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Colorectal Cancer: In Treatment: At Work (Stages 0, 1)

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It may help get trough treatment if you keep in mind that colorectal cancer does not have a negative long-term impact on the careers of most people. There may be problems in the work place in the short term, but they do not affect the long term.

Protection Against Discrimination Because Of Your Diagnosis

The Americans With Disabilities Act (ADA) and similar laws provide protection against discrimination and require reasonable accommodations to allow people with a disability to do their work.

Colon and rectal cancer are not always considered to be a protected disability. In order to be considered to be a disability under the ADA, the condition must be substantially limiting.

It is not advisable to get into a legal battle if you can possibly avoid one. As a practical matter,

  • If an employer says that the law doesn't apply, remind the employer of the effect on other employees and potential new employees if word gets out that the employer discriminates against people with cancer.
  • Whether you are protected by the law or not, you have to negotiate for an accommodation. It is not granted automatically. To learn how to request and negotiate for an accommodation, click here..

"Just in case," start keeping track of facts that would be relevant to a discrimination claim.

  • Include good things that happen such as when you receive a pat on the back.
  • Include anything that could be considered to be discrimination. Enough facts can create a pattern.
  • A good place to keep track is in a work journal.

If you believe you have a discrimination claim, the EEOC offsite link is there to help for free (in addition to private alternatives). For more information, see the Americans With Disabilities Act]

If You Haven't Told About Your Health Condition At Work

Be cautious about telling now.

Cancer may cause co-workers to feel uncomfortable around you. On the other hand, there are many, many stories of co-workers who pitched in to help, including providing sick days for a co-worker’s use and taking food to co-workers at home.

There is no legal obligation to tell as long as your condition does not endanger other people. On the other hand, the greater the secret and the longer you keep it, the greater the stress. It may be very difficult to keep a secret if you need time off to take your treatment or if you suffer from side effects.

You may need hours or even days away from work because of your treatment, or you may need an accommodation (a change) at work because of treatment side effects. For instance, if you have fatigue, you may need rest time. If you have diarrhea, you may need to work near a bathroom. If you are undergoing chemotherapy and get a fogginess or forgetfulness (commonly referred to as "Chemo Brain") you may need to have deadlines extended. (For information about dealing with these and other treatment side effects, click here).

If your work situation isn’t a good place to talk about your illness, perhaps your best option is to be discrete about what is wrong.

  • Filing an insurance claim does not automatically trigger disclosure of what is wrong with you. In most situations, the insurer and the company’s benefits department are specifically prohibited from such disclosure.
  • Many companies also have a system under which you can send your claim directly to the insurer.
  • It may be difficult to be discrete if you need a lot of time off for treatment or dealing with side effects.

If you do decide to tell, think about:

  • First consider who to tell. 
    • An employer must keep the information confidential. It is better to tell a supervisor in human resources rather than a lower level person. Supervisors are more likely to know about and honor the confidentiality requirement. Remind him or her that you expect this information to remain confidential -- at least until you have a chance to decide who you want to tell and when. For more information, click here.
    • There is no similar restriction on co-workers so what you tell co-workers is not confidential information. For information about telling co-workers, click here. 
    • An advisor at work  can be helpful in figuring out what are the practical steps to take, and what to expect, from your employment situation.  If you haven’t already, look for a person who has been with the company long enough to know how it reacts to people with cancer and who knows the ins and outs of the company’s benefits. Of course, you want to find a person who will keep your discussions confidential.
  • You may need to tell your employer and likely your co-workers if:
    • You will need time off beyond what you are entitled to as vacation or personal time, or you need an accommodation at work to permit you to do your job while undergoing treatment.
    • You need an accommodation such as moving closer to the bathroom or shifting some of your work to co-workers for a while. 
  • It may help determine whether to tell if you think about whether your employer is cancer friendly or not. For information, see; How To Determine If An Employer Is Friendly To People With Cancer.
  • For more information, see: Disclosing Your Health Condition To Your Employer

If You Need To Take Hours, Days Or Weeks Off From Work

If you need to take time off work because of your treatment or side effects, you may be entitled to the time under any of the following concepts:

If you will need time off:

If You Need Changes At Work To Permit You To Do Your Job

Before you ask for changes at work to permit you to do your job, it is advisable to do the following:

  • Make note of everything you do on a daily basis, including deadlines. It can be as simple as keeping a written log of what you do each day as you go through the day so you don't forget anything.
  • Make a list of current projects and foreseeable next steps.
  • Think about what could be postponed or given to other people.
  • Note important dates when things have to be done.
  • If you haven’t disclosed your cancer to your employer, talk to your boss or a supervisor in human resources as soon as possible. Even if you are protected under the Americans With Disabilities Act and similar laws or even a union, there is no protection until your employer is informed of your situation.

Negotiate for what you need to permit you to work while going to treatment and medical appointments and dealing with side effects:

  • Think about specific accommodations that would work for your needs, including alternatives. In addition to thinking about what would work for you, balance your employer’s needs.
  • Examples of reasonable requests to permit you to work while undergoing colorectal cancer treatment:
    • Leaving work early on Fridays for chemo treatments.
    • Starting the work day later to accommodate radiation treatments.
    • Working from home all or part of the week. (See Work: At Home)
    • Sharing work with someone else.
    • Extending deadlines.
  • All accommodations involve a negotiation with your employer. Learn how to negotiate for what you need. (See: Work: How To Request And Negotiate An Accommodation)
  • Keep notes of what happens during every discussion with your employer about your condition and needs. Include name of person, date, what was discussed. Include your impressions and examples of facts which led to your impression. You may need this information in case you later need to file a discrimination claim under laws such as the Americans With Disabilities Act

Now Is A Good Time To Review Employer Benefits In Light Of Your Diagnosis

Benefits may look different to you from the point of view of a person who has been diagnosed. For instance:

  • If you have a tax advantaged savings account such as a Health Savings Account , now is the time to take full advantage of it. Our article about Health Savings Accounts shows you how.
  • Increase the amount of your life insurance if you can. 
    • Even if your beneficiaries do not need the money, you can get money from a life insurance policy while alive if your life expectancy becomes shortened. A sale is through a process known as a Viatical Settlement or a Life Settlement
    • You can purchase life insurance during open enrollment periods when no health questions are asked.
  • Buy disabilityincome insurance and/or long term care insurance if you become eligible. Your health condition makes it more likely that something else may happen. 
  • During open enrollment periods, look at health insurance alternatives from the point of view of a person with cancer. Survivorship A to Z's Health Insurance Evaluator helps you compare policies from such a point of view.

NOTE: If finances are a problem, look at the Survivorship A to Z information about dealing with a financial crunch. It provides information from the point of view of a person living after a diagnosis. 

If Your Work Requires A Lot Of Physical Effort

If you are having difficulty doing your job because of your condition or because of treatment:

  • Ask your advisor to help create a plan that will work best for the company and for you. 
  • If you are a member of a union, talk to the shop steward or another union official.
  • Negotiate with your employer to get an accommodation to let you do work that requires less physical effort  at least while undergoing treatment and immediately after until you get your strength back. You may even be legally entitled to the accommodation under laws such as the Americans With Disabilities Act. To learn how to negotiate an accommodation, see above.


  • This article only covers subjects of general immediate concern to people in treatment. Additional work subjects are contained in Work: At Work.
  • If you are a small business owner, click here. If you are self employed, click here.

If you were diagnosed with stage 3 or 4 colon or rectal cancer, click here.

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