BACK TO WORK AFTER CANCER   

Returning to work after cancer is no easy feat. Impossible as it might seem–especially after battling cancer–the day comes when treatment is finished. Facing a job again can be nerve-wracking, stressful, and exhausting.
For some survivors, it’s important to jump right back on the wagon, to prove you’re in control. For others, it might be tempting to postpone work indefinitely. With the long term effects of chemotherapy still being researched, many patients experience what is called ‘chemo brain’ for years afterward. It’s described as a cognitive impairing side effect that makes you feel foggy, and can make completing simple tasks like following a book or quickly recalling information difficult. 
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 .

Many welcome a return to work as a return to normality, pay-checks, company, sense of identity and other factors. While others found it was tough going back to work. They struggled to fit in again, struggled to concentrate on tasks, hampered by their “chemo-brain” and unrelenting fatigue. They know that they are not alone in experiencing this .

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, patients who get daily radiation treatments, should schedules their appointments early in the morning or late in the afternoon. Some patients get their chemotherapy treatments on Fridays so she can be at home over the weekend when they feels weak.

Setting Professional Boundaries 
Learning to Say No Effectively–Everyone has limits and it is important to take the time to figure out what yours are and what triggers them, especially while juggling both work and cancer treatment and recovery. In our personal lives, it may be easy to tell someone that we need space or to be left alone. However, work culture often makes that hard to do making it critical to find productive ways to communicate your limits. Learning to set these boundaries on-the-job might enable you to decline certain types of requests, such as staying late for non-essential tasks or being given new projects to complete. Although it can be difficult to say no, figuring out how can help you become a better employee; you won’t be over burdened with extra work, and you won’t feel trapped by every ask you receive.
For example:
• “I appreciate that you thought of me for this project but I’m a bit swamped this week, and am concerned about my ability to get this back to you in a timely manner.
For more support in identifying what triggers your limits consider talking to a social worker who can also help you craft personalized language to communicate your needs at work.

Recasting Yourself After Cancer
A common fear for people returning to their same job/company following a diagnosis or treatment is that they will be seen as the “cancer girl” or “cancer boy” in the office forever and that that will hold them back. You may be wondering things such as:
• Will your office always see you as a person with cancer?
• How do you get your workplace to see you as the professional you are rather than someone who has/had cancer?
• Is there a nice way to say “please stop bringing it up”?
Being able to swivel the conversation back to a place where you feel comfortable is empowering and helps to reset the view your colleagues have of you. It’s also important to remember that it may take time to recast yourself in the eyes of your workplace. Try not to get frustrated and to remember the more you focus on work the more everyone else will follow your lead.

Men, Cancer & Work: Coming to Terms with the “New Normal”
A diagnosis of cancer can affect the identity often attached with one’s work—especially if you see yourself as a provider, protector and moving-up-the-ladder kind of guy.
Even if you aren’t the sole breadwinner in a family–and even if you’re single, with no dependents–the diagnosis and dealing with it is likely to make a chink in your work armor, according to mental health experts.
Men with cancer tend to become more depressed than women with cancer, according to Tetyana Pudrovska, PhD, a researcher at the Population Research Institute, Penn State. That, of course, can affect work performance and recovery. In her words: “Cancer poses a threat to the masculine identity because it entails lack of control over one’s body and other consequences incompatible with traditional masculinity
How to cope– For high-powered types, the major threat is having to stay home or slow down. Within reason, you may opt to try to increase the pace as your health allows. Consider taking an office nap, for instance, instead of barreling through, then finishing the day’s work once you are more refreshed.

Back to Work
Easing back into the routine–After your medical leave is over, gear up for the next challenge: making your re-entry to your job as comfortable as possible. For cancer survivors, returning to work often brings mixed emotions: relief, trepidation, hope — and perhaps awkwardness. Even if you are sure you’re ready to return, you may worry: Will you encounter skepticism or support? That depends partly on how you approach the situation, experts say. Here are some suggestions for smoothing the transition from cancer patient back to valued employee.
Follow Your Style–If you’re naturally talkative and share information easily, you’ll probably want to update co-workers and your boss on your recovery. If you’re more private, just tell everyone you’re doing fine and let it go at that. 
Get up to Speed–It is important to feel confident again about your job abilities. How do you do so? 
Test your psyche. Just as important as feeling capable of doing the job is feeling psychologically up to speed. If you’re feeling below par, you might seek one-on-one counseling from a social worker or a therapist, or join a support group of other cancer patients returning to work.
Evaluate your readiness to work. Are you ready to come back full-time or part-time? If part-time sounds more feasible, consider what accommodations you will need. Do mornings work better, or afternoons? 
Attend workshops or seminars to refresh your skills.
Attend industry events to keep your knowledge up-to-date

Make a Plan
Once you’ve decided whether you are fit to return full-time or part-time, make a schedule, see if it fits your employer’s need and then prepare to follow it.
• Take a look at your workstation. Does it need to be redesigned or fitted with equipment such as back support or other devices to make you more comfortable?
• Focus on the work itself, even if catching up means tending to tedious tasks such as returning a boatload of telephone calls or tackling a mountain of mai
Your cancer history, the law and your insurance
One of the main provision of the recent health care reform implements new regulations which will prevent all health insurers from denying coverage to people for any reason, including health status, and from charging higher premiums based on health status and gender.

Are you being treated fairly?
Legally, your cancer history can’t be used against you in the workplace. But it can be difficult to determine if your cancer history is being used unfairly, because discrimination can be subtle. Some hints: If someone clearly less qualified is promoted, you should suspect the cancer history. If you hear disparaging comments, you are being treated unfairly. One woman (who filed a lawsuit) told of the day the office staff had to exit the building during a blackout and her boss said others should just follow her, since her radiation therapy made her glow. If tasks you used to do competently are being given to someone else, that might be a clue your supervisor thinks you’re not as capable. If your assignments or projects are not as challenging or time consuming as they were before your cancer treatment, that might be a clue. But the evidence is very “fact-specific” for each workplace situation
Moving to another company
Perhaps you’re unhappy enough to look for another job, you’ve decided to go after your “dream job” or you just have an opportunity for an interview with another company. Going on a job interview is always challenging, but if you have a cancer history it might be more so. If you decide to look around for a new job, experts recommend squashing that natural urge some cancer survivors have to talk about it, at least right away, with a potential new employer. Also, you should know that your potential new employer does not have the right to ask about your medical history. The employer only has a right to know if you are qualified to do the job.

Get tips on job hunting after cancer treatment
Experts: 
Relieving Stress
Reducing Workplace Stress
Today, most cancer treatment centers offer stress-reduction programs. If you take advantage of these opportunities from the beginning, you are less likely to become overwhelmed with stress over time. A few ways to get started:
Breathe
People under stress tend to breathe in short, shallow breaths that do little to bring in oxygen and a lot to increase tension in the chest and shoulders. Next time you feel panicky or tense, take a few moments to breathe deeply. Getting more oxygen into your system will slow your heart rate, decrease your blood pressure and relieve that sense of panic.
Exercise
Physical activity is one of the most effective ways to combat stress, so take steps to incorporate bouts of exercise into your workday. Go for a walk at lunchtime, or head to the gym for a yoga class or treadmill time. Throughout the day, take short breaks to stretch or do simple exercises in your desk chair. You can also try meditation during a 10- or 20-minute break)\

Listen to Music
It’s hard to stay tense when your favorite song is playing. Load your iPod with music you love or pop CDs into your computer drive and listen quietly.

Head Outside
Sunlight and fresh air can help you de-stress. Eat your lunch outside, take strolls during breaks or suggest that your next one-on-one meeting with a colleague be a walk-and-talk affair.
Laugh
A growing body of research has found that laughter can reduce the physical symptoms of stress by increasing the flow of oxygen throughout your body and releasing feel-good endorphins in the brain.
Just Say No
Simplify your life by setting up boundaries at work that will allow you to say no to certain types of requests, such as staying late for non-essential projects. Although it can be difficult to say “no,” learning how can help you become a better employee; you won’t be overburdened with extra projects, and you won’t feel trapped by every request you receive. 

Delegate
If you’re someone who likes to do everything yourself, it’s time to get over it! Look over your workload for the next several months to determine what requires your personal attention and what can be distributed to others. Keep in mind that you can provide guidance and direction without being on-site.
Keep the Lines of Communication Open
If you decide to tell your colleagues, be as open as possible with them about your needs — and possible limitations — as your treatment progresses.

Relaxation Strategies
Effective Breathing
• Sit up straight in a comfortable chair, feet flat on the floor, neck and shoulders relaxed.
• Take a deep breath through your nose, with your mouth closed. Use your diaphragm when inhaling – consciously pushing your belly outward as you inhale. Put one hand on your abdomen, if you like, to feel how it rises and falls.
• Exhale slowly through your mouth, with your lips pursed as if you were whistling (or about to give someone a peck on the cheek). Make your exhalation twice as long as your inhalation, pulling your diaphragm in as you empty the air from your lungs.
• Repeat three or more times, until you feel yourself relax.
Progressive Relaxation
• Remove your shoes and any uncomfortable or restrictive clothing, including eyeglasses.
• Remove any possible distractions. Turn off the television, radio and phone, and dim the lights to a comfortable level.
• Sit in a comfortable chair, head and neck relaxed, with your hands at rest in your lap, palms up. (You can lie down if you prefer, just don’t fall asleep!)
• Close your eyes and breathe deeply.
• Keeping your eyes closed, focus your mind on your feet and toes. Slowly tighten the muscles in your feet, hold for a beat, and slowly relax.
• Repeat this tightening and relaxing pattern with each of the muscle groups in your body, gradually working upward. Move your focus from the calves to the thighs to the glutes, through your back, chest and head, including your face. Don’t forget your hands and arms.
• Continue to breathe deeply until you feel relaxed and calm. You can test your level of relaxation by putting your hands against your face or neck. Warm hands mean a relaxed body. If they’re still cool, continue the exercise until they warm up.
Visualization
• Remove your shoes and any uncomfortable or restrictive clothing, including eyeglasses.
• Remove any possible distractions. Turn off the television, radio and phone, and dim the lights to a comfortable level.
• Sit in a comfortable chair, head and neck relaxed, with feet flat on the floor and your hands resting in your lap, palms up. (You can lie down or sit on a mat if you prefer – just be sure you are comfortable enough to stay in this position for ten to 20 minutes.)
• Close your eyes and picture yourself in a pleasant, restful place – a green meadow by a cool lake, the soft sand of a Caribbean beach, a warm rock by a clear mountain stream.
• Fill in every detail as you breathe in deeply through your nose and exhale slowly through your mouth.
• With each breath, slowly let the tension ease out of your body’s muscles. Allow the muscles in your feet, your legs, your back, shoulders, arms, hands and feet to relax as you sink further into the restful world of your inner picture.
Additional Resources

Books
The Art Therapy Sourcebook, by Cathy A. Malchiodi (Lowell House)
Creative Visualization, by Shakti Gawain (New World Publishing)
Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness, by Jon Kabat-Zinn (Delacorte)
Healing Essence: A Cancer Doctor’s Practical Program for Hope and Recovery, by Mitchell L. Gaynor (Kodansha International)
Living Beyond Limits, by David Spiegel, M.D. (Ballantine Books, 1993)
Minding the Body, Mending the Mind, by Joan Borysenko, Ph.D. (Bantam New Age Books)
The Relaxation and Stress Reduction Workbook, by M.M. Davis, M. Eshelman, and E. Eshelman (New Harbinger Publications)
Staying Well With Guided Imagery, by Belleruth Naparstek (Warner Books)
Stress Blasters, by Brian Chichester and Perry Garfinkel (Rodale Press)
Stress Remedies, by Carl Sherman (Rodale Press)
Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life, by Jon Kabat-Zinn (Hyperion)
Yoga For Dummies, by George Feuerstein, Ph.D. and Larry Payne, Ph.D. (IDG Books Worldwide, Inc.)

Traveling with Cancer

Throughout your experience with cancer you will have reason to travel, perhaps for treatment itself, and probably for work and pleasure too. The good news is that many cancer patients are able to travel comfortably and safely as long as they take proper precautions and use common sense

Choose your destination wisely .

Your travel experience will be much more pleasant if you choose a savvy, supportive, experienced travel companion, preferably one who knows you and your destination well and will be able to help you should you require assistance.
Know and respect your body’s limits

Your Mindset 
Know yourself
There’s no “right” way to cope with cancer. Each person handles the emotional challenges differently. Think about how you usually function in an emergency and expect to react the same way. It may help to understand the strengths that brought you through adversity before.

What does cancer mean to you?
Cancer triggers a terror different from most other diseases, even though they may have worse consequences. Any sense of doom you may have probably comes more from this historic dread than from the current realities concerning your type of cancer and its treatment. Cancer is not a death sentence for most people. It does not necessarily lead to helplessness, pain, disfigurement, disability or the end of your career. Accept that these exaggerated fears are normal, but do not let them prevent you from having a worrisome lump or symptom checked out or from deciding to undergo recommended treatment. And do not conclude that you will not have the energy or focus to pursue life goals. Most people find that their anxiety diminishes greatly once treatment begins and they are taking active steps to combat the disease.

Let it out
Express your feelings, no matter how awful or embarrassing they may seem to you. Keeping them bottled up may prevent you from moving beyond the distress. However, at work or at home, you may need to promote the image that you are in greater control than you may feel. In that case, you need to find a person you can trust or a safe place — at a support group, in a therapy session with someone who has had cancer — where you can vent your anger, fear, sadness and even those alternating hopeful and hopeless feelings .
It’s a control problem
Uncertainty and lack of control over your body and your future often underlie the anxiety that people experience at the time of diagnosis. People who have always felt in control of their futures, their careers and their families may have particular difficulty, as will those who find it difficult to deal with change. Becoming a medical patient and enduring the the passive waiting that tests and treatments entail can provoke a feeling of loss of autonomy. Distinguishing between what you can and cannot control will help restore confidence and competence
It’s not your fault
Resist blaming your personality, attitude, coping style, emotions, lifestyle or personal habits for your cancer. Cancer experts repeatedly emphasize that there is absolutely no scientific basis for these conclusions. The more you blame yourself, the less empowered you will feel to combat the disease.

Resist blaming your personality, attitude, coping style, emotions, lifestyle or personal habits for your cancer. Cancer experts repeatedly emphasize that there is absolutely no scientific basis for these conclusions. The more you blame yourself, the less empowered you will feel to combat the disease.
Slow Down
If it’s too challenging to resume your frenetic work habits, focus on one responsibility at a time instead of multi-tasking. It’s okay if it takes you longer than usual to return non-urgent phone calls and e-mails or if the filing piles up a bit. During this transition period, 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
Listen to your body instead of pushing yourself too hard. Break for lunch daily, and take additional short breaks throughout the day. Go for a 10-minute walk outside whenever possible – the fresh air and exercise should help clear your mind and boost your energy levels so you can focus on the task at hand when you return to your desk
Write Down Your Priorities
Use the list to figure out what your most important tasks are, then focus on completing those first. When you aren’t feeling well, reread your priorities to remind yourself that you don’t need to live up to other people’s unrealistic expectations, actual or imagined, you just need to do what’s on your list.
Focus on the Familiar
If your work-related goals have changed so much that you decide to embark on a new career path, it can be helpful to return to your old position for a while before interviewing for a different job. Regaining your confidence as a full-time employee in a familiar environment can be invaluable.