What Your Employees with Cancer Want You to Know (But May Find Hard to Say)

When an employee is diagnosed with cancer, most organisations genuinely want to do the right thing.

Managers want to be supportive. Colleagues want to help. There is often care, concern, and a real intention to respond well.

And yet, despite this, many employees still find working during cancer more difficult than it needs to be.

From an occupational psychology perspective, this is not surprising.

Working with cancer is not just a health issue that sits alongside work. It changes how a person experiences their role, their capacity, their identity, and their place within a team. It also changes the kinds of conversations that need to happen, and how easy or difficult those conversations feel.

This is not just something I have seen in research. It is something I have experienced personally, navigating cancer alongside work and study over several years. What becomes clear, very quickly, is that the challenge is rarely just the illness itself. It is everything that sits around it.

The difference between work feeling manageable or overwhelming is rarely about one single factor. It is about how multiple elements come together. These include the job itself, the support available, the person’s internal resources, and the quality of communication around them.

It is not just about health. It is about what work represents

In occupational psychology, work is not simply a set of tasks. It plays an important psychological role in people’s lives.

Work provides structure at a time when life may feel uncertain. It offers a sense of purpose when other priorities are disrupted. It allows people to maintain a sense of identity that exists outside of being a patient. Research on work and identity highlights how closely our roles are tied to how we see ourselves, and how disruption to those roles can affect confidence and wellbeing (Ashforth & Mael, 1989).

This helps explain why many people want to continue working during cancer treatment, even when it is difficult.

From experience, there is also something about the normality of work that becomes even more important. Being able to contribute, to think about something other than treatment, and to feel like yourself can be incredibly grounding.

At the same time, cancer introduces new physical and psychological demands. Fatigue, treatment side effects, cognitive changes, and emotional strain can all affect how someone experiences their ability to work.

This creates a tension. Work can be both a source of support and a source of pressure, sometimes at the same time.

Understanding the balance between demands and resources

The Job Demands–Resources model provides a useful way of understanding this tension (Demerouti et al., 2001; Bakker & Demerouti, 2007).

At its core, the model suggests that people are more likely to stay engaged and well at work when there is a balance between the demands placed on them and the resources available to them.

Demands include workload, pressure, and emotional strain. Resources include support, flexibility, autonomy, and understanding.

When demands outweigh resources, strain increases. When resources are sufficient and responsive, people are better able to cope and remain engaged.

For employees working with cancer, the overall level of demand they are experiencing increases. This is not limited to work. It extends across their entire life. Treatment schedules, physical symptoms, and uncertainty all contribute to this.

If the workplace does not adjust accordingly, even a role that was previously manageable can start to feel overwhelming.

What becomes particularly clear, both in research and in lived experience, is how quickly this balance can shift. A role that feels manageable one week can feel significantly harder the next, depending on treatment cycles, side effects, or emotional strain.

It is also important to recognise that many workplace factors are not fixed as either helpful or harmful. They shift depending on how they are experienced.

Flexible working can act as a strong resource when it is tailored and responsive. It can reduce pressure and allow someone to continue contributing in a way that feels manageable.

However, when flexibility is limited, inconsistent, or not aligned with what the person actually needs, it can become an additional demand.

This aligns with JD-R theory, which highlights that the same feature of work can function differently depending on context and perception (Bakker & Demerouti, 2007).

The role of relationships in shaping experience

Relationships at work play a particularly important role in shaping how demands and resources are experienced.

Supportive relationships can act as a buffer against stress. They can reduce uncertainty, provide reassurance, and make it easier for employees to communicate openly about what they need. Social support is consistently identified as a key job resource linked to wellbeing and engagement (Bakker & Demerouti, 2007).

When employees feel that their manager understands them, or is willing to listen and adapt, it can change how work feels on a day-to-day basis.

From experience, even small moments in conversations can have a significant impact. A response that shows understanding can make it easier to be open next time. A response that feels dismissive, even unintentionally, can make someone more cautious.

When relationships feel uncertain or strained, emotional demands increase. Employees may begin to question how they are being perceived or worry about being seen as less capable.

Even well-intentioned responses can sometimes create challenges. For example, removing responsibilities without discussion can affect a person’s sense of competence and identity, which links closely to self-efficacy theory (Bandura, 1997).

This highlights an important point. It is not just the presence of support that matters. It is how that support is experienced.

What is happening internally. Psychological resources and self-perception

Alongside what is happening in the workplace, there is also a complex internal experience that is often less visible.

This is where the concept of Psychological Capital becomes particularly relevant.

Psychological Capital refers to the psychological resources people draw on when facing challenges. These include hope, self-efficacy, resilience, and optimism (Luthans et al., 2007). These resources influence how people interpret situations, how they respond to setbacks, and how confident they feel in their ability to cope.

For employees working with cancer, these resources fluctuate.

There are days where confidence feels strong, and days where it is much harder to access. There are moments of optimism, and moments where uncertainty feels overwhelming.

Self-efficacy plays a key role here. If someone begins to doubt their ability, whether due to fatigue, cognitive changes, or feedback from others, this can influence their willingness to engage, contribute, or ask for support.

From experience, this is not always obvious to others. Someone may still be meeting expectations on the surface, while internally questioning whether they can sustain it.

At the same time, the workplace can either support or undermine these psychological resources.

Positive feedback, realistic expectations, and supportive conversations can strengthen confidence and resilience. Unclear expectations or poor communication can reduce them.

This reflects research showing that PsyCap is not fixed, but can be developed and influenced by context (Luthans et al., 2007).

The conversations that are happening, and the ones that are not

Perhaps the most significant factor running through all of this is communication.

From an occupational psychology perspective, conversations are not just about sharing information. They are how people make sense of what is happening, how expectations are negotiated, and how relationships are maintained.

In the context of working with cancer, conversations can be particularly difficult.

Employees may not know what to say or how much to share. They may be trying to protect their privacy while also needing support. They may not have clear answers about what they need.

Managers may feel unsure about what to ask. There is often a concern about saying the wrong thing or overstepping.

This uncertainty on both sides can lead to conversations being avoided, delayed, or kept at a surface level.

From experience, these are often the moments that matter most. Not the formal meetings, but the small, everyday conversations where understanding is either built or missed.

When conversations do not happen, or do not go deep enough, assumptions begin to fill the gaps.

From a demands and resources perspective, this lack of clarity becomes an additional demand. It increases mental effort, emotional strain, and uncertainty.

When communication is open and ongoing, it becomes a resource. It reduces ambiguity, supports better decisions, and strengthens relationships.

What your employees need from you

Employees navigating cancer are not expecting perfect responses.

What they are often looking for is something more human and more flexible.

They need space for conversations that can evolve over time. Their needs may change, and support needs to change with them.

They need to be asked what would help, rather than having assumptions made on their behalf.

They need recognition that what they are managing may not always be visible, but is still very real.

They need flexibility that feels genuine and responsive.

Most importantly, they need to feel that they can be honest without it negatively affecting how they are seen or treated.

When these conditions are in place, work is more likely to remain something that supports them, rather than something they have to struggle through.

A final thought

From an occupational psychology perspective, working with cancer highlights something important about work more broadly.

The experience of work is shaped by the balance between demands and resources, by how people see themselves, and by how they are responded to by others.

In this context, the difference between work feeling manageable or overwhelming is often not the illness itself.

It is whether the environment, the relationships, and the conversations around that person are helping them cope, or making it harder.

And more often than not, that difference starts with how we communicate.

If this is something you are navigating, or supporting others through

This is exactly the focus of my work at Elevation Occ Psy.

I’ve recently developed a dedicated strand on Working with Cancer at Work, bringing together occupational psychology, research, and lived experience to support individuals, managers, and organisations to navigate these challenges more effectively.

You can explore this here: www.elevationoccpsy.com/workingwithcancer

Or feel free to get in touch if you would like to talk things through.