Back to Work,
Back to Life
Your Breast Cancer Return-to-Work Toolkit
By Jessica Whorton, HR Professional and Breast Cancer Survivor
Stage 3A Invasive Ductal Carcinoma
New Mexico
Thoughts from Jessica
“Vulnerability is not winning or losing; it’s having the courage to show up and be seen when we have no control over the outcome.”
These words from Brené Brown perfectly capture the essence of returning to work after breast cancer. It’s a profound act of courage – showing up as a fundamentally changed person in a familiar space.
Jessica’s Perspective
My journey to writing this guide began with a conversation. When Cynthia from LearnLookLocate.com approached me about sharing my experience of returning to work after cancer, I hesitated. Would revisiting those challenging years be too painful? But, I realized that my unique perspective – having survived not just cancer but life-threatening complications and now working as an HR professional – could provide insights that might make someone else’s journey a little less daunting.
Returning to work after breast cancer treatment isn’t simply resuming your job—it’s navigating an entirely transformed reality while reclaiming a crucial part of your identity. The path back is rarely straightforward, especially for those who, like me, faced complications that extended far beyond the expected challenges of treatment.
The Journey No One Prepares You For....
My cancer story goes beyond the diagnosis and standard treatments. After my double mastectomy, I developed a severe MRSA infection that threatened not just my recovery but my life. As I began to heal from that battle, a pulmonary embolism struck without warning, leaving me gasping for breath and facing yet another life-threatening complication.
When I finally began chemotherapy, my body revolted with a severe allergic reaction that transformed me from a vibrant professional to a convalescent, dependent on others for basic needs. For several years after my treatment officially “ended,” I remained largely bedridden, watching my professional identity slip further away and wondering if I would ever return to the career I had worked so hard to build.
Each of these complications extended my absence from work, deepened my isolation, and forced me to reconsider what “normal” could look like in my professional future. But they also taught me resilience in ways I never would have chosen but now wouldn’t trade.
The Survivor's Perspective
What No One Tells You About Going Back
When my oncologist finally suggested I might be ready to consider returning to work on a part-time basis, I experienced a rollercoaster of emotions: hope that my body was healing, excitement about reconnecting with my professional identity, and absolute terror about whether I could actually function in a workplace again.
The Emotional Landscape
No One Talks About
“Vulnerability sounds like truth and feels like courage. Truth and courage aren’t always comfortable, but they’re never weakness,” says Brené Brown. Being honest about the emotions that come with returning to work is the first step toward navigating them successfully:
Fear of capability:
After years as a convalescent, I questioned whether I could handle even basic professional tasks. The cognitive impacts of treatment – the infamous “chemo brain” – left me wondering if I could trust my own thinking. Would colleagues notice when I struggled to find the right word or lost my train of thought mid-sentence?
Anxiety about perception:
Identity revolution:
Financial tightrope:
Recurrence anxiety:
The Physical
Reality No One
Prepares You For
BEYOND emotions lies the tangible,
daily challenges that require
thoughtful planning
Fatigue
The fatigue after cancer, especially after becoming convalescent, isn’t just feeling tired—it’s a profound exhaustion that can hit without warning. During my first months back, I sometimes sat in my car during breaks just to close my eyes, fighting to gather enough energy for the remainder of the day.
A Changed Body
My physical capabilities were dramatically different. Simple tasks like climbing stairs or carrying files could leave me winded. Lymphedema made typing for extended periods painful. Neuropathy in my feet made standing uncomfortable. These weren’t temporary inconveniences – they were my part of the new me, requiring permanent adaptations.
The Medical Merry-Go-Round
Even years into survivorship, follow-up appointments remained frequent and often anxiety-inducing. Coordinating these with work responsibilities required constant negotiation and planning.
Cognitive Shifts
“Chemo brain” fundamentally altered how my mind processed information. My previously excellent memory became unreliable. Multitasking, once my strength, became overwhelming. I had to develop entirely new systems for organizing information and managing tasks.
The Communication Challenge
The hardest part for me was explaining these needs without sounding like I was making excuses or requesting special treatment. Finding language to advocate for myself while maintaining professional relationships required careful thought and practice.
Practical Survivor Strategies
Through trial and error, I discovered approaches that helped me navigate this challenging transition:
Rebuild Physical Stamina
Before returning, I began practicing “work-like” activities at home, gradually increasing duration. I practiced my commute on low-pressure days, sat at a desk for longer periods, and established sleep patterns compatible with work hours.
Personalized Energy Management
I mapped my energy patterns and built my schedule around them:
- I scheduled my most demanding tasks during morning hours when my thinking was clearest
- I created a “recovery corner” in my office with a comfortable chair where I could take short breaks
- I kept protein-rich snacks and electrolyte drinks accessible for quick energy boosts
- I used cooling products when hot flashes struck, including a small desk fan and cooling neck wraps
Disclosure Boundaries
I developed three levels of disclosure:
- For my supervisor and HR: specific medical limitations and needed accommodations
- For close colleagues: general explanation about still recovering and occasional limitations
- For others: minimal or no information unless necessary
Legal Protections
To compensate for memory and processing challenges:
- I used a detailed digital calendar with multiple alerts for deadlines and meetings
- I kept a dedicated notebook for meeting notes and important conversations
- I created templates for recurring tasks to reduce the cognitive load
- I requested written follow-ups after important verbal discussions
- I scheduled regular “organizing time” to process information and update systems
Self-Advocacy
Understanding that the Americans with Disabilities Act (ADA) protected me empowered my self-advocacy. Reasonable accommodations I was entitled to include:
- Flexible scheduling for medical appointments
- Modified work schedules (including gradual reentry)
- Adjustments to my physical workspace
- Redistributed marginal job functions
- Extended breaks when needed for medication or rest
Reset Expectations
Convincing myself to adjust my expectations was surprisingly the most difficult challenge. Every day, I had to consciously:
- Celebrate small victories rather than comparing them to my pre-cancer performance
- Document progress to see improvement over time
- Practice self-compassion when limitations would affect my work
- Remember that adaptation is itself a professional skill
The HR Perspective
Creating Successful Transitions
My experience as a cancer survivor profoundly shaped my approach as an HR professional. I recognized that returning employees weren’t just managing physical recovery but navigating a complex emotional landscape while rebuilding their professional identity.
Understanding the Legal Framework
The legal protections available to cancer survivors create a foundation for successful return:
The Americans with Disabilities ACT (ADA)
Contrary to what many believe, you don’t need to be “disabled” in the traditional sense to qualify for ADA protections. Cancer can qualify as a disability under the ADA, even when in remission, because it substantially limits a major life activity when active. This entitles you to reasonable accommodations unless they would cause “undue hardship” to your employer.
The Family Medical Leave ACT (FMLA)
Beyond providing the initial 12 weeks of job-protected leave during treatment, FMLA can be used intermittently during your return for follow-up appointments or symptom flare-ups. This means taking hours or days as needed rather than continuous leave.
State and Local Laws
Some states and municipalities offer additional protections that may apply to cancer survivors, including expanded disability definitions, greater leave entitlements, or protection for employees of smaller companies not covered by federal law.
What HR Should Be Doing to
Support Cancer Survivors
Individualized transition planning-Every cancer experience is unique, and return-to-work plans should be tailored to individual needs rather than following a standard template. This means having in-depth conversations about specific limitations, triggers, and strengths.
Flexible reintegration options:- After my illness, I know that a gradual return is often crucial for success. This might include:
- Phased return schedules (starting with part-time hours and gradually increasing)
- Temporary reassignment to less physically demanding responsibilities
- Hybrid work arrangements combining office and remote work
- Job sharing or redistributed responsibilities during the transition
Manager and team preparation: HR should guide managers about supporting returning employees, including advice on communication, performance expectations, and team dynamics. With the employee’s permission, preparing colleagues can also create a more supportive environment.
Ongoing support systems: The challenges of cancer survivorship don’t end after the first few weeks back. HR should check in regularly and be prepared to adjust accommodations as needs evolve, recognizing that some effects of treatment may be permanent while others may emerge over time.
Confidentiality and dignity: Medical information should be kept strictly confidential, with only necessary details shared with managers (and only with the employee’s permission). This protection prevents discrimination and allows the employee to control their narrative.
How to Work Effectively with
HR as a Cancer Survivor
From my perspective as both a survivor and an HR professional, here’s how to navigate this HR dialogue successfully
Early Contact
Don’t wait until your planned return date is near. Reach out several weeks before to begin discussing accommodations and transition plans. This allows time for thoughtful planning rather than just rushed arrangements.
Be Specific
Rather than general statements like “I might need some flexibility,” try confidently asking for specific requests: “I’ll need to leave by 3 pm on Wednesdays for follow-up appointments” or “I would benefit from a workspace closer to the restroom due to medication side effects.”
Documentation
A letter from your healthcare provider detailing recommended accommodations can validate your requests without disclosing unnecessary medical information. This documentation strengthens your position and helps HR understand the medical necessity of accommodations. (Believe me, HR Professionals would rather you not disclose specific medical information to them!)
Job Functions
Under the ADA, employers must accommodate you to perform essential functions but aren’t required to eliminate those functions. Understanding which duties are considered vital to your role helps frame reasonable accommodation requests likely to be approved.
Solutions
When possible, offer specific accommodations and, in a professional tone, say: “I’m experiencing fatigue in the afternoons. Could I adjust my hours to start earlier when my energy is highest, or could we look at a hybrid schedule with afternoons at home?” This collaborative approach often leads to more successful outcomes.
Accommodation Process
Accommodation development should be collaborative. Be open to alternative solutions that meet your needs while working for the organization. This back-and-forth discussion is legally required and often results in more effective arrangements.
Navigating Disability
Benefits During Return
If you’ve been on disability leave, the transition back requires careful financial planning:
Short-term disability: These benefits typically last 3-6 months. Review your policy’s definition of disability and any requirements for returning to work. Some policies offer partial benefits during a graduated return.
Long-term disability: These policies often allow partial work returns or trial work periods without immediately terminating benefits. Understanding these provisions can make a gradual return financially feasible when you’re uncertain about your capacity.
Social Security Disability Insurance (SSDI): If you’ve been receiving SSDI during an extended recovery like I did during my convalescence, look into their “Ticket to Work” program, which allows you to test your ability to work while maintaining benefits and Medicare/Medicaid coverage.
Always communicate proactively with your disability benefits provider before returning to work to understand how your return will affect your benefits and what options might be available for a gradual transition.
The Unexpected Gifts Finding Strength in Vulnerability
“Only when we are brave enough to explore the darkness will we discover the infinite power of our light,” Brené Brown reminds us. My cancer journey – with all its complications and challenges – showed me this truth firsthand.
As I gradually built my professional identity back up after years of illness, I discovered that my cancer experience had given me unexpected gifts that enhanced my work:
Deeper empathy: Having faced vulnerability at its most profound level, I can now connect with others’ challenges with genuine understanding.
Clearer priorities: The insignificant workplace dramas no longer consume my energy. I focus on what truly matters – both professionally and personally.
Authentic leadership: Having faced death, I now lead from a place of genuine vulnerability and transparency that creates psychological safety for my teams.
Enhanced problem-solving: After having been catapulted into the complex medical system while seriously ill, workplace challenges seem manageable by comparison.
Healthier boundaries: I learned to say “no” to preserve my energy for what matters most, resulting in more focused and practical work
These gifts didn’t emerge immediately. They developed over time as I integrated my cancer experience into my professional identity – not as a limitation but as a source of unique insight and strength.
Final Thoughts: Your Journey Forward
Returning to work after breast cancer – especially after facing severe complications, as I did – isn’t just about resuming where you left off. It’s about creating a new professional identity that honors who you were and who you’ve become.
As Maya Angelou wisely said, “I can be changed by what happens to me. But I refuse to be reduced by it.” Your cancer experience has changed you, but it need not reduce your professional capabilities or aspirations. With patience, self-advocacy, and support, you can navigate this transition and find new meaning and satisfaction in your professional life.
Remember that showing up authentically – with your strengths and limitations – isn’t a weakness. As Brené Brown teaches us, it’s the ultimate form of courage. And courage, as you well know, is something cancer survivors have in abundance.
About the Author
Meet Jessica
Jessica Whorton is an HR professional and 12-year breast cancer survivor who specializes in helping cancer survivors navigate workplace transitions. After facing life-threatening complications during her treatment, including MRSA infection, pulmonary embolism, and becoming convalescent due to severe chemotherapy reactions, she gained unique insight into the challenges of returning to work after an extended medical absence. Her experience includes serving as an HR consultant, where she provides expertise to nonprofit organizations on employee training, policy development, and talent acquisition strategies.
