As a manager, you may be one of your employee’s most important sources of support. You don’t need to be a medical expert, but a basic understanding of cancer and its treatment can help. This knowledge will also help you to plan for and recognise any issues that may develop at work.

Cancer is not a single disease with only one type of treatment. There are more than 200 types of cancer, each with its own name and treatment. There are around 2.5 million people in the UK living with cancer, and that number is increasing. On average, people are living with cancer for longer than in the past.

We have an animation that explains what cancer is.

We have more information about different types of cancer and cancer treatments. You can also find this information by calling our support line on 0808 808 00 00.

The effect of cancer and its treatment on a person and their work can vary widely. For example, it can depend on:

• the type of cancer
• its stage (the size of the tumour and whether it has spread)
• any symptoms the cancer might be causing
• the type of treatment and its side effects
• how the person copes when faced with a traumatic situation.

Some people find working helps them feel normal and in control. Carrying on with or returning to work can help people cope while they are waiting for a diagnosis, having treatment, or caring for someone with cancer.

Other people need to work because they can’t afford to be away for long. Some people give up their jobs because their cancer is advanced or the symptoms make it impossible to work. The side effects of treatment can affect some people’s ability to work. Others may not be able to work because they have low self-esteem or confidence issues.

If your employee is caring for someone with cancer, they may need to reduce their hours or give up work. Before an employee decides to leave their job, it is important that you have a discussion with them about options or arrangements that could help them stay in work.

Knowing more about cancer treatment can help you understand how it may affect your employee’s work life. The main treatments are surgery, radiotherapy, chemotherapy, hormonal therapy and targeted therapies. They may have a combination of treatments.

Many people have side effects from cancer treatment. You may be able to make it easier for the person to cope with side effects at work by making reasonable adjustments. For example, this may be by allowing frequent breaks, giving access to a fridge to store medicines or allowing them to wear a different work uniform.

Treatment side effects may change over time. For example, your employee may become more tired. Encourage them to let you know how things are, so you can review their working arrangements.

The effects depend on the type of operation. If the person has day surgery, they may only need a short time off work. But if they need radiotherapy or chemotherapy afterwards, this can have more of an effect on their ability to work.

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

If the surgery affects how a part of the body works, it may prevent the person from doing certain parts of their job.

Radiotherapy uses high-energy x-rays to destroy cancer cells. People usually have it from Monday to Friday, as an outpatient in hospital. It can take up to several weeks, depending on their course of treatment.

Radiotherapy 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 the treatment for before or after the person finishes work. Other people stop working completely during radiotherapy and for a few weeks afterwards.

Side effects

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. Side effects usually last for a few weeks after treatment and then gradually improve.

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

There is usually a break of a few weeks between treatments, to allow the body to recover. Some people can’t work because they’re too unwell. Others may take a few days off after each treatment and work reduced hours.

Side effects

These can include:

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

If your employee feels able to work, there are precautions they may need to take to reduce their risk of infection. This could include working from home, or working different hours so that they travel to and from work at quieter times. These adjustments could help them to mix with fewer people who may have an infection.

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

Side effects

Hormonal therapies usually have a lesser effect on a person’s ability to work. But they can cause tiredness, weight gain, hot flushes, sweats and muscle pain.

These drugs interfere with the way cancer cells grow. People can have them as a drip (intravenous infusion) or as tablets.

Side effects

These are often easier to manage than other treatment side effects. Possible side effects include flu-like symptoms, chills, headaches, a raised temperature, risk of infection and tiredness.

People may be able to carry on working if they 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 treatments and their side effects. Call our cancer support specialist on 0800 800 00 00.

Coping with fatigue

Fatigue (extreme tiredness) is a common side effect of cancer treatment. It can also be a symptom of some cancers. It can be worse at different stages of treatment, or at different times of the day. Cancer-related fatigue is not like normal tiredness. It can’t be helped by sleep and it can make simple tasks feel exhausting.

Fatigue can affect people in different ways and it may continue long after treatment is over. It may mean your employee:

• finds it harder to perform certain tasks
• has less strength and energy than before
• has difficulty concentrating or remembering things
• becomes exhausted during meetings or after light activity
• struggles to control their emotions
• is sometimes dizzy or light-headed.

Fatigue, together with the other effects of cancer and its treatments, may mean that your employee is unable to work for long periods. Tiredness can also make people irritable and affect how they talk to others.

If your employee is caring for someone, that person’s fatigue can have an impact on them too. They may need more time off to look after the person with cancer.

You can help your employee cope with fatigue by making some adjustments at work. You could allow flexible working, working from home, reduced hours, or give them lighter tasks. Simple things like rest breaks or a short walk outside can also really help.

Body changes

Cancer and its treatment can cause changes in how a person looks. These may be temporary or permanent. You and your colleagues may need to be prepared for this. Body changes will depend on the person’s situation, but can include:

• hair loss
• changes in complexion or skin tone
• scarring
• weight loss or gain.

Changes like these could affect the person’s body image. This is how they think and feel about their body. Call our cancer support specialists on 0808 808 00 00.

Being diagnosed with cancer and then having treatment can understandably have a huge impact on someone. It can also affect their family, friends and colleagues.

Going for tests and waiting for the results can be an anxious time. Many employees may wish to keep their situation confidential at this point. If they tell you what is happening, you can ask them if they need time off for medical appointments.

When someone is diagnosed with cancer, the shock can make them feel numb at first. Some people can take a while to accept that they have cancer and they may try to carry on as if nothing is wrong. They may feel a mixture of emotions, including:

• anger or bitterness
• sadness
• fear – of the disease, treatment and dying
• loneliness and isolation.

Your employee may need some time off if they, or a family member or friend, are diagnosed with cancer. They may want to be with people close to them and try to recover from the shock before coming back to work.

Learning that cancer has come back can also be devastating news. This can be particularly difficult if the person needs more treatment, or if there are fewer treatment options than before.

Uncertainty can be one of the hardest things to deal with when faced with a cancer diagnosis and can cause a mixture of emotions. Some people manage this by taking one day at a time and not looking too far into the future. Others want to find out as much as possible to help them get back some sense of control.

If your employee becomes upset

Cancer can cause many different emotions. Sometimes people find their moods can change suddenly and at unexpected moments. If this happens to your employee at work, it might help to offer them a private space for a while. You could suggest they go home for the rest of the day. Ask if they would like you to contact a family member or friend to travel home with them.

Your own emotions

You and your colleagues may also have strong feelings and this is only natural. You can ask for support to help you cope with your own emotions. It may help to talk to another manager in your workplace. Remember to think about confidentiality and how much the person may want others to know.

You can also call our cancer support specialists on the Macmillan Support Line on 0808 808 00 00. We are here to help anyone who is affected by cancer, including you.

Many people recover well and can go back to their normal working life after treatment has finished. But having cancer and recovering from it can have a big psychological impact. Some people find it difficult getting back to normal.

People may struggle with fatigue, their emotions and any changes to their body caused by the treatment.

Some treatments leave people with long-term side effects, such as:

• tiredness for many months or sometimes years
• pain or lack of movement in an arm after breast surgery
• only being able to eat little and often after stomach surgery
• needing to use the toilet more often after bladder or bowel cancer treatment.

People often want to get back to work but have difficulty returning to their old job. They need your understanding and support to do this successfully. It is also important to review the support you give them over time, as long-term side effects can fluctuate.

Some people recover well after treatment and they are never affected again by the cancer. But some people may be living with the knowledge that their cancer can’t be cured, even though they may feel well at the moment. Their cancer may return at some point and they may need further treatment. Some of these people may then have further periods without cancer. For others, the cancer may be more advanced.

Some people live with cancer for many years without ever having serious symptoms. But some people may die from their illness within a matter of weeks or months. It can be a shock for people when a colleague dies, especially if it’s soon after a diagnosis.