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Cancer develops when cells in a part of the body begin to grow out of control. Although there are many kinds of cancer, they all start because of out-of-control growth of abnormal cells. Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person's life, normal cells divide more rapidly until the person becomes an adult. After that, cells in most parts of the body divide only to replace worn-out or dying cells and to repair injuries. Because cancer cells continue to grow and divide, they are different from normal cells. Instead of dying, they outlive normal cells and continue to form new abnormal cells. Cancer cells often travel to other parts of the body where they begin to grow and replace normal tissue. This process, called metastasis, occurs as the cancer cells get into the bloodstream or lymph vessels of our body. Treatment options may include surgery, radiation, chemotherapy, hormone therapy, immunotherapy, and targeted therapy.
Some generalized symptoms and signs such as unexplained weight loss, fever, fatigue, or lumps may be seen in several types of cancer; however, other signs and symptoms are relatively specific to a particular type of cancer. Staging is the process of finding out how much cancer there is in the body and where it is located. Doctors use this information to plan treatment and to help determine a person's outlook (prognosis). Cancers with the same stage usually have similar outlooks and are often treated the same way. Staging is also a way doctors can communicate with each other about a person's case. For most cancers, the stage is based on three main factors: the original (primary) tumor's size and whether the tumor has grown into other nearby areas, whether the cancer has spread to the nearby lymph nodes, and whether the cancer has spread to distant areas of the body.
Cancer and the Americans with Disabilities Act
The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Cancer
People with cancer may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.
Questions to Consider:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
Situations and Solutions:
The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.
A psychiatric nurse with cancer was experiencing difficulty dealing with job-related stress.
He was accommodated with a temporary transfer and was referred to the employer’s employee assistance program for emotional support and stress management tools.
A lawyer with cancer was experiencing lapses in concentration due to the medication she was taking.
Her employer accommodated her by giving her uninterrupted time to work. She was also allowed to work at home two days a week.
A temporary agency provides computer programmers for companies
Once the programmers are assigned to a company, the company sets their schedules and production standards and provides all necessary equipment and supplies. The temp agency pays the programmers and addresses any issues that come up. One programmer was diagnosed with cancer and needed a flexible schedule, telework, and leave. Because both the temp agency and the company qualified as an employer of the programmer, they worked together to provide the necessary accommodations and to cover the work load when the programmer needed leave.
A meat packer with cancer had fatigue due to treatment for cancer.
The individual was offered a flexible schedule that changed his tasks to filling specialty order requests. These requests were made several weeks ahead of time and allowed for additional flexibility in hours.
A graphic design artist working for a non-profit requested to work at home two days a week to cope with side effects from cancer treatment.
The employer was open to the idea, but had not permitted employees to work at home before and was uncertain if this would be an effective solution for both the employee and the business. A JAN consultant suggested implementing working at home on a trial basis and offered JAN’s Sample Temporary/Trial Accommodation Approval Form to assist the employer in documenting the accommodation. Using practical ideas shared by JAN for implementing work at home as an accommodation, the employer drafted a trial accommodation agreement and approved the accommodation for a three-month period.
An employee with a history of cancer needed time off periodically to get follow up medical testing to make sure his cancer had not returned.
The employee had a history or record of a disability and therefore was entitled to an accommodation.
A secretary with cancer was having difficulty working full-time due to fatigue from chemotherapy treatments.
Her employer accommodated her by allowing her to work part-time and allowing her to take frequent rest breaks while working.
A customer service representative recovering from colon cancer had a colostomy bag, which often smelled of feces.
When confronted about this problem, the employee said she had been embarrassed about cleaning the bag in the employee restroom so she had not been cleaning it enough. She was provided with a private area to clean her bag.
An employee was recently diagnosed with thyroid cancer and is having trouble with attendance due to the fatigue limitations associated with the chemotherapy.
The employee is running low on paid sick leave. The employer allowed the individual to work from home to enable the individual to work more easily as well as providing additional unpaid leave as an accommodation on days when the individual simply cannot work.
A machine operator who was undergoing radiation therapy for cancer was accommodated by having his workstation moved.
The move transferred the individual to an area of the plant where no radiation exposure existed.
A security guard with breast cancer was burned from radiation treatment.
She had difficulty wearing the polyester uniform with embroidered insignia that was required by company policy. The employer modified the dress code policy by having a uniform made of cotton material with the logo and employee name added with a no-sew iron-on adhesive.
A child care worker with cancer had difficulty walking through a campus environment.
The employee requested the ability to stay in one building. The employer contacted JAN for options. JAN suggested a mobility aid that the individual used solely for job functions.
A warehouse worker whose job involved maintaining and delivering supplies was having difficulty with the physical demands of his job due to fatigue from chemotherapy treatment.
The individual was accommodated with a three-wheeled scooter to reduce walking. The warehouse was also rearranged to reduce the individual’s climbing and reaching.
An engineer working for a large industrial company had to undergo radiation treatment for cancer during working hours.
She was provided a flexible schedule in order to attend therapy and also continue to work full-time.
JAN Publications & Articles Regarding Cancer
Accommodation and Compliance Series
Consultants' Corner Articles
- A Support Person as an Accommodation
- Accommodations Related to Commuting To and From Work
- Accommodations, ADA, and Light Duty
- Confidentiality of Medical Information under the ADA
- Dealing with Stress in the Workplace
- Leave & Undue Hardship Under the ADA
- Using Ergonomics to Accommodate Limitations from Breast Cancer