Working while coping with the symptoms and side effects of cancer

Fatigue (tiredness and weakness) Back to top

Cancer and its treatment often make people feel very tired and weak. Fatigue| affects everyone differently and can have many different signs. Some people find that their tiredness is mild and doesn’t interfere much with their work, however it can have a significant impact for others. Some of the more common effects of fatigue are:

• difficulty doing small tasks (everyday activities like brushing your hair or cooking can seem impossible)
• a feeling of having no strength or energy (you feel as if you could spend whole days in bed)
• having trouble remembering things, thinking, speaking, or making decisions
• breathlessness after only light activity
• dizziness or feeling light-headed
• feeling more emotional than usual.

Fatigue can affect the way you think and feel. You may find it impossible to concentrate on anything, which may greatly affect your work.

Fatigue may also affect your relationships with your manager or colleagues. It can make you become impatient with people, or make you want to avoid socialising as it’s too much effort.

When you know a bit more about your treatment and what you may need, talking to your manager will help you plan so you’re able to do the work that’s most important when you feel least tired. It can help to keep a diary of your fatigue levels [PDF, 59kb]| so that you can track how your treatment affects your energy.

You can then arrange to do important work activities at a time when your energy levels are higher. Keeping a note of your energy levels will help you to identify the days when you’re best able to work, and you can then discuss this with your manager. There may be certain aspects of your role which are more tiring. These could be put on hold or delegated to others. See the work planning tips below.

Don’t feel that you have to work if you’re too tired. Or if you do want to carry on working, you may be able to find ways of making your work less tiring for a while.

Keeping a fatigue diary Back to top

You can use the fatigue diary to keep a record of your energy levels.

Energy levels can be described as:

1. No fatigue
2. Mild fatigue - but able to do normal activities
3. Some fatigue - but able to do some activities
4. Moderate fatigue - able to do some activities but need rest
5. Severe fatigue - difficulty walking or doing activities such as   cooking or shopping
6. Extreme fatigue - needing to sleep or rest all day.

Work planning tips Back to top

• Talk to your employer and colleagues about deadlines, which tasks are most important and what you can manage.
• Talk to your occupational health adviser if you have one. They have a responsibility to support you to be able to do your job and to help you with any health or medical problems that affect your work.
• Keep a diary of how you feel and see if patterns emerge - this will help you to judge peak performance hours.
• Talk to your manager about a change of duties if necessary.
• With your manager, plan a reduced or more flexible schedule if you can - look at the days you’re needed at work and schedule your time around this.
• Delegate work when possible.
• If appropriate, name a person to assess which phone calls you need to take, and to forward important emails.
• Work from home when possible. Your manager should tell you if there is a home-working policy and what is involved.
• Let colleagues know how you will manage your work, how to contact you and when you will check in with them.
• Talk to your doctors about the best times for appointments and treatments, for example, Friday afternoons to allow you to recover over the weekend.
• Try meditation or complementary therapies to reduce stress
• Eat as well as you can to keep your energy levels up
• Plan a period of rest after activity. Short naps and rest periods are useful - you may need a rest after meals.
• It can help to plan your days around your treatment. Try to avoid anything energetic or stressful for 24 hours before and after your treatments, or if you have a high temperature or low blood counts.

How your manager can help Back to top

Your manager may be able to help by:

• changing your hours so that you can travel to and from work at less busy times
• asking your colleagues to be supportive and to help with some of your work
• allowing you to take short breaks to rest or lie down
• finding you a parking space near to your place of work
• allowing you to work from home, if possible
• finding you ‘lighter’ work if your job involves physical exertion or heavy lifting.

Risk of infection Back to top

Some cancer treatments, particularly chemotherapy|, can reduce the production of white blood cells which fight infection. If your level of white blood cells is very low, you’re more likely to get an infection|. Your doctor or nurse will tell you if your white blood cell count is low.

If it’s very low, you may not be able to work so you may need to warn your employer about this. It’s also a good idea to avoid people who have sore throats, colds, flu, diarrhoea and vomiting, or other kinds of infection such as chickenpox.

If you come into contact with anyone who has an obvious infection, it’s best to ask your hospital doctor or specialist nurse for advice as soon as possible. You may need to take medicines to prevent you from getting an infection.

It’s important to get some gentle exercise and fresh air during or after cancer treatment, but it’s good to avoid crowds where possible. This includes avoiding using public transport, especially during the rush hour, and crowded workplaces where you may be mixing with people who may have an infection.

Numbness or tingling of the hands and feet Back to top

Some chemotherapy drugs affect the nerves in the hands and feet. There may be increased sensitivity, sensations such as numbness or pins and needles, or pain in the hands and feet. This is called peripheral neuropathy|. The sensations and numbness can make it difficult to hold things or to write or type. This can sometimes mean you take longer to carry out your normal tasks at work.

Some people may find it difficult to carry on working if they have this side effect. It will usually get better once you have finished your treatment but it can take weeks or months for you to fully recover.

Changes to your appearance Back to top

Cancer and its treatment can sometimes affect your appearance. For example, you may have changes in your skin or weight, hair loss|, or scars from surgery. This may be hard to cope with, especially if your work involves meeting the public, performing or working face-to-face with customers.

There are things you can do to help make the best of your appearance, and there are organisations which can offer you support. Some hospitals have programmes run by Look Good...Feel Better|, which helps women manage the visible side effects of treatment and feel confident about how they look.

For some people, it may help to change the way they work, if possible. For example, you could talk to clients in a teleconference from home, instead of meeting them in person.

We have more information and advice on coping with body changes|.

Other symptoms or side effects Back to top

There may be a number of other symptoms or side effects depending on the type of cancer you have and cancer treatment you’re given. For example, some people find that they have effects such as soreness or pain|, feeling sick| or problems with eating|. If you have any symptoms or side effects due to your treatment, your doctors can usually prescribe medicines to help reduce them.

If the symptoms or side effects continue, let your doctor know so that more effective treatments can be prescribed. Sometimes, changing the time you take the medicines can make them more effective. You can discuss this with your doctor or nurse.