Key takeaways
- Stage IV cancer might mean taking more time off work and coping with ongoing side-effects
- Making the decision to continue working can be difficult. Talking to your employer as well as an occupational therapist and other advisors can help you decide.
- You do not have to tell your employer or colleagues about your stage IV diagnosis, but there can be benefits to letting them know
- As cancer is legally considered a disability, you have the right to reasonable adjustments to make working safe and comfortable
Stage IV cancer is cancer that can be treated, but not cured. It’s also sometimes referred to as secondary cancer or metastatic cancer. Treatment for stage IV cancer aims to control the cancer and relieve any symptoms. This is balanced with supporting a person to maintain a good quality of life for as long as possible.
Many people with stage IV cancer want to continue working, perhaps for financial reasons, wanting to retain a sense of normality and routine, or simply because they enjoy it. In this guide Perci Health’s Lead Cancer Nurse Specialist Rachel Rawson, will help you understand what your options are and what rights you have when it comes to working with stage IV cancer.
Do I have to keep working if I receive a stage IV cancer diagnosis?
You don’t have to keep working if you receive any kind of cancer diagnosis and whether you choose to do so is a personal choice. There are many reasons why you might want to continue working: you may find your job fulfilling and there may be financial considerations that impact your decision. Alternatively, you might want to leave your role to spend time with family and friends or because you no longer feel physically well enough to continue working.
Before deciding, it’s important to be clear about employment law and your rights. It may be helpful to speak to your employer or an occupational therapist, as there may be reasonable adjustments that can be made to help you continue working if you choose. An occupational therapist can support you to stay in work or return to employment in a way that works for you. For example, your employer may be able to offer you reduced hours or changes to your role so that you can continue to work part-time or from home. An independent financial advisor will also be able to give you information about how different paths will impact your pension, employment benefits and any other financial benefits you receive or are entitled to.
It can be really helpful to work with an occupational therapist to identify your current needs, which sometimes need careful planning especially when you have stage IV disease. My role is to provide a detailed plan on how your employer can support you to return to some form of working pattern that fits with your treatment, side-effects and energy levels.
– Anna Howells, Occupational Therapist, Perci Health
How might working with stage IV be different to working with primary cancer?
With stage IV cancer, you’re likely to have more treatment appointments and scans, which can mean taking more time off work. You might experience more side-effects from the cancer as well as its treatment, and cancer-related fatigue is often more pronounced, which may affect your ability to do your job in the way you used to. Coping with the day to day psychological impact of your diagnosis can also be very challenging and require professional support.
If you are experiencing fatigue, it’s important to move as much as you can. If you are having chemotherapy and you are keen to exercise the key is to be aware of its cycles. Usually, a few days after treatment you’ll need to rest. You can introduce light activity when you start to feel better, and then increase it towards the end of the cycle. Working with a clinical exercise coach can help you to match your level of activity to your symptoms, and to exercise safely. Always be aware of how your body is feeling. If something doesn’t feel right, let your treatment team know.
Nick Michell, Clinical Exercise Coach, Perci Health
Do I have to tell my employer about my stage IV diagnosis?
You don’t have to tell your employer that you have cancer or that it is stage IV. But, if you do continue working, there can be benefits to telling your employer about your cancer diagnosis, such as receiving reasonable adjustments that are required by law for employees with cancer. Letting people at work know about your diagnosis can also extend your support network to include your managers and colleagues.
How might stage IV cancer impact my pay and pension?
If you continue working and still do your normal number of hours, there should be no change to the pay you receive. However, if the adjustments made to your role include changing your schedule to part-time work, then you will receive a pro-rata rate of pay. If you take temporary leave from work for any reason, the pay you receive will depend on your employer’s policies. You may receive full or partial pay, or receive statutory sick pay. Speak to your HR department or check your employment documents for more clarity about the policies your employer has.
If you have previously paid into a pension scheme or still do so, you may be able to withdraw your funds early. This is commonly known as an ill-health policy and your employer’s HR department, or pension provider should be able to tell you more. An independent advisor will be able to help you decide on the best course of action and how your decision might affect any other benefits you receive. The Equality Advisory & Support Service, Macmillan, who are partnered with Citizens Advice, and Working with Cancer, can also offer support and advice around this issue.
What happens if I take sick leave?
If you are employed but too ill to continue working, you may be entitled to take sick leave and receive sick pay. Depending on your role, how long you have been employed by the company, and their policies, you may receive full or partial pay for a period of your sick leave. If your employer does not have their own sick pay scheme, you may still be entitled to Statutory Sick Pay (SSP). Some employers offer income protection or critical illness insurance through their healthcare plan, which can support you if you need to take sick leave. If you’re not sure whether your employer offers this type of cover, ask your HR team.
Can my employer make me redundant if I have stage IV cancer?
Your employer cannot end your employment or make you redundant because of your diagnosis. This would be considered discrimination under the Equality Act 2010. They also cannot push you to resign or retire. However, if they are unable to make necessary adjustments for you to continue working, then they may be able to dismiss you. If you do find yourself in a situation where your role is at risk, your employer should be following due process as outlined by their company policies. If at any point, you feel you aren’t being treated fairly, you can contact an independent agency, such as Citizens Advice or Acas (Advisory, Conciliation and Arbitration Service), or Working with Cancer for advice.
Working with stage IV cancer can be challenging, but professional support can make all the difference to your ability to continue working, safely and comfortably, for as long as you are able to and want to. Our Cancer Nurse Specialists can refer you to the Perci professionals including dietitians, clinical exercise specialists and physiotherapists, clinical psychologists, occupational therapists and other professionals who can help.
While we have ensured that every article is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns, please talk to one of our healthcare professionals or your primary healthcare team.