Cancer is not a death sentence. Many people living with the disease continue to work throughout their diagnosis and treatment.

But by its very nature, cancer is disruptive. No one finds working while receiving chemo or radiation an “orderly situation,” says Rebecca Nellis, chief mission officer at the nonprofit Cancer and Careers.

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However, a positive workplace can be a tremendous source of support during a challenging time. A recent  Cancer and Careers survey found that 75 percent of respondents wanted to keep working after their diagnosis because it provides them with a sense of pride and accomplishment that is critical to recovery.

Nellis, who works with cancer patients, offered her insights on working during treatment. 

Gather information 
Before revealing your diagnosis to your employer — if, in fact, you chose to do so — fact-finding is a crucial first step. Knowing the timeline for your treatment plan, the possible side effects and precisely how they will affect your ability to do your job can help you present the situation to an employer feeling informed and prepared, explains Nellis.  

Next, comb through your employee handbook and gather info about disability and sick leave policies. Understanding exactly what you’re entitled to can give you confidence when sharing sensitive information.   

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Know your rights
Nellis emphasizes that it’s crucial to know your rights guaranteed by the Americans with Disabilities Act. (Though the word “cancer” isn’t anywhere in the title, the law still applies.)

“The ADA does two important things: protect from discrimination and provide a reasonable accommodation,” explains Nellis. 

A “reasonable accommodation” means that employers are required to provide assistance or modifications that allow employees who have a disability to continue to do their job. 

“If we’re talking about someone who is a retail manager and fatigue is gong to be a major factor, can they stand for eight hours a day?” says Nellis.  

Know what support looks like 
A pro-tip for those who work with someone going through cancer treatment: Don’t coddle or condescend. 

“Co-workers shouldn’t become so focused on the cancer that they forget the colleague they’re talking to,” says Nellis. "They’re there because they want to work, and work provides normalcy.”

Even gestures that come from a good place, like running an office fundraiser or taking on additional responsibility on behalf of sick colleague, require buy-in and permission.   

“If they’re really private, they may not want something [calling attention to their illness],” adds Nellis. “Make sure you run everything by the colleague, and get their support.”

Try offering to do very specific tasks — buying lunch for a week or assisting with a particular part of the job, suggests Nellis. This can send a message of support without smothering.

Know your worth outside of work  
In some instances, people with cancer stay on the job out of necessity: Work provides the income and benefits paying for their treatment. Other times, the motivation is personal. 

“We work because it’s part of our identity, so it really challenges a sense of self,” Nellis states.

Self-worth and work often are inextricably linked. That’s why if working becomes untenable, some people “may struggle to see themselves as more than just their cancer diagnosis.” 

This sense of loss is particularly hard for people in their 20s and 30s, since they’re “prone to seeing their job as a key part of their identity….you’re in the mix and you’re part of something, and most people don’t want to worry about being left behind.” 

If a cancer patient is forced to leave work, Nellis encourages them to ask about financial assistance programs or disability insurance.

Mind the gap (on your resume) 
For cancer patients who do take time off, the return to work can “become a really stressful piece of the puzzle,” says Nellis. “We spend a lot of time working with people about how they’re going to sell themselves.”

In some cases, a life-changing illness is an opportunity for survivors to professionally pivot. Nellis has worked with many people who wonder if “60 hours a week is worth it” after they’ve faced their mortality.

Though she doesn’t have all the answers, Nellis says career-related questions often change after cancer.

“It’s more about what gives you meaning? What do you derive joy from?”