Coping with side effects

If you’re having cancer treatment, there’s a risk you’ll have some side effects. 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 occupation. The most common side effects are:

  • 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.
  • Risks of getting an infection – chemotherapy can cause a drop in your white blood cells count. This may put you at risk of getting an infection.
  • Peripheral neuropathy – some chemotherapy drugs can cause numbness, pins and needles or pain in the hands and feet. This 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.

You may find that those side effects affect your ability or your confidence to work. Your doctors can give you medicines to help control symptoms. If you’re working for an employer, you can also talk to them and discuss adjustments that would support you at work.

Symptoms and side effects of cancer

The cancer or its treatment may cause symptoms or side effects. Common side effects and ways of dealing with them are discussed here. We have more information about different cancers, cancer treatments and side effects of treatment.

Fatigue (tiredness and weakness)

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

  • difficulty doing small tasks (where everyday activities like brushing your hair or cooking seem impossible)
  • a feeling of having no strength or energy (feeling 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.

You may have to take time off work if you’re too tired. Or if you want to carry on working, it may be possible to work with your employers to find ways of making your work less tiring for a while.

Risk of getting an infection

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 important to avoid people who have sore throats, colds, flu, diarrhoea or vomiting, and 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 best to avoid crowds where possible. This includes avoiding using public transport, especially during rush hour. You should also avoid crowded workplaces where you may be mixing with people who have an infection. The Access to Work scheme may be able to provide funding for you to get taxis to work if this is an issue.

Numbness or tingling of the hands and feet

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’ve finished your treatment, but it can take weeks or months for you to fully recover.

Changes in your appearance

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

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

There are things you can do to help make the best of your appearance, and there are organisations that can offer you support.

Some hospitals have programmes run by Look Good Feel Better, a charity that helps women manage the visible side effects of treatment and feel confident about how they look.

If you’ve lost your hair as a result of treatment, you may like to read our information on coping with hair loss. We also have information on body image and cancer and a booklet called Feel more like you: expert advice for your skin, nails and hair during cancer treatment, which you can order from our be.Macmillan website. You could talk to your doctor or nurse about other sources of help.

Other symptoms or side effects

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

If the symptoms or side effects continue, let your doctor know so they can prescribe more effective treatments.

Sometimes changing the time you take the medicines can make them more effective. You can discuss this with your doctor or nurse.

Possible long-term effects of cancer treatments

Many people recover well and can return to a normal working life after their treatment has finished. However, others will have ongoing problems caused by their treatment. For example:

  • tiredness for months or sometimes years
  • soreness of an arm after breast surgery
  • needing to eat little and often after stomach surgery
  • needing to use the toilet more often after bladder or bowel cancer treatment.

If you have long-term side effects from your treatment, you may need a lot of understanding and support from your employer.

We have more information about things they can do to help you.

Tips for dealing with symptoms and side effects

  • 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 judge when to work and when to rest.
  • Talk to your manager about a change of duties if necessary or any adjustments to your role that you think would help you.
  • 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 do things like assess which phone calls you need to take and forward important emails.
  • Work from home when possible. Your manager should tell you if there’s a home-working policy and what’s involved.
  • Let colleagues know how you’ll manage your work, how to contact you, and when you’ll check in with them.
  • Talk to your doctors about the best times for appointments and treatments. For example, going on Friday afternoons might allow you to recover over the weekend. Try meditation or complementary therapies to help reduce stress.
  • Eat as well as you can to keep your energy levels up. We have more information on our website about healthy eating and cancer.
  • It can help to plan the 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 count.
  • Plan a period of rest after activity. Short naps and rest periods are also useful after meals. Your organisation/company may have a first aid room or somewhere similar you can use.
  • Your manager may be able to help by making reasonable adjustments, such as changing your role or working hours.

Back to Information for employees

Policies and resources

People affected by cancer may face challenges related to work. Macmillan can offer information and support

Working during treatment

Deciding whether to work during cancer treatment can be very difficult. It depends very much on individual circumstances.

Making treatment decisions

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

Talking to your employer

You’re not required to tell your employer about your cancer, but it can help them to support you during treatment.