Recovery, remission and follow-up
If treatment is successful people may be told they are in remission, which can mean either that the disease has been significantly reduced (partial remission)...
People with cancer need some time out from their work or studies to attend hospital and many stop work altogether during treatment. Some people we talked to had missed work or school before their lymphoma diagnosis because they felt unwell; one woman gave up her job because she felt tired and listless, not realising she was ill.
As people’s reaction to treatment varies, so does their need for time off work. People who had few side effects from treatment (see ‘Unwanted effects of chemotherapy’ and ‘Radiotherapy’) could often continue working except on the treatment day and perhaps a few days afterwards, and appreciated the sense of normality it provided. Others took sick leave for the duration of their treatment or left their jobs or studies to concentrate on their health. People who needed a long stay in hospital (see ‘High dose therapy and stem cell transplantation’) had to take sick leave. Some people used the time off work to re-evaluate their careers. One man retrained as a photographer and set up his own business, another did some teaching practice, and a woman left her job to go to art college. Sick leave also allowed parents more time with their young children.
The ability to work during treatment varied according to the type of job. Many self-employed people could work flexibly; those with desk jobs could more often continue than those with physically active jobs. Many whose work involved contact with the public stayed away to reduce the risk of catching infections when their immune system was weakened by treatment (see ‘Blood cell counts and infection risk’). For instance a GP stopped seeing patients because of the infection risk but went in to work one or two days a week to keep up with his non-clinical workload. Similarly a health visitor kept her hand in on days when her immune system was strong. A woman who worked long hours said that she decided with her employers that it would be best for her to go off sick and for somebody else to cover her work as it couldn’t be done part-time. A self-employed woman sold her business after she was diagnosed and started a new one after she had recovered.
In the UK employers are not allowed to discriminate against people with cancer. They are expected to make reasonable adjustments to workplaces and working practices to ensure cancer survivors are not disadvantaged. Most people we spoke to said their employers had kept in regular contact during their sick leave and had been supportive of their needs. Several said colleagues had visited or sent flowers, cards or good wishes. A man whose wife worked for the same company as he did said she had been allowed time off to visit him in hospital whenever necessary. Another person said that although her manager had initially been awkward about her impending sick leave, once she had researched her rights her relations with her employer improved. However, some people fared less well’ when the initial goodwill of one man’s employer ran out he changed job; another said one of his bosses made derogatory remarks about his time-keeping.
After being off sick many people worried about returning to work and sometimes found it difficult to adjust to the routine again. Some were eased back into work by starting part-time and gradually increasing their hours, by working from home, or doing lighter work. One woman had maintained a routine during her sick leave by getting up early to prepare her daughter for school and then going to the gym; that helped her. A man had changed his attitude to work and no longer felt guilty about stopping when he was tired. A young man had put his illness on his curriculum vitae as a positive life experience and had no difficulty in getting a job.
Some people took early retirement on health grounds, either because they realised they could not return to work or because on returning to work they struggled to meet their responsibilities. One man lost his job as a game keeper because of his illness and although he sought work during a remission he then relapsed and could not work (see ‘Finances’).
Some people who were in full-time education when they fell ill had to miss lessons, causing them to fall behind with their studies. A teenage woman received lessons in hospital and passed enough O-Levels to get by and later obtained more qualifications. A 16-year-old who spent five months in hospital later sat his exams in college and then went to university. A woman studying for A-levels was given extra lessons after school to make up for those she had missed. The school offered to write to the exam board about her illness or to allow her to repeat the year, but she declined and did less well in her exams than she could have done if she had not been ill. Two university students repeated a year of their course; one said she thought she did better in her exams because she was more mature and her friends were not there to distract her from her studies. A mature student completed her Master’s degree soon after diagnosis but had not started her planned PhD. Another was pleased to have completed an Open University course during her treatment.
Several younger people said their illness experience had made them want to help other young people or had influenced their career choice. One went to work with carers then became a teacher, another became a pharmacist, and another a nurse.
A woman who had just retired when she was diagnosed with lymphoma but had not yet had any treatment (see ‘Watch and wait’) initially thought that she would have to stop doing things, but after a few months decided it was no way to live and took up new interests. Other activities affected by the illness and treatment among people we talked to included travel, hobbies, housework, family responsibilities and social activities.
For information on benefits and financial support see ‘Finances‘.
If treatment is successful people may be told they are in remission, which can mean either that the disease has been significantly reduced (partial remission)...
In the UK, people who are employed but too ill to work are entitled to basic statutory sick pay for up to 28 weeks (for...