For many cancer survivors, ringing the bell at the end of treatment isn’t the finish line. It’s the beginning of another challenge: returning to work.
While most survivors successfully re-enter the workforce, new research suggests that simply having a job doesn’t tell the whole story.
During a recent interview with BINJE Managing Editor Linda Lindner, Ada Chen, a research scientist at Kessler Foundation’s Center for Employment and Disability Research, discussed findings from her latest study examining the work experiences of more than 3,000 cancer survivors across the United States.
“The employment rate is actually very high,” Chen said. “About 90% of the people in our study were working.”
That may sound encouraging, but Chen says the more important question isn’t whether cancer survivors are working—it’s what happens after they return.
Chen’s research found that many survivors return to work only after making significant compromises.
Some move from full-time to part-time schedules because of lingering fatigue or pain.
Others accept lower-paying positions, lose valuable benefits or find themselves unable to pursue promotions because they simply can’t perform at the same level they once did.
“What we’re seeing is that it’s less about getting back to work and more about the quality of that work,” Chen explained.
The average participant in the study was 43 years old, placing many survivors in what are typically considered the prime years of their careers.
For workers climbing the corporate ladder, a cancer diagnosis can interrupt promotions, reduce earning potential and create long-term financial consequences.
One of the biggest misconceptions, Chen said, is that life returns to normal once treatment ends.
Many cancer survivors continue living with long-term side effects for years—and sometimes decades.
Fatigue, chronic pain and weakness are common among survivors whose jobs involve physical labor. Office workers often struggle with cancer-related cognitive impairment, commonly known as “chemo brain,” which can affect memory, concentration and decision-making.
“We see people who have been cancer-free for many years still coming back for rehabilitation because the effects of treatment can last a lifetime,” Chen said.
Those lingering symptoms are often invisible to coworkers and managers, making understanding in the workplace especially important.
One of the strongest themes to emerge from Chen’s research had little to do with medicine and everything to do with workplace culture.
Chen says that her research found when survivors were asked about the biggest barriers to returning to work, many pointed to their employers.
Flexible scheduling, time off for medical appointments, opportunities to work remotely when needed and supervisors who demonstrate empathy were repeatedly identified as factors that make returning to work easier.
On the other hand, survivors reported that stigma, misunderstanding and a lack of support often made the transition far more difficult.
“A supervisor who understands what an employee is going through can make an enormous difference,” Chen said. “Education is essential because many employers mistakenly assume that once someone is declared cancer-free, they’re fully recovered. That’s simply not the reality for many survivors.”
Even though most participants in the study were employed, many still reported feeling financially insecure.
Reduced work hours often meant smaller paychecks and fewer employer-sponsored benefits. Yet many continued working because employment provides access to health insurance—a benefit that can be especially important for people managing long-term health issues or ongoing rehabilitation.
Some survivors, Chen said, find themselves making difficult tradeoffs between protecting their health and maintaining their careers.
Although federal laws such as the Americans with Disabilities Act are intended to protect workers who need reasonable accommodations, Chen believes there is still significant room for improvement.
Based on comments from survivors, many employees aren’t receiving the workplace flexibility they believe they’re entitled to, including modified schedules or time to attend medical appointments.
Her team plans to explore those issues further in future research by examining workplace policies and interviewing employers and supervisors.
Chen believes healthcare providers should discuss employment much earlier in the treatment process.
Instead of waiting until treatment ends, she says returning to work should become part of a survivor’s overall care plan.
Patients should talk with their healthcare teams about how treatment may affect their jobs, what accommodations might help and what a realistic return-to-work timeline looks like.
Likewise, survivors should know they have the right to request reasonable workplace accommodations.
“Many people don’t realize those protections exist,” Chen said.
Chen says supporting cancer survivors doesn’t necessarily require expensive programs.
Simple changes—flexible schedules, remote work options when appropriate, phased return-to-work plans and manager training—can make an enormous difference.
Just as importantly, organizations should create clear, respectful accommodation processes so employees don’t feel they’re asking for special treatment.
For Chen, the goal is simple: shift the conversation.
Instead of measuring success by whether someone returns to work, employers and researchers should ask whether cancer survivors are able to return to meaningful, sustainable careers.
“It’s time,” she said, “to focus on the quality of employment—not just employment itself.”
