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Returning To Workby Dr. Lisa Shusterman

The good news is you’re returning to work. The bad news is you’re returning to work. An intense mix of thoughts and feelings surrounding your return to work is normal and understandable. Dealing with the diagnosis and treatment of breast cancer affects your work world and, at the same time, your work world can affect the way you deal with your illness.

How your work and your health interact depends on the length and type of your treatment, the stress level of your job and the quality of your support system. Your main priority should be taking care of yourself in a way that maximizes your recovery. Your energy needs to go toward you first. Then, the better you feel, the better you will be able to meet your responsibilities both at work and at home. Knowing this is one thing, though, and doing it is another.

Of Schedules and Secrets

Doctors’ appointments and treatment procedures that occur during the work day can interrupt your routine. To minimize the disruption, Carole Wise, a computer specialist who gets daily radiation treatments, schedules her appointments early in the morning or late in the afternoon. Joyce Braeger gets her chemotherapy treatments on Fridays so she can be at home over the weekend when she feels weak and nauseated.

"I can’t stand all the attention that is on me,” complained Barbara Offit when she went back to her job in a pharmacy after her lumpectomy. Often when you return to work, your co-workers treat on you differently. They may seek you out to ask you how you are feeling. They may offer advice about your treatment or want to tell you stories about people they know who have had breast cancer. “I finally realized,” said Barbara, “ that I am not obligated to tell anybody anything I don’t want to.” Barbara learned that a cancer patient is in charge of what she tells others and what she keeps private. If you find that someone is pressing you to talk when you don’t want to, you can say (nicely), “Thanks for your interest, but I’d rather not discuss that.” If the other person gets offended because you do not want to talk about certain things that are personal to you, it is his or her problem, not yours.

Wanda Barton, a breast cancer patient who was returning to her job in a real estate office, worried about how others would react to changes in her appearance. Like many other women she felt self-conscious about how she looked. For example, if chemotherapy makes you lose your hair, you may be concerned about how you look in a wig. If you have had a mastectomy, you may think that everyone is staring at your chest to see how you’ve changed. To deal with others’ reactions to your changes, you need to feel okay about them yourself. Wanda spent time in front of the mirror telling herself that she is still the same even if her looks are altered. She said aloud, “I am still me.” Some women practice at home how they will handle people’s comments and questions. Perhaps your spouse or good friend can rehearse difficult situations with you. Work on your confidence and ignore remarks that make you feel uncomfortable.

Try this: "Could You Help Me?"

It is absolutely key that you get support from family and friends when you return to work. If, for example, radiation treatments tire you, your support system can help to pick up the slack on things at home. Women tend to be reluctant to ask others for help, but this is the time to learn to do it. Even at work, you may find that others are willing to pitch in and assist you if your lowered energy keeps you from completing your assignments in a timely manner. Most bosses are supportive and flexible. If this is not true for you, you may want to consider talking to the Human Resources Department about your options. By law, you may be entitled to accommodations if you are unable to do your entire job.

It is possible that you want to return to work and even try to return to work, but can’t because you are too tired or uncomfortable. Many strong, independent women have felt the same way, so don’t be too hard on yourself. In reality, some jobs are just too hard to do if treatment is intense and side-effects are numerous. If you have to take a leave or go on disability, even for a short time, then you may want to talk with a counselor who can help you adjust to the changes breast cancer has brought into your life. Eventually, for most women, breast cancer becomes a smaller part of life, not the first thing they think about when they wake up in the morning.

The overwhelming majority of breast cancer patients who want to return to work are able to do so with a minimal amount of disruption. The up side of returning to work after cancer is that you feel more normal, more productive and more in control of your life. In my most recent meeting with Wanda Barton, she told me that “before I went back to work, I was a mess. I was thinking about cancer all day long. Working keeps me focused on issues other than my diagnosis, prognosis and treatment.” For Wanda, and for many other women, returning to work is a positive part of recovery.

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