Coping with side effects

You may experience a range of side effects during and after cancer treatment. These can affect people differently. Some may require that you take time off work. Others may only be mild and not interfere too much with your job. The most common side effects are:

  • Tiredness (fatigue) – you may feel very tired and weak and might struggle to do small daily tasks. You may have no energy and feel breathless or dizzy after light activity.
  • Risk of infection – chemotherapy can cause a drop in your white blood cell count. This may put you at risk of infection.
  • Risk of bleeding – if your platelet cells are low, you will need to avoid doing things that may cause you to cut yourself or bruise.
  • Numbness or tingling of the hands or feet (peripheral neuropathy) – some chemotherapy drugs can cause this. It will get better when treatment finishes.
  • Changes in appearance – treatment can affect the way you look. You may have skin changes, weight changes, hair loss or scars.

Your doctors can give you medicines to help control symptoms. You can also talk to your employer and discuss adjustments that would support you at work. This could include, for example, changing your working hours or duties.

Coping with side effects or symptoms

You may be coping with some treatment side effects or symptoms at work. There are things you and your employer can do to help make things easier for you.

Plan work days around treatment. Try to avoid physically demanding or stressful tasks the day before treatment and for a few days after it.

We have information about different treatments and managing the side effects.


Tiredness

Tiredness (fatigue) is a common problem. You may feel extremely tired as if you have no strength or energy. It may make it hard or sometimes impossible to do everyday things at work. Tiredness can also make it hard to concentrate or make decisions. You may also feel more emotional and less patient than usual.

If you want to carry on working, ask your manager about looking at ways of making your work less tiring. This is part of making reasonable adjustments.

Possible changes could include:

  • regular rests and short naps – you may find this useful after an activity or a meal
  • working from home
  • avoiding physically demanding duties
  • planning work around times when you have more energy.

Ask your manager if there is a first aid room or comfortable place you can rest. Keeping a note of how you feel can show when you are usually more tired. This can help you to judge when to work and when to rest.

Regular physical activity can help to reduce tiredness. Even taking a short walk on your lunch break could give you more energy. It can also help to reduce stress.

Explaining the effects of fatigue to your colleagues can help them to understand what you’re coping with. It may be difficult for some people to know how tired you are, especially if you look well.


Risk of infection

Some cancer treatments, particularly chemotherapy, can reduce the number of your white blood cells. These are the cells that fight infection. This means you’re more likely to get an infection. Your doctor or nurse will explain when your white blood cell count is likely to be low.

If your white blood cell count is very low, you may not be able to work. It’s a good idea to warn your employer about this possibility.

You will need to avoid people with sore throats, colds, flu, diarrhoea or vomiting, and other kinds of infection such as chickenpox. If you’ve been in touch with someone with an infection, ask your doctor or nurse for advice as soon as possible.

If your workplace is busy you may be mixing with people who have an infection without being aware of it. Ask your employer about working from home when you have more risk of infection – your nurse can tell you this. It’s also best to avoid crowds when travelling by public transport. Ask about flexible working arrangements so you can travel at quieter times.

The Access to Work scheme may be able to provide funding for you to get taxis to work if this is an issue.

My HR department organised a deep clean, then distributed anti-bacterial wipes and hand gels. Folks were really good and made more of an effort in the canteen and common areas.

Ryan


Risk of bleeding

Your platelet cells, which help your blood to clot, may be low. If they are, you will need to avoid doing things that may cause you to cut yourself or to bruise.


Numbness or tingling of the hands and feet

Some chemotherapy and targeted therapy drugs affect the nerves. This can cause numbness, pins and needles, or pain in your hands and feet (called peripheral neuropathy). It may make it difficult to hold things or to write or type so certain tasks may take you longer. Ask if there are any adjustments your employer can make to your role to help with this.

Peripheral neuropathy usually gradually gets better in the months after treatment but sometimes it is permanent. We have more information about peripheral neuropathy.


Changes to your appearance

Treatment may cause skin changes, weight changes, hair loss, or scars from surgery. This can be hard if your work involves face-to-face meetings with clients or the public.

It takes time to adjust to a change in your appearance and to feel less anxious. We have suggestions on dealing with other people’s reactions and managing anxiety.

If you have an obvious change in your appearance, you could ask someone at work to tell the people you work with. Or you may prefer to tell people yourself about the cause.

If your job involves dealing directly with the public it may help to work alongside someone else for a while. This is just until you build up your confidence.

Some people may work from home until they feel more confident. Try to make sure this is short-term. If concerns about your body image interfere with work or socialising, it’s important to talk your doctor or nurse. There are different ways they can help you.

We also have helpful advice about hair loss, caring for your skin and nails and covering up changes during treatment.


Other side effects or symptoms

There may be other side effects or symptoms depending on the type of cancer you have and your treatment. Let your doctor know if you have other difficulties, for example pain, feeling sick or eating problems. They can prescribe medicines to help or give you advice. If your symptoms don’t improve, tell your doctor or nurse.

Some people who have finished treatment may develop long-term side effects.


Tips for dealing with symptoms and side effects

Talk to your manager about making adjustments to help you manage side effects or symptoms.

You could both think about some of the following:

  • more flexible working arrangements
  • scheduling your time around the days you’re most needed at work
  • agreeing which tasks are most important, what you can manage and what you can ask others to do
  • changing your duties or making any adjustments to your role you think would help
  • home working when possible – your manager can tell you if there’s a policy and what’s involved
  • having someone who will assess which phone calls you need to take and who will forward important emails
  • letting colleagues know how you’ll manage your work, how they can contact you, and when you’ll check in with them.

Taking good care of yourself is also important. Eating well can help you to feel better and can give you more energy. Finding ways to relieve stress can also help.

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Your rights at work

If you have or have had cancer, you are protected by law from unfair treatment at work.