The Lynx Group

Managing Cancer at the Workplace Enhances Productivity, Has Value for Employers

October 2014, Vol 5 , No 8

Los Angeles, CA—It is a good business decision to invest in better cancer management for employees with cancer, according to Lillie D. Shockney, RN, MAS, University Distinguished Service Associate Professor of Breast Cancer, Johns Hopkins Breast Center. This type of effort can maximize the productivity of employees with cancer or cancer survivors and reduce the work-related impact on coworkers, said Ms Shockney at the Fourth Annual Conference of the Association for Value-Based Cancer Care.

Of the 13.7 million cancer survivors in the United States, 40% are of working age, and the vast majority of them wish to work during their treatment. To achieve this goal, a discussion with the oncology team about the timing of the treatment plan is imperative, said Ms Shockney.

Accommodating Employees with Cancer

Ms Shockney requests that the oncology team consider Friday as a day to administer chemotherapy for patients who continue to work, given that most patients will experience side effects in the ensuing 24 hours. “I also want to make sure that if she’s going to be receiving radiation, she may want the 7:00 am appointment, or the 5:30 pm appointment, rather than the 2:00 pm appointment,” Ms Shockney said.

Getting patients into cancer rehabilitation before acute treatment to avoid deconditioning is also helpful, as is preparing patients for treatment-related side effects up front.

In researching work-related issues in cancer survivors, Ms Shockney discovered that 63.5% of cancer survivors continue to work while receiving treatment or return to work during and after their treatment. More than 70% of persons aged ≥65 years in the United States do not plan to retire, meaning that more people in the future will be diagnosed with cancer while they are working. “We need to get our arms around that with some degree of speed,” she said.

Several factors lead to a greater likelihood that an employee with cancer will continue to work and maintain productivity. These factors include:

  • Flexible working arrangements
  • Counseling and supportive services for the employee and coworkers
  • Training and rehabilitation services
  • A longer duration of sick leave
  • Ensuring continuity of care.

Employees who could work during cancer treatment often do not, because of a lack of workplace support. Caregivers and coworkers of patients with cancer also feel the impact: caregivers and survivors use significant sick time, vacation time, and short- and long-term disability.

Work absence is costly, said Ms Shockney. The cost of lost productivity among US employees with cancer is equal to 30% of the nation’s healthcare spending.

Return to work success depends on a supportive work environment, which includes time off for appointments, discretion regarding hours and workload, and preparation for workplace reentry. Older people and those who do manual labor are less likely to return to work, regardless of the work environment.

Managing Cancer at Work Program
Two years ago, Ms Shockney assumed the role of Director of the Johns Hopkins Cancer Survivorship Programs, at which time she set the goal of first developing a program to manage cancer in employees. The program became known as Managing Cancer at Work.

Managing Cancer at Work is a unique approach to managing cancer care–related benefits (Figure).


Specifically designed for the workplace, it combines personalized nurse navigation with a web-based educational portal. These portals are customized for employees, managers, caregivers, and oncology nurse navigators.

“Our employees can get their screening mammogram on work hours,” Ms Shockney said. “If they have a lump or bump or something that’s of concern, they can come over today. It doesn’t matter what the hour; we will work them in today to have a diagnostic evaluation done.”

The program directs employees to get the right treatment at the right time and place at each stage of cancer, optimizing care and avoiding waste, said Ms Shockney. Navigators help direct patients to the most appropriate care.

Nurse Navigators

Education about advance directives, wills, and social services is also offered as part of Managing Cancer at Work, as well as specialized support for employees with advanced cancer and general screening and prevention education for all employees.

Adding new life goals and preserving older goals can be accomplished through the one-on-one nurse navigation. “That does mean doing things in a proactive way, so whether that be fertility preservation or some other referral that they would benefit from,” Ms Shockney said.

“The navigator can customize specific information that would be of particular importance for an employee, and she also has navigation tracking software that we’ve built into it for the purpose of keeping track of what intervention she has done…and then the specific process and outcomes measures. That employee can also offer 5 people in their family or friends who are supporting them the ability to also access this information.”

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