Janine Hayward: Assisting employees impacted by cancer

Cancer sucks. Cancer treatment sucks. I should know, I live with multiple myeloma, an incurable blood and bone cancer, and both of my parents have undergone, or continue to undergo, treatment for cancer.

As a chartered clinical psychologist (and director of ComposurePsychology), I know first-hand that cancer is insidious. It could be argued that it is scarier than COVID, because we have come to accept it as a relatively normal part of our lives. Most people will be impacted by cancer in their lifetime. Every person in my global team of 15 clinical psychologists at Composure Psychology has been impacted, either directly or indirectly, by cancer, over and above their relationship with me. Cancer gets about, it definitely impacts our working, as well as our personal, lives, although you may be surprised to hear that this impact is not always negative (more about this later).

Each person and the impact cancer has on their life, their interactions with family, friends and colleagues, their sense of self and their relationship with cancer, is unique, despite many similarities.  One person’s experience of chemotherapy can be very different from another’s.  I have worked with some people undergoing cancer treatment who found radiotherapy a breeze, in comparison to being inside the enclosed space of an MRI machine, which scared the living daylights out of them.

It can be incredibly hard to understand how to help, what to say and what not to say.  I once wrote a blog, ‘Killing Me With Kindness’, to address this very issue.  Another challenge with cancer is that people can look healthy, as if they don’t actually have it, that their life hasn’t been turned upside down or that they are coping extraordinarily well. They may be, in particular that hour, or on that particular day. What we don’t see is the next day, when they may be slumped on the couch, exhausted, nauseous and wondering where the version of themself that they know (that they quite liked, or at least didn’t mind so much really) has disappeared to.

The impacts of cancer are numerous. It robs people of time. All of sudden, time is taken up with travel to and from hospitals and appointments, undergoing tests, treatment, clinic reviews, and treatment recovery. Imagine how you would fit all this in if you are already the main caregiver for your family, young children or an elder with health needs; this is hard enough even when you have no dependents. Cancer can rob people of their sense of self, of control, of independence and regulation, as the trauma and treatment play havoc with hormones and emotions.

Financially cancer is a nightmare.  There are so many hidden expenses.  New and additional travel costs, increased childcare and other care costs (while at hospital or recovering), holistic health costs (for some, ridding themselves of toxins by switching to organic food or eco-cleaning products is important). Supplements to kill and prevent cancer are expensive with some of the recommended complimentary protocols adding costs in excess of an additional £200 per month.  In some countries, cancer treatment runs into the tens and even hundreds of thousands of dollars.  Gaining advice from specialist cancer clinics, nutritionists and other health practitioners all costs additional money, which I guarantee wouldn’t be in anyone’s original budget.  These are all before the seemingly extreme costs; gaining access to drugs unavailable through the public health system in the country in which you live, or putting money aside to travel to somewhere like Dignitas to manage one’s own death. Each person living or dying with cancer WILL be impacted financially, and will also have to prioritise some costs over others.

Cancer can rob people of a worry-free life.  Ordinarily, none of us are free from worry about something, however even when a person has recovered and achieved a wonderful milestone such as a five-year remission, many employees will continue to worry about if and when cancer will return. Employees impacted by cancer can have their base level of anxiety rise and become more vulnerable to feeling easily overwhelmed or panicked.

What can employers do to make a positive difference?

Employers have a huge role to play in easing the burden of the impact of cancer on their employees. What’s more, taking on this role makes good business sense!

Employers, you can help employees retain their dignity, and lessen the stress and burden involved during an extremely challenging time. Treating your personnel the way you may hope you or a loved one would be treated by their employer, seems especially important given that most of us will be in this very position at some stage, either as the person undergoing treatment, or supporting someone who is.

Key tips for employers to best support your staff:

Recognise difference and create partnership

Each person impacted by, or supporting someone with, cancer has different needs, and each individual’s needs will change a lot over time, often even within each day or week. Asking how you can help, checking in regularly to see if needs have changed and if different help is needed, is vital for ensuring you and your employee create a partnership which enables them to live well with cancer.  While maintaining income may be important to one employee, another may prefer to gain financial support with unforeseen costs, or access already existing well-being support services. Another employee may feel help in the form of regular massage or new working hours may be more beneficial right now.

Facilitate flexibility to maintain productivity

Your flexibility to support an employee to undertake the most important work tasks at the times of the day or the times of the week in which they feel at their best will help your business achieve necessary goals, while also facilitating the employees continued sense of value, contribution and self-esteem.

Model non-judgement and compassion, and build staff resilience

Remember that each employee is likely to hold a diverse set of beliefs, will have had varied past experiences and created different rules to live by in relation to health, help and threatening health events.  If you are aware of this, you will be less likely to assume incorrectly what an employee is thinking, needing or hoping for.  Active listening, validating what an employee says, showing compassion and being non-judgemental about an employee’s cancer choices, mixed emotions and reactions will all help the employee and your teams build resilience.

Investment in developing all staff resilience skills, and particularly your People/HR teams, will help modelling of skills which include:

• pausing and noticing one’s own thoughts,
• catching automatic unhelpful reactions – instead,
• behaving in line with company values
• avoiding reacting to an employee impacted by cancer out of needing to make oneself feel better, less uncomfortable – instead,
• allowing for space to hold the employee’s needs in mind.

Building resilience skills will not only support the employee to feel heard, understood and less of a ‘cancer patient’ and more of a work colleague, it will also help your whole company to support employee wellbeing.

Cancer is not always a bad thing and employers can benefit

Like me, some employees may even see cancer as more of a gift than a hindrance.  A gift which, in my case, has evoked increased and focussed proactivity, productivity, creativity and candour with kindness. Cancer is not solely a negative burden, it can allow your employees to see what is most important to them, including aspects of work and work life that they wish to maintain, change or approach differently. A cancer ‘gift’ can enable employees to take a wider perspective, stop sweating the small stuff, and let go of tendencies to unhelpful perfectionism or being too hard on themselves, which are linked to unhelpful procrastination, decreased motivation at work and tension with colleagues.  Whilst employers may need to invest more time with an employee impacted by cancer, they can experience an employee gaining a renewed appreciation of their role, increased productivity while at work and a new sense of focus. 

Provide access to bespoke Psychology and Wellbeing services

Employers using a tailored bespoke psychology service as an extension of their own people or HR team can rest assured that employees are in safe, confidential, professional hands.

Clinical psychologists will help employees manage and overcome stress associated with all elements of cancer, to identify the role work with your company plays in their life, how work can help and what it may need to look like to be practical and achievable during cancer management.  Working with clinical psychologists also helps employees understand and process their relationship to cancer, to treatment, to needing, accepting or being offered help, and to make difficult decisions relating to all aspects of cancer and its implications.  Possibly, most importantly, clinical psychologists will help your employees to find their voice, so that they may calmly and candidly discuss their needs with you while often feeling at their most vulnerable and scared.  This enables you to better understand how you and the business can support those needs whilst retaining this valuable resource.  Specialist health psychologists working with people impacted by cancer and chronic Illness are also able to signpost employees to financial, social and complementary cancer support.

In summary

• Supporting employees impacted directly, or indirectly, by cancer makes good business sense.
• Employers can lessen an employee’s cancer burden by modelling resilience and treating each employee as a colleague with diverse and changing needs. In turn, employees will likely continue to have and improve meaningful, productive relationships with their work and colleagues.
• Providing partnership and income stability, flexibility in working hours and expected intensity, access to additional financial or complementary support so that a person can continue to work, retain their sense of self and feel part of something other than their cancer, is likely to leave an employee feeling their emotional wellbeing is cared for and that they are living well with cancer, with the help of their employer.
• Cancer is not always all bad. Some employees may consider cancer as a gift as well as a challenge, and be able to offer a renewed motivation and focus, and appreciation of work.
• Provision of effective, bespoke psychology and wellbeing services delivered through highly qualified and experienced clinical psychologists who apply evidence-based therapy is essential for helping employees manage and overcome the impacts of cancer and learn how to live and work well, while managing cancer and long term implications.

Helpful Links

1. PsychingOutCancer Stories and Psychology Tips from a Clinical Psychologist with multiple myeloma. (Blood and Bone Cancer).  Spanning 2016 to present day: https://www.psychingoutcancer.com/
2. Specific blog entries regarding what to say and what not say, to do and not to do when supporting someone impacted by cancer:

• Killing me with kindness https://www.psychingoutcancer.com/killing-me-with-kindness (which also includes a video on things not to say to someone with cancer)
• Generosity – the good and bad sides https://www.psychingoutcancer.com/generosity-and-its-foibles