Returning to work after cancer

The professional reality of working with breast cancer and why rights and adjustments matter.

When I was diagnosed with breast cancer in 2021, I had no idea how profoundly it would reshape my life, not just physically, but emotionally and professionally. What surprised me most was how little is said about what comes after initial treatment, especially in the workplace.

For me, the return to work was one of the hardest parts of the journey. Nobody sat down with me to explain my rights, how long-term sick leave policies and income protection worked, or what adjustments I was entitled to. I pushed through because I didn’t know any better. And I know I am not alone.

This article is for anyone navigating this hidden side of cancer: to validate the reality of working through or after treatment, and to highlight the rights, support, and choices that are too often invisible.

Why work matters beyond a paycheck

For many, returning to work after cancer is not only about financial stability. Work can offer structure, a sense of normality, social connection, and purpose at a time when everything else feels uncertain. But the reality is that work after cancer is rarely 'back to normal.' It is often about learning to live and work with an ongoing, chronic condition.

Long-term treatment and invisible side effects

What most people, including HR, line managers and colleagues, don’t realise is that breast cancer rarely ends with surgery, chemotherapy, or radiotherapy. Around 80% of breast cancers are hormone receptor–positive, which means long-term endocrine therapy is prescribed, often for 5 to 10 years.

These medications can trigger medical menopause regardless of age, with symptoms that are invisible to others but deeply disruptive to everyday life:

• Hot flushes and night sweats

• Joint pain and stiffness that make long office days exhausting

• Brain fog, memory lapses, and concentration problems

• Insomnia and chronic fatigue

• Emotional fluctuations, sensitivity, or low mood

• Reduced ability to handle stress

For many, managing these side effects is one of the hardest parts of the cancer journey, and it directly affects work and everything we do.

The stress of getting back to normal

Returning to work after cancer can give us identity, routine, and a sense of normality. Work can be grounding, but it can also bring stress, which is one of the biggest risks for recurrence. The pressure to perform ‘as before’ often clashes with the reality of ongoing physical and emotional challenges, even as colleagues assume life has returned to normal.

Common challenges include:

• Anxiety about performance and memory lapses

• Fear of recurrence, especially in the first 2–3 years

• Stress around annual scans ('scanxiety'), which can weigh heavily for weeks

• Metastasis scares — sudden new symptoms that trigger the fear of cancer returning

• Exhaustion from managing energy, appointments, and recovery time

• Uncertainty in workplace relationships

• Shifts in career goals and priorities, with many prioritising work-life balance over the fast track

The journey is rarely linear. Some days feel almost normal, others are consumed by the emotional weight of waiting for scan results or managing side effects. For years, I tried to push through, rushing back to work after scans, quietly dealing with metastasis scares, and pretending I was unchanged.

Only when I formalised my condition with HR did things shift. Suddenly, I could take time off for scans or medical appointments without guilt, because it was understood that this was part of living with a chronic health condition. Having that acknowledgement made the ups and downs far easier to manage.

Legal protections and your rights

In the UK, cancer is recognised as a disability from the moment of diagnosis under the Equality Act 2010 (or the Disability Discrimination Act 1995 in Northern Ireland). This gives employees the right to reasonable adjustments, regardless of whether they are in active treatment or long-term disease management.

Treatment-induced menopause can also fall under disability law if the symptoms have a substantial, lasting impact. And since April 2024, employees in the UK also have the right to request flexible working from day one.

Knowing your rights is essential because not every manager will automatically understand them. Protecting your health at work is not about asking for special treatment; it is about accessing legal protections designed to safeguard your wellbeing.

And this is where education is crucial. Many line managers simply don’t know that cancer is legally defined as a disability, or that employees have a right to adjustments. Without this knowledge, requests for accommodations can be misunderstood as concessions rather than entitlements, and that misunderstanding can even slip into discrimination. Not because managers are bad people, but because most have never been taught what supporting someone with cancer truly means.

In fact, research by Working With Cancer and the Institute for Employment Studies (2024) found that 96% of organisations do not have cancer-specific policies, and the majority of HR professionals and line managers lack training and confidence in how to support employees with cancer. It’s not that support is impossible; it’s simply that too many organisations haven’t yet invested in awareness and systems to make it happen.

The role of support at work

For a long time, I tried to prove cancer hadn’t changed me. I worked through burnout, ignored side effects, and kept quiet about what I was going through. Only with the help of a therapist did I begin to accept that my values and priorities had shifted, and that I needed to be more radical about my needs. That was the turning point when I formalised my condition with HR and stopped trying to carry everything alone.

Through that process, I connected with the organisation Working With Cancer. They helped me and my employer understand what real workplace support could look like. With their guidance, we began to put better systems in place so others wouldn’t have to go through the same confusion I did.

First steps if you are returning to work

Returning to work after cancer can feel overwhelming. You may still be recovering physically and emotionally, while also trying to navigate what to share, how much to take on, and whether colleagues will understand. It’s a lot to carry at once, but there are practical steps that can make the transition more manageable.

·       Know your rights: In the UK, cancer is legally defined as a disability from the point of diagnosis. You are entitled to reasonable adjustments.

·       Formalise your condition: Register your diagnosis with HR or occupational health so that protections and support are on record.

·       Have an open conversation with your line manager: Explain what you are experiencing and what adjustments might help. Clarity builds understanding and makes it easier to get the right support.

·       Ask for flexibility: Explore phased returns, flexible hours, or remote working if you need them. These are legal adjustments, not concessions.

·       Protect your energy: Scan days, treatment cycles, and side effects are draining. Plan recovery time where you can and pace yourself.

·       Remember you are not alone: Specialist organisations like Working With Cancer can help both employees and employers navigate this journey.

Disclosing your condition

I’ll never forget one moment during onboarding for a new job, HR asked me to complete a life insurance form in the office. It required me to declare my cancer history and provide medical documents. I froze. I didn’t know what to say or how to respond. Eventually, I submitted the form months later (and was declined cover because of my cancer history).

That experience taught me how disclosure is never straightforward. It is not just an emotional decision; it has very real practical consequences. But what I’ve also learned is that as hard and scary as disclosure feels in the moment, it often makes the journey easier in the long run. Once HR and your team know about your condition, conversations about support and adjustments become possible. Without that, you are left carrying the burden alone.

Moving forward

If you are returning to work after cancer, know that you are not alone. Many of us are still figuring out how to balance treatment side effects, shifting priorities, and professional lives. Asking for support is not a weakness. It is resilience.

And for employers, this is the moment to step up. Cancer awareness should not only be about ribbons and fundraising, but also about creating workplaces where people with cancer are supported to thrive.

Find out what organisations can do to build that culture of support and why it matters.

Your health is not negotiable. Your right to accommodation is not optional. Your voice in defining what support looks like is essential.