Going back to work after a break of a few weeks or months can be difficult. You may feel that you’re able to go back to your old job but feel nervous about it. It’s common for people to feel awkward. They often wonder whether they’ll still be able to do the job and how people will react to them.

For many people, going back to work can help them feel like the cancer is over and they can return to normal life. A job can restore normality, routine, stability, social contact and income.

Before you go back to work, you and your manager could agree on a return-to-work plan. This is where you both discuss and agree on the best way forward.

The plan should be flexible, allowing for regular reviews and changes along the way. The possibility of flexible working and a gradual, phased return to work are potentially helpful ways of easing yourself back into the workplace. You should be fully involved in these conversations. If you’re still coping with some of the effects of cancer treatment, it’ll be particularly helpful to discuss any temporary or possibly longer-term changes that can be made to your work to help you.

If your workplace has an occupational health adviser, your manager can arrange for you to see them. The adviser can see you from time to time until you’re fully back at work. If you feel like things have moved on while you were away, for example, new systems or processes have been introduced, you may want to ask for time or training to catch up.

Phased return to work 

If you can, plan to return gradually. This can be agreed with your manager and with assistance from occupational health and/or your GP. You and your manager can decide which parts of your role are most important, and which you should focus on until you feel stronger.

 It’s important to agree with your manager that you’ll have regular rest breaks. There may be a temptation to push yourself too far, too quickly, for example if you’re a manual worker such as a bricklayer or mechanic. If you’ve had treatment for a brain tumour then it’ll usually be at least a year before you’ll be allowed to drive again.

It also helps to remember that recovery may not always be straightforward. You may have some setbacks or a change in circumstances along the way, so try to remain flexible.

Job flexibility 

If you feel that you can’t cope with your job, you might like to:

• reduce your hours (go part-time)
• change the times you work
• change your duties.

You should discuss this with your manager or the human resources department as soon as you’re sure about this. However, it’s important to realise that things may change and what may not seem possible now may be possible in a few weeks or months. They should be willing to be as flexible as possible about your work arrangements to allow you to go on working as much as you can. 

They’re required to consider this under the Equality Act 2010 or the Disability Discrimination Act 1995.

Under discrimination laws, employers are required to make reasonable adjustments to ensure you’re not at a disadvantage to others in your workplace.

Some examples of adjustments could include:

• allowing a phased return to work after extended sick leave
• allowing you time off to attend medical appointments
• changing your job description to remove tasks that cause particular difficulty
• allowing some flexibility in working hours
• allowing extra breaks to help you cope with fatigue
• temporarily allowing you to be restricted to ‘light duties’
• adjusting performance targets to take into account the effect of sick leave and side effects such as fatigue
• moving you to a post with more suitable duties (with your agreement)
• moving your work base – for example, transferring you to a ground-floor office if breathlessness makes it difficult to climb stairs
• ensuring suitable access to premises if you’re using a wheelchair or crutches
• providing appropriate software, such as voice-activated software if you’re not able to type
• allowing working from home
• providing appropriate toilet facilities.

If you’re considering going back to work after treatment, it’s important to think about the following:

• The option of full-time or part-time work. Look at how much income you need to cover your monthly outgoings.
• You may have had your mortgage, bank loan or credit agreement paid by an insurance policy while you were ill. This will end when you go back to work, so remember to include it in your calculations.
• If you’ve been out of work for a long time, you may have financial problems and possibly be in debt. StepChange Debt Charity can give you advice. We also have information about Managing your debt, which you may find useful. You can also order this information as a booklet from our be.Macmillan website
• You can keep claiming some benefits even when you go back to work, but others will stop. For example, you might still be able to receive Personal Independence Payment while working, but Employment and Support Allowance could be affected.
• Universal Credit is a ‘top-up benefit’ for people on low income, especially for part-time workers.
• Help is available for self-employed people or people who want to be self-employed – contact your nearest Citizens Advice. We have a booklet for people who are self-employed, which you can order for free from be.Macmillan.
• You can continue to accrue annual leave while on sick leave. You may wish to take some annual leave instead of sick leave before returning to work. You should discuss this with your employer.
• Think about whether you have income from occupational pensions, private pensions or life assurance. For example, you might be able to freeze, transfer or cash in a pension.
• It may help to contact an independent financial adviser. There are organisations that can help with this and you can search for them on our website.
• It may help to contact Macmillan’s Financial Guidance Service, which can help you understand the options available to you with your personal finances.

If you've been claiming benefits

If you want to go back to work after some time away and you've been claiming benefits, there are options you’ll need to consider. Remember there are non-financial factors that may affect your decision.

Many issues are taken into account when assessing benefits, so it’s only possible to give general information here. Each person’s entitlement has conditions specific to their situation, taking into account age, savings, income, hours worked, number of family members, childcare costs and housing costs.

It’s possible to be eligible for more than one benefit at the same time, but some benefits can’t be paid together.

It’s essential that you take advice from an experienced benefits adviser. You could call one of our cancer support specialists on 0808 808 00 00 or Citizens Advice. You can also check whether there’s a benefits adviser in the social work department at your hospital.

You should check your entitlement to benefits and tax credits to work out whether your income would be higher with these or by going back to work.

You’ll need to know:

• whether you’d be better off financially
• whether savings affect your eligibility for certain benefits
• how much you’d need to earn to compensate for the loss of benefits you may be receiving at the moment
• how the number of hours you work will affect your eligibility for certain benefits
• how claiming a different benefit would affect your situation
• who should make the claim for any benefit if you’re living with a partner – there could be occasions when it’s beneficial for one partner rather than the other to claim.

Benefits affected if you go back to work

Personal Independence Payment, Disability Living Allowance and Attendance Allowance can be paid whether or not you’re working.

Eligibility for these allowances depends on your care needs (for the care component) and your inability to walk (for the mobility component). For example, if your walking improves and/or you need less help with personal care, this could affect your entitlement to Personal Independence Payment.

The Department for Work and Pensions may re-assess the rate you’re paid.

The higher rate of the mobility component of Personal Independence Payment or Disability Living Allowance allows you an exemption from road tax and entitles you to a Blue Badge parking concession. You can also use the higher rate of the component to buy or lease a car under the Motability Scheme.

If you receive Employment and Support Allowance, this will stop if you go back to work. It’s important to review your situation after a few weeks. If you’re finding it difficult to continue to work, you may re-qualify for Employment and Support Allowance at the same rate and on the same basis as before, if you make a new claim within 12 weeks.

You may be allowed to do a certain amount of ‘permitted work’ while claiming the following benefits, even though they are for people who are unable to work:

• Employment and Support Allowance.
• Incapacity Benefit.
• Income Support because of incapacity for work.

Permitted work can include:

• voluntary work
• unpaid work experience approved by the DWP
• any work where you earn £20 or less a week
• work as part of a treatment programme carried out under medical supervision while you’re in hospital (or attending as an outpatient) as long as you earn £107.50 or less a week
• supported work (supervised by someone employed to find work for disabled people) where you earn £107.50 or less a week
• any work for up to 52 weeks (or indefinitely if you are in the ESA support group) where you work less than 16 hours a week on average, and earn £107.50 or less a week.

To find out more about permitted work, speak to a welfare rights adviser.

Even though cancer treatment may have lasting effects, people who have had cancer are still able to work hard and effectively.

People often expect to feel glad once treatment has ended, and think that they’ll be able to put the cancer behind them and go back to their normal life. Some people are able to do this. But many people find this can be a difficult time as they adjust to all they’ve been through and the impact it’s had.

It’s normal to feel tired for several months after treatment, and it takes time to recover your usual energy levels. Many people take time to make other adjustments in their life following cancer. This can include making changes to their diet, relationships and how they use their spare time.

People can experience many different emotions after cancer and its treatment. They may be afraid the cancer will come back and they’ll have to go through further treatment.

They may wonder whether the cancer has been cured. Some people may feel depressed for a while.

Usually these feelings gradually become less frequent, and after some time most people begin to enjoy life again. However, some people may need support and help in coping with their emotions. Some people find a support group helpful. Others choose to see a counsellor.

You’ll usually continue to see your GP or go to hospital for check-up appointments for a few years after your treatment.