The women we interviewed spoke about the impact that breast cancer had on their work and careers as well as on their personal finances. In this page you can read about the extent to which they experienced support at work, the financial implications of having cancer, returning to work during or after treatment and the overall impact on their lives.
Support at work
Women who experienced strong support from colleagues throughout their illness were appreciative of their reactions.
They were wonderful. I didn’t really… I do personal support so a lot of the… in-home personal support. So a lot of people don’t know, but of course I had to tell my immediate boss and a couple of people I work with they were very supportive. They said anything you want just let us know and I was off work for a year, I had no problem coming back and they were wonderful.
Women described colleagues that called them at home, sent cards, and Amanda even received a handmade quilt from her boss. Carol's colleagues provided home cooked meals. Jeanette, who worked in the service industry, received support from customers who noticed her baldness and shared their stories with her. Amanda received great help from a colleague to organize her leave through administration.
Telling colleagues about the diagnosis was usually a challenge and colleagues were often shocked or upset after learning about the diagnosis.
I’ve been very open at work with all of the treatments, with the reconstruction that I’ve undergone here recently. We have many, many jokes and laughs about different things but people care, they truly do care and when I’m not feeling right for whatever reason, whether it’s tiredness, a new surgery is coming up or medical appointments that impacts me.
Donna described how her "heart cracked wide open with the illness" after she was diagnosed. Not all women we spoke to felt that they received as much support as they might have wanted.
I would tell you that I didn’t, I didn’t have problems. However the support of my colleagues came a little late because, even if me with my team leader at the time – I had completed all the paperwork and I had told them – I had given the permission to talk about it, but it’s like it was kept secret during many months.
At some point in time, it’s me that informed few people and then, a little later, the news started to spread, but it really took some time. No, it wasn’t… it wasn’t like I hoped it to be.
Taking time off
Most women going through chemotherapy took time off from work – from several weeks to, more often, 1 to 2 years. Women that underwent radiation therapy or surgery were sometimes able to work throughout and others took only a few weeks off or reduced their working hours. These decisions or situations were highly dependent on the individual circumstances of each woman and her illness, including factors such as the severity of the disease, treatments, the extent of insurance coverage, number of available days of sick leave, and support from colleagues, family, and friends, and the nature of their work. Kathryn has been on sick leave for 11 years ever since she was diagnosed with metastasized breast cancer. She said "There's nobody there to tell you how you're going to feel about not being able to go back to work, about how shitty you're going to feel."
Several women combined work and chemotherapy. Some found it helpful to work but most found that they needed to adapt their work schedule to take time to heal or rest. Donna initially expected to be able to continue working but then used up her available sick time. Her boss told her just to take the time she needed and it would be all figured out. Melissa, who took a few days off for each chemotherapy session now thinks it would have been better if she had given herself more time to heal. Nadia (B) managed to work throughout her radiation treatment and said: "Everybody told me after the second week of radiation, 'you will not be able to go work' but I did it and I am very proud of myself."
But the first reaction was, if I’m dying, I need to do something better with my life and then after a while and a lot of reflection I guess… I think when I took that time off work, when I decided I wasn’t going to work, because there were a few people shocked that I… because some people work through this… “You!
A few women, such as Jeanette and Samantha, said work was a helpful distraction and provided some social support, while Shelley felt that the routine of work, life and home life helped her recover.
Amanda found it helpful to be off work in order to prepare for her surgery, although she was surprised how easily she was able to stop work from one day to the next. Melissa took 5 weeks off after finishing treatment and felt the time was helpful to recuperate and to spend time with her family. Sirkka felt too sick and weak to go to work and took time off. Kathryn, a teacher, hadn't realized how stressful her job was until she took the time off, and felt blessed to be off.
Impact on career
Even though most women eventually returned to the same position, some talked about the negative impact breast cancer had on their working life. Amanda was excited about starting a new job but had to leave that position. Nalie could not return to her job after her sick leave and found it difficult to be 25 years old and unemployed because of her illness after imagining a more stable life and career. Naoual returned for a little while but was unable to continue working.
My (working place) is a very nice place to get sick because people are very understanding and very smart about what they say so it’s lovely. So the impact on work was… I couldn’t keep the teaching up during that time and they were very understanding. I had a 6 month leave available and I took it and I came back after that. I had taken on a larger administrative job 2 weeks before my diagnosis and just because I’m still in treatment and there’s some side-effects, I’m not headed back to that position in January as previously planned, so it has impacted my career for sure. A lot of people with a chronic illness will say that their career got somewhat derailed by that. I don’t think it’s a long-term derailment but it’s certainly a short-term one.
That’s right, but right now, with still in active treatment, it’s inadvisable mostly because, I’m sure people listening to this will understand, cancer is a busy job. You have a lot of appointments. It’s very hard for you to be relied upon in a workplace setting if there’s less flexibility. I need the flexibility now to say “Well no I can’t meet tomorrow because I’m in treatment.” or “I’m having a follow-up exam.” and I don’t want everyone to continuously have to work around me. I kind of pre-empted that by keeping the job with a lot more flexibility so that it’s okay to be at work at the hospital with my set-up and I can still get things done but I don’t need to be in a face-to-face meeting.
It’s a huge issue for women. I think some of the research that shows women don’t come back to the same level of job or they lose their job or feel that they can’t continue with it. I can totally see why. I was really lucky I have a flexible employer and I had access to paid leave and that is a tremendous benefit. I’m lucky to have a job that has all of those things, but I don’t think that’s true for all women. I’m lucky that I have a decent job and my spouse has a decent job and he didn’t lose a lot of time during that. But absolutely, for women, the job loss or keeping their jobs during it I think is very, very difficult and I’m sure it derails careers and it derails earning potential for sure, like other illnesses.
Isla said: "I think employers can be sensitive to that try to keep ways for women to be in the workforce during this (treatment)."
Things such as having long and short-term disability plans, unused sick leave, being retired, available emergency financial aid programs, and good medical coverage limited the financial consequences for some. But, other women described longer periods without pay as they only had limited sick leave or had to wait before sick leave was being paid. Iceni, for example, spent all her savings as she did not want to go on welfare and had to return to work while she was still not well.
Devastating in the… okay how do I context this? As a professional as somebody who wants to earn her own way in the world, this has been so problematic, because the assumptions underlying all of this is that somebody else will look after you, specifically your partner.
The additional costs associated with things like travel and parking for appointments, treatments or medications not fully covered by provincial health programs, or for wigs or specialized bras were substantial. Some women were not able to afford these extra expenses. Iceni, for example, decided to make her own bras and Annie travelled over an hour by bus for every treatment and appointment – she could not afford other means of transport. Iceni felt that people should be offered parking vouchers. Young women in certain provinces had to make additional expenses if they decided they wanted to undergo a treatment to freeze eggs as chemotherapy can affect women's fertility. You can read more about this in Preserving fertility. Jocelyn said "Do you know how much it costs to freeze them? I think just to extract them was about $4,000 ….. No, I wasn't going to do that to me and my partner. People don't like to talk about it, but it's expensive having cancer even with a really nice medical care system like we have here, not everything's covered."
Some women such as Carol, Naoual, and Ginette made use of private clinics for some of their treatment. While they had to pay out-of-pocket, in general they felt that they received faster or better services. Carol balanced the use of private and public services based on how urgent they were: “The biopsy I needed immediately for the diagnosis, the surgery I wanted done right away, but then afterwards you have a CAT* scan, you have an MRI**, you have several other thing but I didn’t need those results right away so I chose do to those at the hospital.”
Getting back to work
Isla, who returned to work, spoke about being lucky to have a supportive environment for a gradual return, but felt that this may not be possible for other jobs, such as teachers or nurses.
My oncologist told me in 2003, “No” I wanted to go back to work, “No you can’t go back to work, too many germs, your immune system’s compromised.” And he didn’t think I was going to be alive very long so he said “No, no work.” So I said “Okay” I listened because …I really realized teaching is a very stressful job, I didn’t realize it until I didn’t do it anymore, how stressful it was.
Returning to work was an eye-opener for Joanne as she realized her body was not back to normal yet. Shelley was thankful that her medical team convinced her to take a bit more time before returning back to work. Quite a few women wanted to get back to work as soon as possible. Jeanette pushed to get back to work and enjoyed it: "To be at work the whole time, it was great. You go into work, you do your job for 8 hours, you don't have time to think about yourself and you just do your work." Kathryn, who is not allowed to go back to work, is giving back by volunteering in her community.
Margaret, Shelley and others also returned to work gradually. Shelley entered a formal return to work program. One woman, still in treatment felt that she wanted more time off and that returning to work would be a lot to manage. Several women commented that balancing an illness with family and work could be overwhelming.
You’re too occupied with your kids and your illness and the appointments. Just taking away the stress of having to juggle everything was really valuable for me during that time period. I’m grateful for paid leave, which we pay into as employees. And which your employer pays into too and which we take when we get sick but that’s what it’s for, it’s an insurance.
This was all very manageable, so for anyone else facing it, it is manageable. I kept teaching until Christmas and at that point, I stopped teaching because it was a little bit harder, plus, I had kids. So as I said to my employer,” I could do kids and cancer or work and cancer but I couldn’t do kids, work and cancer.” I took a leave of absence during the heavy lifting part of chemo but I was able to maintain a fairly normal life. I was cross-country skiing. I don’t say this like a badge of honour because not everyone’s going to feel like doing that. But, for me, carrying on a normal life, trying to get away for weekends, keeping up with cross-country in particular which my husband and I really enjoy, remaining active trying to eat well, was very important to me and was all doable during that time.
*CAT scan (Computerized Axial Tomography Scan): Body scan that produces cross section images of the body's internal structures.)
** MRI (Magnetic Resonance Imaging): Imaging test that creates a 3-dimensional picture of the body's internal structures using magnetic force and radio frequencies.