Alongside fear, uncertainty and the possibility of a life curtailed cancer brings many other undesirable consequences. These issues receive little media attention and this lack of publicity coupled with poor employer, government and public awareness means the implications for individuals, families and the economy at large remain hidden from view.
I know most about breast cancer so will highlight the issues through a lens I am all too familiar with. In almost all cases people diagnosed with breast cancer will require some form of surgery and surgery inevitably requires time in hospital as well as time to recover. For many cancer patients it is not a stand alone event. Even without complications people with breast cancer may find themselves facing multiple surgeries over a period of years in order to ensure the physical aspects of the disease and its aftermath are fully taken care of. As well as surgery, many patients also require additional treatments such as radiotherapy, chemotherapy, hormone or immunotherapy. These treatments can take months or years and frequently come with side effects, some of which may be permanent. Like surgery, these treatments often require regular trips to hospital for their administration or follow-up which inevitably requires some time away from work.
Cancer is an expensive business because treatments and the time taken to administer them are both are expensive. But this is only part of the story. More of us are developing cancer, more of us are developing it at a younger age and worryingly, that trend looks set to continue. Economic pressures and fragilities make it very unlikely our countries can afford the significant costs involved in providing disability benefit for hundreds of thousands of working age cancer patients who suddenly find themselves out of work. Yet despite legislation, e.g. the Equality Act in the UK or the US ADA, many working age cancer patients still find themselves facing discrimination, exclusion from the workplace and enforced redundancy. There are many good employers in the world but there are also far too many who remain ill-informed and retain outdated policies that fail to adapt to the changing face – and health – of the workforce.
This lack of awareness and inflexibility is short-sighted because it places enormous strain on the economy let alone the hardship it inflicts for individuals and their families. Research highlights that cancer survivors work at least as hard as their colleagues and take less time off for trivial illnesses when compared to other employees. In competitive employment markets where demand for skilled workers is high, finding ways to retain the services of cancer patients is therefore good for business, good for the individual and good for the economy as a whole. Although some cancer charities have attempted to provide relevant employer education and awareness, a straw poll of friends with cancer suggests there is still much to do on this front. It’s time governments and mainstream media joined forces on this issue because most cancer patients don’t want to be consigned to the dole queue or long term disability payments. It is more than an issue of income or economy, it’s also an important factor in an individual’s perception of their personal contribution and self-worth.
In many societies the way we perceive ourselves, our confidence, standing, personal and social usefulness is now intrinsically linked with our work. Our jobs, particularly when we’ve trained for them for many years or worked hard to achieve particular goals, have become part of who we are. We measure our worth not only in terms of the salary we earn but the contribution we make as employees. Cancer patients who are forced to give up work often suffer a huge sense of grief and a damaging loss of self-worth at a time when stability and security are of paramount importance. It is not the case that early stage cancer patients need less demanding jobs because they won’t be able to “keep the pace” after treatment. It is not the case that all stage 4 patients are too unwell to work, or will prefer to “spend their remaining time doing other things.”
The number of patients dealing with depression, PTSD or social anxiety as a result of enforced loss of work is significant and likely to increase as the number of working age cancer patients increases. Once again this presents a drain on local and national resources that extends well beyond the realms of individual suffering so it’s time governments and mainstream media joined forces on this issue too. Unemployment creates all kinds of social, economic and psychological problems so keeping people in work has to be a primary aim. With more lateral thinking, more flexible employer attitudes and the application of some everyday common sense, keeping people in work is rarely impossible in an age where we can connect from anywhere, converse from anywhere and complete most computer-enabled processes from anywhere. Even in more manual jobs it’s possible there are tasks employees can usefully and successfully complete with some creative thought about job design and desired outputs. We need to reach a point where pushing people out of their jobs because they have cancer is a decision of last resort.
Awareness of cancer as a critical and chronic disease has increased quite significantly in recent times but awareness of its wider implications – for individuals, families, employers, society and the economy as a whole – remains shrouded in mystery, myths and misinformation. We all have a role to play in unveiling and addressing these important issues because they aren’t going away. Without action and in a world where cancer is increasingly affecting younger people of working age these issues willcontinue to affect our children and our children’s children if we fail to act.