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Why some don't share: Cancer diagnosis can make it hard to keep your job

Before she developed a breast tumor, Tara Cernacek assumed that anyone who was diagnosed with cancer would want to quit their job and stay home. But that all changed with her own diagnosis.

“Work was a saving grace for me,” Cernacek says. “It got me out of thinking about being sick. It made me feel productive. And it gave me the money for treatments.”

Courtesy of Cancer and Careers / Cancer and Careers
After her breast cancer diagnosis, Tara Cernacek wanted to keep working for a "sense of normalcy.”

Cernacek isn’t alone. Nearly three out of four cancer patients and survivors say they want to stay with their jobs and feel that work helps with recovery, according to a recent survey conducted by Harris Poll. Like Cernacek, nearly two-thirds of survivors say that they needed to work through their treatment period to make it financially.

That doesn’t mean it’s easy to stay on the job. Many people receiving cancer treatment face daunting challenges related to their career — among them, fatigue, 42 percent, pain and discomfort associated with treatments, 26 percent and slowed mental processing, or chemo-brain, 20 percent. And they may fear that disclosing a cancer diagnosis could put their job prospects at risk.

At least 61 percent of patients and survivors checked “somewhat agree” or “strongly agree” to the statement: “I feel like disclosing my cancer diagnosis will negatively affect my chances of getting hired.”

'Sense of normalcy'

When Cernacek was diagnosed she told her boss and fellow employees, most of whom rallied around her in support. “I got a lot of help from them meeting deadlines,” she remembers. Her boss wasn’t especially happy about her needs for flextime, but allowed it.

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Eventually though, the company downsized and laid a number of workers off, including Cernacek. “I didn’t realize how much I needed work for internal reasons until that happened,” she says. “When I got laid off, I got so depressed. I felt useless. Work had given me a sense of normalcy.”

That sense of “normalcy” becomes very important when “your life is in crisis,” says Lillie Shockney, an associate professor at the Johns Hopkins University School of Medicine, administrative director of the Johns Hopkins Breast Center and founder of Hopkins program, Managing Cancer at Work.

“Even though people may say you should just go home and rest, sitting at home and dwelling on your cancer is not emotionally healthy,” Shockney says. “Plus, most people have a second, extended family at work. They spend as much time with their co-workers as they do with their actual families.”

In many cases, work is very much tied up with a person’s identity, says Rebecca Nellis, chief mission officer at Cancer and Careers, a non-profit organization that provides help for people who want to work during and after cancer treatment. “Cancer becomes a mortality crisis that becomes an identity crisis that becomes a financial crisis,” she says.

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A big part of the financial crisis is the fact that insurance coverage is often linked to the patient’s job, and most plans have co-payments and deductibles, Shockney says.

Patients getting treatment often can’t do their jobs in exactly the same way as they had before the cancer, Nellis says. That’s where the Americans with Disabilities Act can come in. Employers are supposed to make accommodations that allow the worker to do her job.

But not every employer wants to make accommodations. “There are federal laws that require them to,” Shockney says. “But not everyone in leadership positions knows what the laws are.”

Related: 'Grateful to be alive': Cancer patient outlives doctor's prognosis by 16 years

Cernacek suspects that her cancer might have had something to do with the loss of her job, with several months of treatments remaining. A new position was found for every other administrative assistant, she says.

Job hunting challenges

The layoff left her searching for a new job when she was looking especially ill. “I still didn’t have all my hair back,” she says. “My skin didn’t look good. I did temporary work from home, but it wasn’t bringing in enough money. Even after I got much better it was a two-year job search.”

With a large gap on her resume, job hunting was a challenge. Cernacek wasn’t comfortable telling prospective employers about her cancer.

Desperate for help, Cernacek eventually reached out to Cancer and Careers. With a career counselor, Cernacek learned how to re-craft her resume and how to deal with questions about the gap in her employment history. Eventually she found a new job.

Her cancer, she says, never came up in the interview.

“They know now because I’m very public about it,” she says. “So I was upfront about it after I was hired. I mentioned it casually, saying ‘I’m a survivor.’ They just said ‘Oh that’s great! Congratulations!”

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