular hormones in the body
preventing the hormones affecting the cancer cells.
Most hormonal therapies are given as tablets, but some are given as injections every few weeks or months.
These treatments are usually given for months or years.
Side effects of hormonal therapies
Hormonal therapies can cause side effects such as weight gain, muscle pain, hot flushes, sweats, tiredness, and lowered sex drive. They’ll 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 normal cell growth, so they usually have less 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, lowered resistance to infection, and tiredness. Some treatments may also cause sickness and diarrhoea.
Many people are able to carry on working while taking these therapies, but tiredness and other side effects may sometimes make it difficult.
Making decisions about treatment
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Sometimes two different types of treatment may be equally effective in treating a cancer, but have different side effects.
Doctors and other healthcare professionals can give you information about different treatments and how each may affect your day-to-day life and ability to work.
The final decision about which treatment to have, or whether to have treatment at all, is yours. It can help to find out as much as possible about the type of cancer you have and the treatments that are planned. You can then discuss the benefits and possible risks with your doctors and decide on the treatment that best suits your situation. You can also ask for a second opinion.
You can watch an online video about getting a second opinion by visiting macmillan.org.uk/secondopinion
Treatment can affect people differently. So it’s difficult to predict exactly how treatment will affect you. For example, if two people are given the same dose of the same chemotherapy drug, one may have few side effects and be able to carry on working, while the other person may have severe side effects and be unable to work for a while.
Questions you may want to ask your healthcare team
What treatments are available for my type of cancer?
How effective is the treatment likely to be?
What are the benefits and disadvantages of the treatment?
How long will each treatment take and what’s involved?
Will I be admitted to hospital and, if so, for how long?
What are the possible side effects of treatment?
What can be done about the side effects of treatment?
How much is the treatment likely to affect my daily life?
How will the treatment affect my physical ability to do my job? For example, will I be able to drive/work shifts/travel by plane?
Will I still be able to work while I’m having the treatment?
What will happen if I don’t want to have any treatment?
Are there any treatment options that will make it easier for me to work? For example, can I be treated near my place of work?
Once you have the answers to these questions, you may need time to think through your choices and discuss them with your family or friends.
If you find it difficult to decide which treatment to have, it may help to talk to people who have already had those treatments. You could ask your doctor whether they could arrange this.
Many cancer organisations and support groups can also help you find someone who’s had a particular treatment.
There are other useful organisations here to help you.