If you’ve just received a colorectal cancer diagnosis, your health is probably—and rightfully—your main focus. But at a time when more and more working-age young people are receiving this diagnosis, balancing cancer and career is another crucial concern.
Sharing intimate health details with your boss may be the last thing you want to do, particularly with a sensitive diagnosis like colorectal cancer. After all, “We don’t normally go around talking about our bowels,” said Shanthi Sivendran, MD, senior vice president of cancer care support for the American Cancer Society.
Hard as it may be, though, the conversation is worth having. Given the time demands and side effects of colorectal cancer treatment, you may need to change your workload or take a leave. If your boss and human resources department know what’s going on, they can often help with that.
“Many people, once they do disclose, discover that their workplace becomes a source of genuine support and understanding throughout treatment and recovery,” said Deniece Maston, SHRM-CP, an HR knowledge advisor with the Society for Human Resource Management.
Disclosing your colorectal cancer diagnosis can be nerve-wracking. Here’s how to prepare.
Get Specifics from Your Care Team
Before you talk to your boss, sit down with your care team to find out exactly what your treatment will entail, Sivendran suggested.
Colorectal cancer treatment varies by person, but usually involves some combination of chemotherapy, surgery, and/or radiation. Each of these can bring unique side effects and treatment specifications, Sivendran explained, which means your needs may change throughout the process.
Know Your Rights
The Americans with Disabilities Act (ADA), Family and Medical Leave Act, and a variety of state-specific laws provide workplace protections for people with serious medical conditions, like colorectal cancer. As long as your employer is subject to these laws—very small businesses may be exempt—you likely have the right to reasonable accommodations (adjustments that allow you to keep doing your job) and/or medical leave. Brush up on the laws before your meeting so you know what you’re entitled to.
Also carefully read your employee handbook, said Monica Bryant, Esq., chief mission officer for Triage Cancer, a nonprofit that helps cancer patients with legal and practical issues. Many companies actually have more generous policies than what’s required by law, she said.
Decide How Much You Want to Share
“Disclosure is a personal decision,” Maston said.
If you’re comfortable sharing the nitty-gritty, feel free. But know that you are not obligated to share your health status with your employer unless you’re asking for accommodations. Even then, you don’t need to divulge every detail; it’s perfectly fine to keep the conversation focused on logistics, like the amount of time off you’ll need or the accommodations that will allow you to keep working.
You don’t even have to say the word “cancer.” You could say something like, “‘I’m dealing with a serious medical condition that will require ongoing treatment. It may occasionally affect my schedule, so I want to talk about possible flexibility or accommodations,’” Maston suggested.
Your employer is allowed to ask your medical team for confirmation that your condition warrants the accommodations you’ve requested, Bryant said, but in most cases they can’t press for specifics. “The employer is entitled to make sure that the employee is eligible for these benefits,” she said, “but they’re not really entitled to details.”
Plan the Timing and Location
Most people start by informing either their HR department or their direct supervisor. There’s no right or wrong order, Maston said. It all depends on your preferences and relationships.
Either way, this is not a conversation that should take place on the fly or out in the open, Maston said. The discussion may be lengthy and/or emotional, so block off a good chunk of time and find a private meeting space.
Bring a Plan for Work Coverage or Adjustments
Do your homework before meeting with your employer, said Laurie Feingold, MSW, LCSW, an oncology social worker with the nonprofit patient support organization CancerCare. Going into the conversation with concrete ideas about work adjustments gives you “control over that conversation” at a time when “so much is out of your control,” she said.
Not sure what to request? “Make a list of all the things that are challenges at the moment, and then think about, ‘What would make these things better?’” Bryant suggested. If you’re in pain after surgery, perhaps an ergonomic chair would help. If you can’t find time to change your ostomy bag, extra breaks might be in order. If you’re struggling to manage fatigue, maybe you need to reduce your hours or work from home.
Think through your ideal outcome—as well as what’s reasonable in your line of work—before the conversation, and request accommodations accordingly.
It helps to actually use the phrase “reasonable accommodations,” Bryant added, since that’s the language used in the ADA. Otherwise, a supervisor may not understand what you’re requesting and think “you’re just asking for a favor or special treatment,” she said.
Document Everything
Once you and your employer have reached an agreement, put it in writing—even informally, such as by email. Having a written record reduces the chances of miscommunications or disputes, and protects you in case you get a new manager during treatment, Bryant said.
Both verbally and in writing, she added, you should make clear that your needs may change as your treatment and health status progresses.
Know What Support Is Available
“It’s really important to get support, and sometimes support outside the medical team,” Feingold said.
That support can come from many sources. Your employer may offer benefits you didn’t even know about, like employee assistance programs or access to cancer-specific patient advocates, Maston said. Organizations like the American Cancer Society can also connect you to a wide range of patient resources, including support groups.
And if you need extra help with workplace accommodations, the Job Accommodation Network is designed to help navigate the process.
“You can titrate what level of detail you want to give at any point,” Sivendran said. Just because you shared certain details with HR doesn’t meant the whole office is entitled to that information.
If you do share your diagnosis with coworkers, get ready for a range of reactions, Sivendran cautioned. “Some people are going to be super supportive, and that’s great,” she said. Others, however, may get uncomfortable, talk about themselves, or press for details.
Prepare yourself for that reality—and don’t be afraid to politely change the subject or say you’re tired of talking about your health if needed. One response that shuts down an invasive question, according to Feingold, is, “‘Why do you want to know?’”
If you want to keep your coworkers updated but don’t have the energy for repeated conversations, ask an office buddy to act as your spokesperson, Sivendran suggested. They can share important updates and be “the person who absorbs that energy” for you, she said.
You don’t have to share every detail of your diagnosis—just enough to get the support and accommodations you need.
