Handling a Critical Illness in the Office

The recent revelation that Elizabeth Edwards' cancer had returned and that a "hot spot" has been detected on her right hip in addition to the cancer found in one of her ribs has brought renewed public attention to the disease that claims 500,000 American lives a year.

Richard Nixon may have declared "war on cancer" 36 years ago but today, the loss of life due to the insidious disease is equivalent to three fully loaded jumbo jets crashing every day. Since 2005, the disease passed heart disease as the leading cause of death in the United States.

For survivors, it's bad enough being diagnosed with the "big C" -- but how do they cope with earning a living while battling the disease?

The American Society of Clinical Oncology says cancer survivors who return to the workplace can face subtle or obvious discrimination. Some employers, the Society says, may assume that a worker's productivity will decline or that performance will fall below the company's standards.

There is concern, too, about the impact on the cost of health insurance which is underwritten by the employer.

Handling the News

There may be discrimination when it comes to promotions or transfers, the Society says. This may include a demotion, being refused a job opening or having trouble taking time off for medical appointments. These difficulties may also be faced by family members who are helping care for the bread winner.

While employees are protected at work by law, Tenbroeck Smith, a director of research for the American Cancer Society in Atlanta, says there is no legal requirement to tell anyone about your condition.

"If your cancer doesn't affect your ability to do the job, there is no reason to tell," he says. "If it's a prospective employer, there is still no reason to tell as long as you are not in active treatment."

The Americans With Disabilities Act prohibits workplace discrimination based on disabilities, including diseases such as cancer, for employers with more than 15 workers. The Family Medical Leave Act requires employers with 50 or more workers to provide up to 12 weeks of unpaid leave for serious illness.

But the law is one thing. Abiding by it quite another.

According to David Landay, author of the 2000 book, "Be Prepared: The Complete Financial, Legal, and Practical Guide to Living with Cancer, HIV, and other Life-Challenging Conditions," it's a good idea to find out how your employer treats people living with cancer.

"Seek out a mentor, someone who knows the company culture or who has had cancer to help you set a practical strategy," he says. He also advises arranging a personal meeting with your supervisor and state a strong desire to keep working while your treatment progresses.

Legal experts say that what you tell your boss is protected information but what you tell your co-workers is not protected.

If you believe you have been discriminated against, positive solutions can be arrived at by learning as much as possible about the company's attitude, track record and grievance procedures. The idea is to reach either an understanding or settlement and avoid a confrontational situation.

However, if that fails a lawsuit may be necessary. Labor relations attorneys can be expensive so do some homework first.

Learn about the legal process, understand time limits and be realistic about possible settlements or outcomes.

Paying for cancer treatment can be costly and difficult. Insurance may provide coverage but if you lose your job, then what?

"Cancer survivors sometimes face 'job lock' when they are afraid to leave their current employer for fear of not being able to get health insurance or losing the coverage they have," says Smith.

"The good news is that many cancer patients become much better employees after their treatment," he says. "And they also report a high level of support from co-workers and employers."

The American Cancer Society provides the following tips for employees with cancer.

-- Plan treatments for late in the day or right before the weekend to allow time to recuperate.

-- Explore work options, such as occasional telecommuting, to eliminate a tiresome commute and provide a more comfortable work atmosphere.

-- Maximize work time with a simple work schedule. Daily chores and administrative duties may be tasks that can be divided among friends and co-workers.

Bill McGuire contributed to this story.