Metastatic Breast Cancer and Your Career

Working can be beneficial, but it may require some modifications to your job
Woman with breast cancer contemplates going back to work.

Receiving a metastatic breast cancer diagnosis can be scary. As the most advanced stage of breast cancer, this is when cancer cells have spread to other parts of your body like your lungs, bones, brain or liver.

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As you come to terms with your new normal and what your treatment plan may look like, it can be overwhelming to think about continuing to work with metastatic breast cancer.

“Metastatic breast cancer is treated more like a chronic medical condition where the patient will remain on some form of treatment indefinitely,” says care coordinator Nancy Dalpiaz, RN, BSN.

But many people opt to keep working with metastatic breast cancer, notes Dalpiaz. She walks us through how to navigate work, what modifications you may need to make and the benefits of keeping your job.

Can you work with metastatic breast cancer?

There’s no easy answer here. It’s up to each individual person.

“There isn’t a one-size-fits-all answer,” says Dalpiaz. “It’s best if you talk things over with your care team about how they feel you will tolerate treatment. There are options to continue with your career. It’s important to identify what is important to you.”

For example, you may have a goal of reaching certain milestones like going on a family trip or seeing your child graduate — and work and your career may not be front of mind.

But for others, working can bring a sense of fulfillment and purpose.

“You want to maintain as much normalcy as possible,” says Dalpiaz. “Try to do your normal activities. You may have to make modifications due to side effects. But I find that people that continue to work do better overall with treatment.”

Another reason you may want to consider working is for the insurance benefits.

“You may need insurance in order to pay for your treatments,” says Dalpiaz.

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Should I take short-term or long-term disability?

If you have metastatic breast cancer, you’re eligible for short-term and long-term disability. Short-term disability is typically up to 90 days, while long-term disability is more than 90 days.

“A lot of times when you start treatment, you’re not sure what your side effects will be or how you’re going to react to the treatments,” says Dalpiaz. “You might want to take time off to just see how you’re going to feel.”

This can also help with peace of mind when it comes to scheduling appointments, testing and treatments. Many care teams can help navigate the world of paperwork with you, helping you fill out the necessary forms and giving you information on what options are available.

“I encourage anyone with metastatic breast cancer to apply for the Family Medical Leave Act (FMLA),” says Dalpiaz. “This allows people to keep their job, but to be able to take off a certain period of time or intermittently for treatments.”

How does breast cancer limit your ability to work?

With metastatic breast cancer, there are a variety of options when it comes to treatment:

Depending on the type of treatment you’re on, you may experience different symptoms like fatigue, nausea, muscle and bone pain, constipation and diarrhea.

And as these treatments will be ongoing, you may need to make a few modifications to your work life based on how you’re feeling and what symptoms you’re dealing with.

“A lot of your decisions are going to come from knowing your body, knowing how you’re going to feel and knowing what you can and can’t do,” says Dalpiaz.

If you have a physically demanding job or are on your feet for most of your workday, you may need to talk to your boss about modifications like the option to take more breaks.

“We have a lot of workflow flexibility in the world today,” says Dalpiaz. “Employers may be able to offer alternative work models like remote work or compressed work weeks.”

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Other modifications can include moving your desk closer to a restroom if you have a sedentary job.

“A lot of people worry that they could be discriminated against in the workplace,” says Dalpiaz. “It’s unlawful for them to lose their job due to a cancer diagnosis.”

You shouldn’t need to quit your job if you don’t want to. Your employer should work with you to make the proper modifications.

Talking to your boss about your diagnosis and outlook

How and what you choose to communicate with your boss and colleagues at work is up to you — there’s no right or wrong way. It’s all about what you’re comfortable sharing and who you want to share it with.

“This is a very personal decision,” says Dalpiaz. “It depends on the relationships that you have with your boss, employer and colleagues — and also how well you’re tolerating treatments.”

Some may opt to inform their managers right away, which allows them to come up with a plan. While others may choose not to say anything unless their diagnosis and treatment starts affecting their work.

Dalpiaz does recommend talking to your human resources representative because they’ll have any necessary paperwork for FMLA, short-term and long-term disability.

There are many individuals who choose to keep working after receiving a metastatic breast cancer diagnosis, while others may choose to quit or retire. Choose whatever option is best for you and whatever feels right.

“Working can give you a sense of purpose. It gives you a reason to get up every day, get dressed and get moving,” says Dalpiaz. “It serves as a great distraction.”

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