Balancing your breast cancer treatment with your job can be tricky business. You can expect to need more time off and some adjustments to your routine, given your treatment and everything you’re dealing with. Still, you may find work to be rewarding in more ways than one.

“I worked through most of my treatment because it made me feel stronger,” says Bershan Shaw of New York. “I went at it with a warrior mentality. I liked seeing my co-workers most days and keeping part of my life normal.” 

Should you tell your employer? Will you keep your job routine the same? Ask for adjustments to make time for your treatments and how you feel? Look into short-term disability?

It depends on what’s best for you. To make those choices, you’ll want to know what to consider first.

Before You Tell Your Boss

The first two things to consider are how private or open you want to be, and what you need from your workplace to get through this time.

“I am pretty much an open book kind of person. I told my supervisors soon after each time I was diagnosed,” says Debbie McCarron of Huntington Beach, CA. She was treated for stage I breast cancer in 2001, stage III in 2009, and stage I again in 2015. McCarron was an executive vice president at a mortgage company, and she now works as a mortgage underwriter.

“It’s going to depend so intensely on the individual person, their preferences and personality, their workplace and concerns around their workplace, how they feel about privacy, and what kind of job they have,” says Rebecca Nellis, chief mission officer at the nonprofit Cancer and Careers. “We encourage people to do a lot of fact-finding and a lot of internal thinking before they disclose.”

If you work at a small company or on a team where people share a great deal of their lives, your answer might be different from someone in a more impersonal workplace who prefers to keep her private life private.

“When I was diagnosed with stage I breast cancer in 2007, I didn’t tell a soul. When I was diagnosed with stage IV in 2009, I knew not to make the same mistake,” Shaw says. At the time, she owned a restaurant and decided to open up to her entire team about her breast cancer.  “They kept me from overworking. They would say, ‘Go home early, Bershan. You need some rest.’ ”

Telling your workplace also isn’t an all-or-nothing proposition. You get to decide whom you tell, when, and how much.

You could only tell your immediate manager, or only your HR department.

“It was important for me to keep doing normal activities, like working,” Shaw says. “I wanted to show other people around me that there isn't one 'right' way to have cancer.”

“No matter what, you’re going to have more doctor’s appointments than the rest of the workforce not facing a life-threatening illness,” says Jean Sachs, CEO of Living Beyond Breast Cancer. “What we have found is that most women do need to go to HR or whomever their supervisor is and let them know that at the very least, they’re going to probably need more time off.”

Finding Balance

You’ll also want to think about what your treatment involves and your type of work. For instance, if you work a flexible schedule, you might feel like you could continue with your tasks. Or, if you have the option, you might choose to pause your career.

“When you’re diagnosed with advanced-stage breast cancer, you realize you now have a different life,” Shaw says. “That can be scary at first, but it can be eye-opening, too.” After treatment and learning that she was cancer-free, Shaw realized she wanted better work hours and an opportunity to help others more directly.  In 2011, she closed her restaurant. Today, she’s a speaker and coach and often works with women who have stage III or IV breast cancer.

Many people need, or want, to keep working while they get treatment, with some adjustments. In general, the law requires an employer to make “reasonable accommodations” for someone facing an illness like cancer. And that term has some wiggle room.

“It could be working from home the days you have treatment, or having a longer break for lunch,” Sachs says. “Part of it is figuring out what’s reasonable for the employee and for the workplace. Sometimes what is needed goes beyond what is reasonable, and that’s something you really want good, open communication about.”

“During my second round of treatment, I went to a support group during my lunch hour once a week. The group ran a little longer than my break, but I told my employer that it was important for me,” McCarron says. Her employer told her to take the time she needed.

It’s wise to read up on what’s available to you legally, both under the Americans with Disabilities Act (ADA) and in your state. Keep in mind that the ADA law applies only to private employers with 15 or more workers, and state and local government employers. But there may be state laws that apply to smaller companies -- TriageCancer.org has a listing of resources by state.

Also, you should know that an “accommodation” can include simple, practical things. For instance, if your job requires you to walk up a flight of stairs several times a day to get to a printer, you could ask that a printer be placed closer to your desk.

Even if those laws don’t apply in your situation, you could still ask. “We hear from people who aren’t covered by the ADA or state law, and it’s a harder road, but it doesn’t mean an employer isn’t willing to do something simple,” Nellis says.

Know Your Benefits

Just as you should read up on what the law offers in terms of work accommodations, it’s also smart to look into your health and disability benefits to make sure you understand your plan.

Your health insurer can answer questions about your coverage and any deductibles you may have to pay. If you’re insured through a plan you bought through the Affordable Care Act, keep up your premium payments to make sure your coverage continues.

If your company has a short-term disability policy, which covers some portion of what you would make if you were on the job, make sure you know how it works:

  • How many weeks it covers
  • How much pay it covers
  • Whether there’s a waiting period before benefits kick in

When you’re out on disability leave, whether it’s short-term through an employer or long-term on a private plan or through the government, your job isn’t guaranteed. “Unless the company has a policy in place that says they will hold your job for X amount of time, being out on disability leave is not about job protection,” Nellis says. “It’s about income replacement.”

The bottom line: Your experience and your decisions will be unique to you.  And the circumstances can change over time. “Radiation, especially, takes a lot of energy out of you, especially after the first week or two. Toward the end of treatment, there were days where I shut the door to my office, put my head down, and rested for 15 minutes,” McCarron says.

“I know many women who keep up a completely full work life,” Sachs says. “I know others who just can’t. They’re too fatigued, or the treatment is too difficult psychologically. And they just have to say, ‘I need to go on short-term disability or change careers or work part-time.’ They really need to figure out where they are in that continuum.” Once you know what you need, chances are that you can find a way to ask for it that your job can support.

WebMD Feature

WebMD Voices

Lisa B.
Coral Springs, FL
Within the past 14 years, I've been on chemo and hormone therapy. The part that gives me hope is new drugs and therapies are more abundant then 20 years ago, with more to come. Every day, breast cancer is my shadow, but is not my life.
Linda L.
Saddle River, NJ
Be your own advocate. If you have a question for your doctor and don't understand the answer, ask again. If it's difficult to speak up, ask a relative or friend to go with you. If you're not comfortable with your doctor or the treatment she recommends, get a second opinion.
Mary G.
Oregon, WI
Swimming helps my whole body relax and relieves my aching bones. Reaching and pulling strokes stretch out and massage my arm. Yoga keeps my breathing calmer, and I use techniques I learn in class to help me go to sleep at night.
Fabianna M.
Dover, NH
Celebrate small successes. It's about progress towards wellness, not an all-or-nothing scenario. After surgery, it was a while before I could drive. The day I got back in the driver's seat, I drove myself to the beach. I remember sitting on a bench for an hour, reveling in the joy of taking my life back.
Mary R.
Livonia, MI
When I was first diagnosed, I was in shock. Getting information helped. My husband and children helped by listening and allowing me to cry when I needed to. I also formed a support group at my hospital. Talking as a group and forming friendships is very helpful. We all know what each of us is going through.
Catriona M.
Canal Winchester, OH
Ask family and friends for help and support. It's so easy to want to try to do it all, but people really do want to help you. You'll need every ounce of strength you have, so let people bring meals and clean your house if they want to. For many, it's how they show they love and care about you.
Suzanne K.
San Francisco, CA
Put your energy elsewhere, in a better place. I got involved with new challenges that inspired me. I joined a new company. I got involved with the Cashmere Foundation, which brings the spa experience to patients undergoing chemotherapy. I feel I'm able to pay back, or perhaps pay it forward, while helping others.
Mary G.
Oregon, WI
Bring a support person to your first appointment to take notes and listen. Learn all you can on reputable websites. Breathe. Gather your inner circle of supportive friends and lean on them. It's OK to be mad as hell. There will be good and bad days. On bad days, think of the good ones just around the corner.
Sheila M.
Swansea, IL
For a very long time, I didn't accept it. When I finally did, I stopped worrying about things that were beyond my control and I started enjoying life. Having MBC has given me a new purpose through my advocacy work with Metavivor's Serenity Project. I want women to stand on my shoulders of hope and love.
Mary R.
Livonia, MI
I always feel better when I'm rested. I sleep 10-12 hours many days. Smiling and having a good sense of humor makes difficult situations better. I don't worry about small things anymore. Meditation, music, and massages help. I also cope by coloring and sewing, when I have the energy.
Sheila M.
Swansea, IL
People often tell me, "Well, you should do this or you should do that." There's no right or wrong answer on how we deal with this disease. I've learned to deal with it on my own terms and in my own way. I continue to let my faith guide me, and I continue to lean on my family and friends for support.
Lisa B.
Coral Springs, FL
In addition to treatment, I do daily meditation, which calms my body as well as my mind. I find it to be very peaceful. I also find walking and yoga to be a form of relaxation -- and it's healthy. I call it ‘doing my homework.' The drugs are doing their job, and it's my responsibility to take care of me.
Lauren H., 39
Oakley, CA
Many with stage IV hate the comment, ‘Well, you don't look sick at all!' This both implies that I should look weak and sad all the time. And since I don't, I'm throwing off their expectations of what someone with cancer should look like.
Jeanette R., 47
Advance, NC
This cancer has been an odd gift, opening my eyes to the beauty in the little everyday things in life. Slow down, pause, savor it. Repeat. … The more I pray for it and practice, the easier it gets.
Lara M., 42
Louisville, KY
The corner … I lived in fear of looking around it for nearly 5 years. Over time, I've learned how to live more fully present instead of worrying about the perceived future.
Ericia L., 42
Massillon, OH
It's about facing one's mortality while trying to keep the courage to continue on for your family. It's like walking through mud with high heels on. You slip and fall and then you get up and try again, over, and over, and over. Sometimes you stay down for a while, sometimes someone throws you a rope to help, but the mud is always there.
Suzi M., 54
White Cloud, MI
I lift up life with cancer with music! With a good soundtrack, I can get through anything. My life consists of various soundtracks that helped me through some of the most difficult times in my life.
Danielle W., 35
Green Bay, WI
Have I done everything that I wanted to do in life? Hell no! My kids are only 8. I’m 34 years old. But I’ll continue to live my life to the fullest with my kids’ happiness first and foremost.
Jeanette R., 47
Advance, NC
I haven’t felt like there has been any new news, but in reflection, that’s not entirely true. Every day that I wake up and get to go to work to help support my family is good news. Every day that I get to spend being a wife and mother is good news.
Lauren H., 39
Oakley, CA
The truth is, I’m not good at having stage IV cancer. I didn’t plan for this, and there aren’t books called 'How to be the Best Version of You With a Stage IV Diagnosis' to provide me with nine steps for dealing with my diagnosis. Instead, I figure it out every day.
Keeli A., 37
Erie, CO
My family’s priorities have changed. We take more vacations, worry about little things less. I’m trying to make my children’s childhood rich with memories and love. When they look back on me, I want them to remember the fun we had, not the illness.

From WebMD

More on What to Expect