• Myrna Sachs - Head of Alexander Forbes Health

What happens when a cancer survivor returns to work?

A cancer diagnosis will impact your health, your family and also your ability to do your job.

With 3 June 2019 marking National Cancer Survivors Day, head of Alexander Forbes Health Management Solutions Myrna Sachs discusses what happens to cancer survivors when they return to work.

Cancer is the second leading cause of death worldwide according to the World Health Organization. According to Lancet Medical Journal, South Africa can expect to see a 78% increase in cancer cases by 2023.

Alexander Forbes Health Management Solutions’ research in critical illness claims over the past two years shows that cancer applications are increasing significantly. “Especially in the age category 20-39, 44% and 42% respectively of the applications received were due to the disease, which is high and a real concern,” Sachs said. Of the total sample looked at, 37% of all applications were due to cancer.

South African legislation and cancer

According to South Africa’s Employment Equity Act, No. 55 of 1998 no-one may be unfairly discriminated against as a person on the grounds of disability. The scope of the Act focuses not on the diagnosis but resulting functional fallouts. “In the case of cancer, depending on the stage, site of the cancer, treatment options employed and presentation of the employee, they may or may not be considered a person with a disability based on the set criteria of the definition of disability,” Sachs said.

Employer awareness around cancer

It is important for employers to be aware that the increasing incidence of cancer in the workforce risks leading to reduced productivity, potentially increased presenteeism, low morale and increased costs of providing cover during sickness absence. “With earlier detection and improved treatment options survival rates are expected to improve and more people will be able to return to a productive lifestyle at home and in the workplace.

Sachs said employers should understand that cancer’s effect on an individual depended on many factors including the primary site of the cancer, stage of the disease, age, health of the individual and type of treatments. “A person declared fit to return to work can still present with constant pain, weight loss, fatigue and nausea. They may still need time off work to attend to medical appointments.” The implementation of a graded return to work approach may also be needed.

Employers are encouraged to conduct a return to work discussion with the employee on their return from sick leave, draw up a return to work plan and monitor this periodically. “This plan should factor in current medical advice on the employee’s condition and capabilities, assess any potential risks and allow for a phased return to work.” Sachs said the reintegration process could include potential change of work load, re-allocation of non-essential tasks, allowing for flexibility in start and finish times or if feasible allow working from home.

For employers without HR support, the burden of managing cancer survivors often falls on the line manager. “It is then incumbent on the organisation to provide support to the line manager in the form of training and coaching.” For employers with wellness programmes, due to the increase in cancer cases there is increasing focus on the health assessments, screenings, good on-site food choices, incentives to stop smoking and disease management programmes.

Employers should be aware that there is a burden on caregivers. “Should an employee have a family member who has been diagnosed with cancer there may be an impact on the employee’s productivity and attendance in the work place. In order to retain talent, some employers are providing paid compassionate leave to caregivers, others are providing case management services which could alleviate the burden on the caregiver.”

Due to stated increase in cancer cases, existing policies should be updated and adapted to equip line managers on what to do, provide information to employees and have reasonable accommodation measures that can be placed for cancer survivors. This policy needs to be congruent with existing wellness programmes, company policy on absenteeism, incapacity and disability in the workplace, that the company may already have and should not be a standalone policy. The insured benefit policy should also be taken into account

What should employees know about cancer in the workplace

Financial obligations and need are the reason most people have to continue working while receiving cancer treatment. “Employees should consider taking out insurance benefits that protect against income loss, such as critical illness benefits or an income protector benefit.”, if the company does not have this in place already.

Though an employee is not legally bound to tell their employer on diagnosis, they are encouraged to share it for initiation of reasonable accommodation measures.

“As an employee, your role at work is important for your sense of well-being.” An Economic Intelligence Unit report has revealed that cancer survivors benefit from their return to work, with a sense of normality, providing a routine and feeling productive despite having to cope with fatigue and other consequences of cancer and its treatment.