Cancer no longer keeps patients from working

Society is moreaccepting of cancer sufferers in the workplace.
LOS ANGELES TIMES
Three weeks after a five-hour operation to remove cancer in her colon, Linda Scotto was back at work as a sales representative for a snack food company.
The Torrance, Calif., resident continues to meet with buyers and travels to trade shows while undergoing regular chemotherapy treatments. Even a second surgery last year to remove cancerous nodules on her lungs hasn't slowed her down.
"My work is one of the main things that gives me a sense of purpose," said Scotto, 45. "You don't want to focus on cancer 24/7. That will kill you."
Medical advances, supportive laws and greater workplace acceptance are allowing many people such as Scotto with advanced cancer or other serious diseases to continue working, in some cases almost immediately after major surgery.
Although some stay on the job to qualify for company-provided health insurance, many do it for the emotional support and mental respite from their diseases. And cancer's stigma is fading for patients and co-workers.
Statistics
About 40 percent of the more than 1 million Americans diagnosed with some form of cancer each year are working-age adults, according to the American Cancer Society. The vast majority return to work after treatment, often within a year, said Tenbroeck Smith, who directs research on survivorship at the Cancer Society's Behavioral Research Center in Atlanta.
Millions of people with early-stage or localized tumors, such as some forms of breast or prostate cancer, have long been able to return to their jobs in the wake of their treatment. Now, said oncologist John Glaspy, a professor at the University of California, Los Angeles' David Geffen School of Medicine, nearly three-quarters of his patients whose tumors have spread also head back to work. In the late 1980s, that was "very rare."
Such "metastatic" cancers were once tantamount to an immediate death sentence. Now it is becoming a chronic but treatable condition for many patients, akin to heart disease or AIDS. New drugs have blunted debilitating effects of chemotherapy that kept patients bed bound during treatment or left them with lasting disabilities. Targeted therapies have improved survival rates.
Every three weeks, sales rep Scotto receives an infusion of Genentech Inc.'s Avastin, which was approved in 2004 to treat several types of metastatic tumors. As an independent contractor who works full-time for New York-based Robert's American Gourmet, Scotto arranges her medical appointments around work.
New therapies like Avastin, targeted at the genetic profile of individual tumors, dramatically have improved the quality of life for patients, said UCLA's Glaspy said.
"Now chemotherapy is highly toxic to the cancer and only a little bit to the person," he said, whereas in past, the treatment was "highly toxic to both."
Laws are helping
Federal and state laws also have helped many workers by requiring employers to accommodate their physical limitations and treatment schedules.
The federal Family and Medical Leave Act allows most employees to take unpaid leave for surgery and treatment. The Americans with Disabilities Act requires employers to make accommodations for workers who, for example, no longer can lift heavy loads or become easily fatigued as a result of treatment.
Some employers go beyond what the laws require to make employees feel comfortable during and after treatment.
Six years ago the Cosmetic Executive Women Foundation, a New York-based industry group with more than 4,000 members, launched cancerandcareers.org to disseminate "best practices" on the job. Among its suggestions to managers are to provide a private room for employees to telephone their physician, and keep workers on leave in the loop on company happenings.
Health and wellness publisher Rodale Inc. was one of the project's early promoters. The Pennsylvania-based company creates a personalized Web site for each employee with cancer, linking them to resources and co-workers with the disease. Managers also receive training on how to re-integrate cancer patients into the office and respond to colleagues' questions.
"We wanted to make sure people understood that we were fully committed to help them," said Amy Plasha, Rodale's vice president of compensation and human resources. The program also has paid off in terms of productivity and morale, she said.
Social networking
Many disease sufferers want to continue working because it provides a big part of their social network, Glaspy said.
"Those social webs, they define ... they keep you alive," he said. "You have to have a reason to roll out of bed in the morning and comb your hair."
In a poll last year, three-quarters of those working with cancer said their bosses treated them very well, according to a survey by USA Today/Kaiser Family Foundation/Harvard School of Public Health.
But not everyone is so fortunate. Beverly Hills, Calif., lawyer Gary Ross hears plenty from workers who have had trouble. Two of every 10 of his callers with cancer are employees who were fired.
"As the treatment improves and knowledge improves, that's when legal wrangling results, because you get into that gray area of what is a reasonable accommodation," he said.
One of his current clients worked for 35 years as head valet at a Los Angeles luxury hotel. After surgery for prostate cancer left him with diminished bladder control, he asked for permission to use a bathroom at the front of the hotel. The company refused, saying it didn't want the valet mixing with guests, and later fired him, Ross said.
"They could have put a port-a-potty in a remote spot, behind a tree or at one of the parking lots where he worked," Ross noted.
On-the-job discrimination and firings are "more common than you would think," said Joanna Morales, who runs the Cancer Legal Resource Center at Loyola Law School.
"People either don't know about the laws or they're choosing not to enforce them," she said, adding, "it goes from professional to manufacturing to labor jobs."