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Chemotherapy: FOLFOX

FOLFOX and Work

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While reactions to being on FOLFOX differ, the great majority of people experience extreme fatigue at some point. The more treatments, the more likely you are to experience fatigue which can affect work.

That said, most people are able to continue to work full time, perhaps with some time off for a day or two during or immediately after receiving a FOLFOX infusion.

Seeking Work

When seeking work, the first question is whether it is worthwhile looking for work now.  If you are just starting FOLFOX, if you can afford to, it is recommended that you wait until you receive the first few infusions to get an idea how you react to treatment. Once you know, you can better hone the type of job to look for, including flexibility to work around days when you may need time to deal with side effects. (It may be that you only need time off before a weekend to do the initial infusion, with the weekend for the continuous infusion).

Keep in mind that you do not have to disclose your health condition to a prospective employer, and a prospective employer cannot ask about your health.

For information about seeking work, including how to write a resume with a health history, how to rework your online presence to make it employer friendly, ace an interview, learn about an employer’s benefits and when to disclose your condition and to whom, click here.


  • Before applying for a job, it is advisable to find out what a prospective employer will learn about you by at least searching on your name through such search engines as Google offsite link, Bing offsite link, and Dogpile offsite link. If there are parts of your life that you would rather a prospective employer not know about, contact a site such as offsite link to find out what you can do..  
  • If you joined a site that relates to colorectal cancer or otherwise discusses your health condition, consider changing the name the public sees like authors sometimes use a “nom de plume” when writing a book. If this isn’t possible through the visible parts of the site, contact the web master and ask that your entries be changed or deleted so that your name no longer appears.

At Work

In theory, it is possible to work while on FOLFOX treatment and not let anyone know that you have colorectal cancer or that you are being treated for it. For example, your ability to work man not be affected if you have your infusion on a Friday afternoon, deal with the continuous infusion over the weekend, and are able to work through periods of nausea or fatigue.

On the other hand, keeping a secret is stressful. It is generally agreed that the greater the secret, the more the stress. If you are inclined to not disclose your condition to your employer and co-workers, think about why. Do you believe your employer is not friendly to people with cancer? If so, click here for help thinking through this question on an objective basis.

If you need a change at work, such as time off during or immediately after an infusion, or to be moved closer to the bathroom if you have episodes of diarrhea, or a change in work schedule or deadlines because of fatigue, or time to rest when needed – your employer may be required to provide such an accommodation due to laws such as the Americans With Disabilities Act (ADA). Under the ADA and similar laws, you must first disclose your condition in order to receive the legal protections.

If you need time off, you may be entitled to it under federal and state laws such as the Family and Medical Leave Act (which permit you to take time off in increments such as hours or days.)  If not, you can still request it as an accommodation under the ADA.

If you disclose your condition and use up all your benefits and need more paid time off, you may be able to borrow sick or vacation days from co-workers.

To learn about:

  • Who to tell, how to negotiate for an accommodation, how to maximize benefits at work, and start to be prepared “just in case” you need to stop work:
    • If you have Stage 0 or Stage 1 colorectal cancer, click here.
    • If you have Stage 2 colorectal cancer, click here 
    • If you have Stage 3 colorectal cancer, click here
    • if you have Stage 4 colorectal cancer, click here  
  • What to do before negotiating for flex time or the ability to work at home, click here
  • How to group your benefits to maximize time off with pay, click here
  • The Family and Medical Leave Act (FMLA) and similar state laws, click here
  • How to keep a Work Journal in case you ultimately need evidence because you feel discriminated against at work, click here.
  • Whether this is a time to change the balance between work and play, click here

NOTE: When treatment is over, do not expect to be back up to speed right away. Let co-workers know that isn’t reality. Try to feel confident that you can do your job again instead of feeling stressed that you don’t compare to your former self.  Take regular breaks and listen to your body. If fatigue continues, follow the coping techniques described in our article about fatigue

On Disability

While on disability, if you are receiving an income either from an insurance company, an employer or a government program such as Social Security Disability Income (SSDI) or Supplemental Security Income (SSI), your case may be subject to review to determine if you are still disabled.

It is advisable to take a few minutes to prepare for such a review by:

  • Keeping track of how your condition and FOLFOX treatment affect you on a daily basis – particularly noting the effect on your ability to do work. (You can keep track of your symptoms with our Symptoms Diary which is also useful each time you return to the treatment center for an infusion). 
  • At each doctor appointment, let your doctor know (i) about your symptoms and  (ii) how your symptoms affect your ability to work. Ask the doctor to note this information in your medical chart.  Every few months get a copy of your chart from your doctor. Check it to be sure there are indeed notes about your ability to work. (It’s also helpful to have a copy of your medical record for a variety of  other reasons, including if you need to see a new doctor or at some point you need to get a second opinion. For more information about medical records, click here.)

If you are receiving SSDI, or SSI, it helps to know your rights with respect to interviewers. For more information, click here 

If you are thinking about returning to work, before you agree to return:

  • Consider volunteering for a while to test your physical and mental abilities and stamina, and to bring your skill set up-to-date. To learn more about returning to work, including effects on benefits, click here.
  • Then think about returning to work part time to ease your way back to work..
  • With colorectal cancer, there is generally no need for occupational therapy. However, if you do need it, it is generally available and covered by health insurance.

Once you feel secure that you are able to start work, consider starting back part-time before scaling up to a full work schedule.

  • If you are receiving Social Security Disability Income (SSDI), to learn about returning to work, including trial work months and what happens if you become unable to work again, click here
  • If you are receiving Supplemental Security Income (SSI), click here..
  • If you are have a group long term disability income policy, click here 
  • If you have an individual disability income policy, click here 
  • If you want to try to return to work, click here. 

Small Business Owner

 As a small business owner, it is important to plan not only for the current situation, but also for the possible eventualities. To learn how, click here.

Self Employed

As a self employed person, it is important to plan not only for the current situation, but also for the possible eventualities. To learn how, click here.

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