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About Cancer
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?
Key Accommodations
Medical Treatment, Appointments, Monitoring, etc.:
- Allow a flexible/modified schedule or making-up time missed for treatment, appointments, etc.
- Allow a reduced/part-time schedule or shift change
- Offer the use of accrued paid leave, or unpaid leave under the ADA and/or federal and state leave laws
- Modify an attendance policy to allow disability-related absences
- Allow flexible work arrangements, like telework, work while receiving treatment, attend meetings remotely
Cognitive Limitations:
- Allow for a self-paced workload
- Reduce visual and auditory distractions
- Adjust supervisory method to allow for prompting and adjusting instructional or management method
- Break large tasks into smaller tasks and allow one task to be completed before the next is presented
- Designate uninterrupted time for tasks that require significant concentration
- Provide written job instructions and prioritize assignments
- Increase job structure
- Provide a day planner or electronic organizer
- Provide reminders
- Allow a flexible/modified schedule
- Make adjustments to address executive functioning deficits like limitations in memory, concentration, multi-tasking
Fatigue/Weakness:
- Allow frequent/periodic rest breaks
- Provide a modified schedule
- Redesign workspace to bring all necessary materials within easy reach range
- Reduce or eliminate strenuous activities
- Limit physical exertion
- Move workspace closer to door, break room, or restroom
- Provide parking close to the worksite
- Allow flexible work arrangements, like telework and remote access to meetings
- Restructure the job so the most difficult tasks are performed at the time of day the employee has the most mental and/or physical energy or stamina
Other:
- Modify a dress code to allow wearing a scarf, hat, unrestrictive clothing
- Provide an ergonomic workstation
- Modify work-site temperature to address temperature sensitivity
- Identify stressors and reduce stress
- Maintain a clean and healthy work environment
- Allow employee to wear a mask
- Clean and disinfect public spaces and high-touch surfaces frequently
- Use air cleaners and filters to mitigate the spread of airborne illnesses
- Provide access to refrigerator (to store food supplements or medications)
Accommodation Ideas:
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.
JAN Publications & Articles Regarding Cancer
Publications
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