Working during treatment

The main cancer treatments are surgery, radiotherapy, chemotherapy, hormonal therapy and targeted therapies. These treatments may cause different side effects, which may make working difficult for you. For example:

  • Fatigue and extreme tiredness can affect your ability to do your work or deal with customers.
  • Chemotherapy can increase your risk of getting an infection or affect your ability to hold things, type or write.
  • Treatment can cause skin changes, weight changes, hair loss or scars. This can be difficult if your work involves face-to-face meetings with people.

If you want to carry on working, there are things you can do to make things easier. It can be helpful to plan ahead so you can work at times when you know you will have more energy. Try to avoid physically demanding tasks before treatment and for a few days after. Let your doctor know if you have any problems, as they can prescribe medicines to help or give you advice.

Treatments and side effects

The main treatments for cancer are surgery, radiotherapy, chemotherapy, hormonal therapy and targeted therapies. You may have a combination of treatments.

You could think about making adjustments to make things easier for you at work. For example, this could mean changing your hours or the types of jobs you take on.

Treatment side effects may change over time. For example, you may become more tired. Review how you are working as your situation changes.

Surgery

The effects of surgery depend on the type of operation you have. If you have day surgery, you may only need a short time off work. But you may need radiotherapy or chemotherapy afterwards. This can have more effect on your ability to work.

A bigger operation means having more time off work to adjust and recover. After certain operations, some people may need therapies to help, for example physiotherapy or speech therapy.

If surgery affects how a part of your body works, it may prevent you doing certain parts of your job.

Radiotherapy

Radiotherapy uses high-energy x-rays to destroy cancer cells. You usually have it Monday to Friday as an outpatient. It can take up to several weeks depending on your course of treatment.

Treatment itself only takes a few minutes. But travelling to and from the hospital and waiting can take up a large part of the day.

Some people feel able to work during radiotherapy but may need to reduce their hours. The radiographers (who give the radiotherapy) may be able to time your treatment for before or after your work hours. Other people stop working completely during radiotherapy and for a few weeks afterwards.

Side effects of radiotherapy

Radiotherapy can make you very tired. This can continue for weeks or months after treatment is over. Other side effects depend on the part of your body that is being treated. Most side effects last for a few weeks after treatment and then gradually improve.

Chemotherapy

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. You usually have chemotherapy as an outpatient. It is given by injection into a vein (intravenously) or as tablets. Some people may need to go into hospital for a few days.

You usually have a break of a few weeks in between treatments to allow your body to recover. Some people can’t work because they are too unwell. Others may take a few days off after each treatment and work reduced hours.

Side effects of chemotherapy

These can include:

  • risk of infection or risk of bleeding (because of the effects on your blood cells)
  • tiredness
  • hair loss
  • feeling sick
  • diarrhoea.

If you feel able to work, there are precautions you may need to take to reduce your risk of infection.

Hormonal therapies

Hormonal therapies reduce the level of certain hormones or block their effects on the cancer cells. You usually have these drugs as tablets, for months or possibly years. Some are given as injections every few weeks or months.

Side effects of hormonal therapies

Hormonal therapies usually have less of an effect on your ability to work. They can cause tiredness, weight gain, hot flushes, sweats and muscle pain.

Targeted therapies

Targeted therapy drugs interfere with the way cancer cells grow. They often have less troublesome side effects than chemotherapy. You can have them as a drip (intravenous infusion) or as tablets. They are often given along with other treatments.

Side effects of targeted therapies

Possible side effects include chills, headaches, a raised temperature, lowered resistance to infection and tiredness.

You may be able to carry on working if you are having a targeted therapy on its own. But tiredness and other side effects may sometimes make it difficult.

We have information about different cancer types and treatments, and their side effects. Call our cancer support specialists on 0808 808 00 00.

After my operation, I didn’t know when I was going to be able to return to work. I’ve had previous surgeries and returned to work too soon.

Lloyd


Questions you may want to ask your healthcare team

The following are some examples of questions you might want to ask:

  • How long will each treatment take?
  • Will I need to stay in hospital and, if so, for how long?
  • How do people typically feel during and after treatment?
  • Will I need time off to recover?
  • How can the side effects be reduced?
  • Will treatment affect any physical demands of my job?
  • Will I be able to concentrate, drive, work shifts or travel?
  • Is there another treatment that works as well but could interfere less with work life?
  • Are there any options that could make working easier? For example, could I have my treatment at a hospital closer to my work?

Sometimes two different treatments work equally well. Your doctor may ask you to choose between them. If one interferes less with your work life, this may help you decide. We have more information about making treatment decisions that you may find helpful.

It can be difficult to predict how treatment will affect you. Two people having the same treatment can have different reactions. You may not be able to make a decision about work until after your first treatment.


Coping with symptoms and side effects while working

You may be coping with some treatment side effects or symptoms at work. There are things you can do to 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.
  • Keep a diary of how you feel during treatment to see if there are patterns. This might help you know when you are well enough to work.
  • Ask your healthcare team if you can have appointments and treatments at times that suit your work duties. For example, having chemotherapy on a Friday afternoon may allow you to recover over the weekend.
  • Try to make time to relax. Things like meditation and complementary therapies may help.
  • Eat as well as you can to keep your energy levels up.
  • Plan to rest after any activity. Short naps and breaks can help. It may also help to rest after meals.

We have more information about coping with side effects, eating well and complementary therapies that you may find useful.

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, see if you could make changes to make your work less tiring. Possible changes could include:

• regular rests and short naps – you may find this useful after an activity or a meal

• changing your working location

• avoiding physically demanding duties

• planning work around times when you have more energy.

See if there is a comfortable place you can rest during breaks at work. Keeping a note of how you feel can show when you are usually more tired. This can help you 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.

We have more information about coping with fatigue.

Risk of infection

Some cancer treatments, particularly chemotherapy, can reduce the number of white blood cells. These are the cells that fight infection. This means you are 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.

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

If you work in busy places, you may be mixing with people who have an infection without being aware of it. If your work allows it, work from home when you are more at risk of infection. Your nurse can tell you when this might be. It is also best to avoid crowds when travelling by public transport. If you can, change your working hours 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.

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.

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

Speech recognition

You might find it helpful to use a speech recognition application on your computer to help with writing. You talk into a microphone and the text appears on the screen, or the computer follows your voice commands. Speech recognition applications are included with many newer computers. You can also buy speech recognition software.

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 more information about body image, which can help with 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 of the change.

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

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

If you have hair loss, our information about coping with hair loss has helpful advice. We also have information about feeling more like yourself, which has advice on caring for your skin, nails and hair.

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 do not improve, tell your doctor or nurse.

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

Back to If you're self-employed

Self-employment and cancer

If you’re self-employed you may worry about work and money during your cancer treatment. Support is available to help you cope financially and emotionally.

Making treatment decisions

When you’re self-employed, you may have particular questions about treatment decisions and how they could impact on your work.

Managing your workload

Cancer treatment can have an impact on the way you run your business. You may need to reorganise your activities to manage your workload.

Managing your finances

If you’re self-employed and have had to reduce your work activity, you may worry about your professional and personal finances. Support is available to help you cope with financial issues.