Navigating Work While Living with Cancer

Cancer and work are two words that rarely seem to belong together, yet for many people they inevitably do. For those undergoing active cancer treatment, the decision to continue working is complex and deeply personal. Work can provide identity, stability, and meaning, but it can also bring new challenges at a time when energy and focus are limited.

In 2021, as part of my MSc in Occupational Psychology at the University of Hertfordshire, I conducted a research project that explored the barriers and facilitators experienced by people who continue to work while receiving cancer treatment. Drawing on a systematic review of existing studies together with an auto-ethnographic comparison, I examined how individuals navigate employment during treatment and what can be learned from their experiences. The findings provide valuable insight for both employees and employers who want to make work more compassionate and adaptable for those living with cancer.

Understanding the Push and Pull of Work

My research identified two main categories that shape how people experience work during treatment: Work Factors and Personal Factors. Each can act as a barrier or a facilitator depending on context, relationships, and mindset.

Work Factors

1. Ability and Expectations

Cancer and its treatment can cause a range of physical and cognitive effects such as fatigue, pain, and what many describe as “chemo brain.” These challenges can undermine confidence and affect how capable a person feels. Several studies in my review showed that individuals often worry about being seen as less productive or about not meeting their usual standards.

One participant expressed this clearly: “The difference between appearance and how you actually feel is complicated and makes people make judgements about whether you are well.”

When others assume that looking well means feeling well, or when expectations are reduced too far, people can feel misunderstood and undervalued.

Facilitator: Supportive managers who set realistic expectations and show confidence in an employee’s ability can help rebuild a sense of competence and trust.

2. Adaptations and Flexibility

Flexibility emerged as one of the strongest facilitators. People valued employers who offered modified hours, remote working options, or temporary adjustments to duties.

As one participant shared, “My work was absolutely fantastic. They completely redesigned my job so I had no client contact. I could do everything by phone.”

In contrast, rigid policies and inflexible roles often created unnecessary stress and limited a person’s ability to manage treatment effectively.

Facilitator: When organisations approach flexibility with empathy and creativity, they allow employees to continue contributing in meaningful ways.

3. Relationships and Support

Relationships with colleagues and managers are central to the experience of working during treatment. Supportive and respectful relationships often sustain motivation, while negative or overprotective attitudes can make people feel incapable.

One participant said, “Work has been very supportive. They genuinely care about me.”Another noted, “The employer did not let me do this, did not let me do that. I felt like such a stupid idiot because I could do nothing.”

Both examples highlight that support must balance care with autonomy. Compassionate inclusion is far more empowering than cautious exclusion.

Facilitator: Building a workplace culture that promotes genuine care, respect, and inclusion helps create belonging and security.

4. Communication and Disclosure

Communication is the thread that connects every other factor. Many people described uncertainty about when or how to discuss their illness at work.

One participant recalled, “I asked the consultant, ‘Should I be going back to work now or stay off?’ and they said, ‘It’s entirely up to you.’”

Without clear advice, employees are left to navigate disclosure and workplace expectations on their own.

Facilitator: Open, ongoing conversations between managers and employees reduce misunderstanding and build trust. When communication is based on empathy and confidentiality, people feel safer to express their needs.

Personal Factors

1. Physical Symptoms and Energy Management

Physical symptoms were among the most significant barriers. Fatigue, nausea, pain, and mobility issues all affected work performance and concentration. Visible changes such as hair loss or scarring also influenced self-esteem.

One participant stated, “I was weak at work, especially in the afternoon. It was hard to complete meeting memos, and my arm ached after typing for a long time.”

Facilitator: Flexible scheduling, regular breaks, and understanding from colleagues can lessen these challenges and allow people to work with dignity.

2. Motivation and Engagement

Motivation and engagement often shift after a cancer diagnosis. Some people re-evaluate their priorities and see work as less central, while others find renewed meaning in their professional roles.

One participant explained, “To be at work was really important for me as a driver for becoming well. It is a place where I am not a patient.”

Facilitator: When work is purposeful and connected to personal values, it supports recovery and resilience. Employers who focus on meaning rather than output help maintain morale.

3. Stress and Emotional Distress

Cancer brings uncertainty and emotional strain. Combined with workplace stress, it can become overwhelming. Participants described anxiety about performance, deadlines, and how colleagues might perceive them.

One individual commented, “It would worry me that I’d be letting the company down and not meeting deadlines.”

Facilitator: Organisations that acknowledge this emotional burden can create healthier environments through counselling access, wellbeing check-ins, and fair workloads.

4. Coping and Adjustment

Many participants used work itself as a coping mechanism. It provided structure, distraction, and a sense of control. Yet coping strategies can falter when fatigue or self-consciousness take hold.

One participant reflected, “When I started to lose my hair, I felt like I lost some of my identity. I kept my video off during meetings and felt invisible.”

Facilitator: Supporting confidence, encouraging self-compassion, and normalising conversations about appearance or energy levels can strengthen positive coping.

Taken together, these findings show that the experience of working with cancer is shaped by a complex interaction between the individual and their environment. The barriers that emerge are rarely caused by the illness alone but by the structures, expectations, and relationships that surround it. When workplaces prioritise understanding, flexibility, and communication, they create conditions in which people can continue to contribute meaningfully, even while managing treatment. Equally, when individuals feel supported, their sense of self-efficacy, motivation, and resilience grows, enabling work to become a stabilising and restorative part of life. This balance between organisational compassion and personal agency lies at the heart of sustainable, humane employment for people living with cancer.

Psychological Capital: The Inner Toolkit

A key finding in my research was the central role of Psychological Capital, often shortened to PsyCap. This concept describes a group of internal strengths that enable people to adapt, recover, and remain hopeful when facing significant challenges. In the context of cancer and work, PsyCap functions as a psychological buffer that helps individuals sustain a sense of purpose, manage uncertainty, and continue to see themselves as capable contributors. PsyCap is composed of four interrelated elements: hope, resilience, self-efficacy, and optimism. Together, they represent the mental and emotional resources that allow people not only to survive adversity but to grow through it.

• Hope is more than a feeling of wishing for the best. It involves setting clear goals and identifying realistic pathways to achieve them. For someone balancing treatment with employment, hope might mean believing that meaningful work is still possible, even if it looks different from before. It provides direction and a sense of agency when circumstances feel uncertain.

• Resilience enables recovery from setbacks and adaptation to change. It allows people to adjust to fluctuating energy levels or shifting work responsibilities without losing sight of what matters to them. Resilience does not eliminate distress but supports the capacity to keep moving forward despite it.

• Self-efficacy builds confidence in one’s ability to manage difficulties and to influence outcomes. Employees with strong self-efficacy are more likely to communicate their needs, ask for adaptations, and engage in problem-solving rather than avoidance. This belief in personal competence can transform how individuals navigate both illness and work.

• Optimism sustains a constructive and future-oriented mindset. It encourages people to interpret challenges as temporary and manageable rather than permanent and defining. Optimism does not deny the seriousness of illness but helps individuals focus on what remains possible and meaningful.

When these four elements interact, they create a dynamic toolkit that supports both coping and performance. Individuals with high PsyCap are better equipped to reframe setbacks as opportunities to learn, adjust, or find alternative solutions. For example, a person experiencing fatigue may recognise this not as personal failure but as a prompt to negotiate flexible hours, reprioritise tasks, or seek practical support. This shift in thinking preserves self-worth and reduces the emotional toll of work-related challenges.

PsyCap also connects closely with workplace wellbeing. Employees who demonstrate hope, resilience, self-efficacy, and optimism tend to experience higher engagement, stronger relationships, and greater satisfaction at work. For employers, nurturing these qualities within teams can create a culture of confidence, adaptability, and mutual respect.

Importantly, Psychological Capital is not a fixed trait but a developable resource. It can be cultivated through reflection, deliberate practice, and supportive interventions. Techniques such as mindfulness, journaling, positive goal-setting, and cognitive reframing all help individuals strengthen their internal resources. Coaching and peer mentoring can further reinforce PsyCap by encouraging self-awareness and adaptive coping.

From an organisational perspective, initiatives that promote resilience and wellbeing training, leadership development, and positive communication can enhance PsyCap collectively across the workforce. This benefits everyone, not just those managing illness. When leaders model optimism, realistic hope, and respect for individual capability, they contribute to a more compassionate and psychologically healthy workplace.

In essence, Psychological Capital represents the bridge between personal strength and organisational support. It is what allows people living with cancer to find stability and meaning in their work, and it reminds employers that empowerment often begins from within. Strengthening PsyCap therefore becomes a shared responsibility and a foundation for resilience, recovery, and dignity at work.

The Role of Communication and Trust

Communication and trust form the foundation of every meaningful workplace relationship, yet they are often tested most when the subject matter is personal, emotional, or uncomfortable. In the context of cancer and work, conversations about health, capacity, and adjustment are rarely easy. They can stir fear, awkwardness, and uncertainty for both the employee and the manager. However, it is precisely in these moments of difficulty that communication matters most. The ability to have open, honest, and curious conversations can transform a potentially isolating experience into one of connection, understanding, and mutual respect.

Honest dialogue allows people to articulate what they need without fear of judgement. It creates space for clarity and shared understanding rather than assumptions. For employees living with cancer, being able to discuss treatment schedules, energy fluctuations, or emotional wellbeing can remove much of the hidden stress that comes from trying to “manage” illness in silence. For managers, it provides the opportunity to respond with empathy and to design realistic adjustments that genuinely meet the employee’s needs.

Equally important is curiosity, the willingness to listen without rushing to conclusions. A curious conversation is not about having the perfect answer, but about being present and asking thoughtful questions that invite openness:

What would help most right now?

How can we make this easier?

What are you finding most difficult?

This kind of inquiry signals respect and care. It acknowledges that the person with cancer is the expert in their own experience and that their voice is essential in shaping any solution.

Difficult or sensitive discussions also require emotional awareness. A manager who can hold space for emotion, rather than trying to fix or avoid it, communicates genuine empathy. Sometimes listening attentively and allowing a person to express their feelings is more supportive than any formal accommodation. It shows that their experience is recognised and that they are valued beyond their productivity.

Creating a culture of openness does not happen by chance. It develops through consistent behaviour, trust, and leadership that model authenticity. Organisations that normalise honest conversations about health and wellbeing send a powerful message that people do not need to hide their vulnerabilities to be accepted. This transparency fosters psychological safety, encouraging employees to share concerns early, seek help when needed, and collaborate on realistic solutions.

When communication falters, silence often fills the gap, breeding misunderstanding and mistrust. Employees may withdraw, overcompensate, or fear being seen as weak. Conversely, when communication flows freely, relationships strengthen, and both individuals and organisations benefit. People feel heard and respected, managers gain deeper insight into the lived realities of their teams, and practical accommodations become easier to implement.

Ultimately, open and curious communication is not just a matter of courtesy; it is a cornerstone of wellbeing and inclusion at work. It reflects a recognition that human experiences, even difficult ones, belong in the professional sphere and that compassion and productivity can coexist. A workplace that invites conversation, listens actively, and responds with empathy creates the conditions for trust to flourish. In doing so, it turns difficult dialogues into opportunities for understanding, growth, and shared humanity.

Recommendations

The findings from my research highlight that the experience of working with cancer is influenced as much by the quality of relationships and organisational culture as by the physical realities of illness. Creating environments that allow people to thrive through treatment requires attention to empathy, flexibility, and dialogue at every level of the workplace. Below are recommendations for both organisations and individuals, drawn from the evidence and reinforced by practical insight.

For Organisations

1. Promote open and emotionally intelligent communication. Train managers and leaders to approach sensitive conversations with empathy, curiosity, and respect. Talking about health, capacity, or personal limits can feel uncomfortable for everyone involved, but avoiding these conversations often causes greater harm. Leaders should feel equipped to ask thoughtful, open-ended questions that invite honesty, such as “What kind of support would be most helpful right now?” or “How can we adapt things to make this easier for you?” Encouraging transparency reduces anxiety, builds trust, and shows that the organisation values the person, not just their output.

2. Encourage flexibility as a standard, not an exception. Flexibility is one of the most powerful facilitators identified in my research. This includes flexible hours, remote working, adjusted workloads, and phased returns after treatment. However, flexibility should not be seen as a special favour but as a core part of inclusive practice. When flexibility is built into organisational culture, employees feel confident asking for what they need without fear of stigma or career damage. This not only benefits those living with cancer but also supports parents, carers, and anyone managing personal challenges.

3. Develop and nurture Psychological Capital. Organisations can play an active role in building employee resilience, optimism, and self-efficacy through structured wellbeing initiatives. Workshops, reflective coaching, and team development programmes that focus on hope, problem-solving, and self-belief can strengthen Psychological Capital across the workforce. These skills help employees manage uncertainty, cope with stress, and maintain motivation even in demanding circumstances. A workplace that invests in mental and emotional resources creates a stronger foundation for collective wellbeing.

4. Provide structured support networks. Facilitate peer groups or mentorship programmes for employees living with long-term conditions such as cancer. Peer connections provide understanding that cannot always come from managers alone. Knowing that others have navigated similar challenges fosters belonging and reduces isolation. Support networks can also guide colleagues and leaders in developing empathy and awareness of the lived experience of illness at work.

5. Adopt an individualised, person-centred approach. Every cancer experience is unique, and so are the circumstances surrounding work. Avoid one-size-fits-all solutions and take time to understand the specific needs of each person. This may mean tailoring adjustments, offering phased returns, or reviewing responsibilities regularly. A person-centred approach recognises that needs may change over time, and flexibility should evolve with them. Small, thoughtful actions often have a profound impact on wellbeing and engagement.

6. Build leadership confidence in addressing sensitive topics. Many managers want to help but fear saying the wrong thing. Providing practical guidance, case studies, and training in emotional intelligence can give leaders the confidence to have authentic conversations about illness, mental health, and capability. When leaders demonstrate openness and vulnerability themselves, they normalise it for others and strengthen organisational trust.

7. Create a culture of compassion and curiosity. Compassionate workplaces view health conversations not as problems to fix but as opportunities for connection and understanding. Curiosity encourages listening rather than assuming. This culture enables both employees and managers to engage in dialogue where solutions are co-created and trust is sustained, even when circumstances are difficult.

For Individuals

1. Communicate openly and assertively. Being honest about your needs can feel daunting, especially when you fear being seen as less capable. However, clear communication builds trust and allows others to support you effectively. Preparing for conversations with your manager by identifying your main priorities, limitations, and suggestions for adaptation can help you feel more confident and in control. Remember that disclosure is a personal choice, but selective openness can reduce pressure and create space for understanding.

   
   
   
   

2. Strengthen inner psychological resources. Cultivating hope, resilience, self-efficacy, and optimism helps sustain balance during uncertainty. Practices such as mindfulness, reflection, and goal-setting strengthen these qualities over time. Writing down small daily achievements or moments of gratitude can also help reframe challenges and maintain perspective. Psychological Capital grows with use, and even modest steps can enhance emotional stability and motivation.

   
   

3. Seek connection and build support networks. Isolation can amplify stress and fatigue. Connecting with colleagues, peers, or cancer support communities can provide both practical advice and emotional reassurance. It reminds you that you are not alone and that others have faced similar challenges. These relationships can also serve as advocates within your workplace, helping to educate others and normalise supportive practices.

   
   

4. Practice self-compassion and flexibility.Work capacity may fluctuate from day to day. It is important to be gentle with yourself and to adjust expectations accordingly. Recognising when to rest, when to ask for help, and when to celebrate small successes is a vital part of sustainable recovery. Self-compassion supports resilience and prevents burnout by acknowledging that effort and courage are achievements in themselves.

   
   

5. Hold on to purpose and meaning. Work can provide a sense of identity and continuity, but only when it aligns with personal values. Focus on the aspects of your role that feel meaningful or fulfilling. Purpose is a key driver of Psychological Capital, and nurturing it can turn work from an obligation into a source of strength and hope during difficult times.

   
   

6. Prepare for change and uncertainty. Living with cancer often means living with unpredictability. Accepting that energy, focus, or priorities may shift helps to reduce frustration when plans do not go as expected. Flexibility in mindset allows you to adapt more easily and to find creative ways to continue contributing. Having honest conversations with your manager about these fluctuations ensures that adjustments remain appropriate and realistic.

Bringing It Together

Both individuals and organisations share responsibility for shaping an environment where people living with cancer can continue to work with dignity and purpose. For organisations, this means embedding compassion, curiosity, and flexibility into everyday practice rather than treating them as exceptions. For individuals, it involves recognising one’s own strengths, communicating needs openly, and seeking connection rather than isolation.

At its core, this is about humanity at work. When people are encouraged to talk honestly, listen with curiosity, and collaborate on solutions, the workplace becomes more than a site of employment; it becomes a community of understanding. Through shared empathy and openness, employers and employees can transform work into a space where strength, vulnerability, and growth can coexist.

Looking Ahead

Although my 2021 study shed light on the barriers and facilitators to working with cancer, it also opened up important questions that deserve further exploration. Future research should investigate how Psychological Capital-based interventions can be practically implemented in workplace settings to improve wellbeing, retention, and job satisfaction among employees managing cancer and other chronic health conditions. It is also crucial to understand how leadership style, organisational culture, and systemic support influence these outcomes. Research that bridges occupational psychology, leadership practice, and lived experience will help create environments that not only accommodate but also empower individuals to thrive during and after treatment.

There is also a need to explore how communication training, compassion-focused leadership, and peer networks can be embedded in everyday practice rather than treated as optional initiatives. The future of inclusive work lies in developing cultures that anticipate difference and vulnerability rather than simply responding to it.

Humanising Work

The intersection of cancer and work is complex, but it also reveals the depth of human adaptability, courage, and resilience. It challenges traditional notions of productivity and capability and reminds us that people are more than their roles or diagnoses. With empathy, flexibility, and curiosity, workplaces can evolve into environments that nurture both wellbeing and performance.

Work can be far more than a place of employment. It can be a source of identity, belonging, and continuity during some of life’s most uncertain times. Supporting employees through illness is not simply a compassionate act; it is a mark of ethical and progressive leadership. When organisations demonstrate understanding and openness, they contribute to recovery, empowerment, and purpose.

Ultimately, humanising work means recognising that people’s lives cannot be separated from their labour. By listening, adapting, and engaging in honest and courageous conversations, organisations help individuals remain connected to life, meaning, and community. When this happens, work becomes more than a duty or an expectation; it becomes a shared expression of resilience, dignity, and hope.

When we centre empathy and understanding, we move closer to workplaces that do not just employ people, but truly empower them. In that space, work becomes not only sustainable but profoundly human.