How to Balance Your Job With Metastatic Breast Cancer

by Sheila M. Eldred Health Writer

When Kirsten Stanley found out that her breast cancer had metastasized to her liver and lymph nodes, her response wasn’t to call her boss and turn in her office keys. Instead, she doubled down and worked harder. “I didn’t want cancer to be the reason I left my career,” says the 43-year-old director of operations at a skin care company in Gulfstream, FL. “I didn’t want to get in the mindset of, ‘I need to quit my job today because I’m going to die tomorrow.’” She’s not alone in feeling this way.

In fact, 44% of women with metastatic breast cancer (MBC) keep working after their diagnosis, according to a study in the journal Cancer. “It allows them to live the life they were intending to live,” says Jane Kakkis, M.D, medical director of breast surgery at Orange Coast Medical Center in Fountain Valley, CA. “Others say, I’m going to quit and do my bucket list.” If the familiar routine and mental stimulation is something you thrive on (or heck, just the water cooler gossip!), there’s no reason to stop. Check out these tips for staying in the game as long as possible.

Make a Plan

“Work can be a very affirming experience,” says Rebecca Crane-Okada, Ph.D., a nurse at Providence Saint John’s Health Center in Santa Monica, CA. “It gives people a sense of meaning and purpose and self-value.” Let your treatment team know what kind of work you do, she suggests. Is it high stress? Is there a lot of physical activity? Are you exposed to chemicals? Based on that information, your providers can help decide if you need certain therapies or if you need to adjust responsibilities at work.

Talk to Your Boss

How much you share with your manager is a personal choice, but you need to say something. Here’s how to make the convo go smoothly: First, schedule a sit down with your supervisor. “You want their full attention, so make sure you have adequate time and a private area to talk,” says Caroline Sarafin, CSW, an oncology clinical social worker at Providence Saint John’s Health Center in Santa Monica, CA. Disclosing more is often better so you won’t feel like you’re sneaking away every time you have an appointment, Dr. Kakkis says.

Be Friendly But Firm With Coworkers

Get ready: You’ll likely encounter at least a few out-of-line colleagues who passively aggressively challenge your ability to still work. Stanley found it best to deal with this directly. When a coworker noted she wasn’t physically present at a meeting because she was sick, she corrected him: “I said, ‘I won’t be able to attend every meeting, but I did call in. My ability to my job is not impacted by my breast cancer treatment.” In fact, she joked, she’d missed fewer days of work for treatment than many employees did for company golf outings.

Think Outside the Box

The ability to work from home is a major perk of modern technology. If your job allows for it, talk with your company's HR department about the possibility—even just one or two days a week can make life a lot easier when you’re running to and from doctor appointments. Another option: Ask your manager about flexible work hours. That way, on days you have chemo, you could start at the office at 7 a.m (early, we know), and still make it to a 4 p.m. appointment.

woman sitting on yoga mat meditating in office
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Rest and Recharge

If you’re good at the 15-minute power nap (and if you’re not, time to learn!), talk to your employer about finding an appropriate space to tuck into now and then. “I had a patient who had a meditation room at her workplace,” Sarafin says. “She could close her eyes, listen to music, and decompress for 20 minutes. It let her get through the rest of the day.” Other restorative options include bringing homemade soup in a thermos to the office or taking a brief walk outside in the fresh air, suggests Crane-Okada.

Create Your Chemo "Office"

Tweak your chemo appointments to optimize your work life. “For patients who work, I recommend scheduling chemo on Fridays to give themselves the weekend to recover,” Sarafin says. And don’t forget your laptop. “I try to be productive with work when I’m getting chemo,” Stanley says. “I can answer emails, for example. It helps me 'escape' the chemo.” Not everyone can juggle chemo and work, but if you can, why not? Delphyne Lomax, 61, of Lithonia, GA, held meetings with business partners right there in her chemo chair during treatment for triple-negative breast cancer.

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Keep It Clean

The tough truth about MBC treatment: Your immune system takes a hit. That means you’re vulnerable to bugs running around that healthy people aren’t affected by. Lomax, a self-described social butterfly, wound up catching pneumonia while Stanley has had several colds. “I have to be very careful in the office environment being around people,” she says. “If I’m sick, I stay home. If someone else is sick, I either send them home or I’m very careful with washing my hands.” She lets employees know that their work ethic is appreciated, but their germs are not.

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Find New Sources of Support

When you have MBC, optimizing your work life means calling on people outside your 9-to-5 world. Speech therapists can help with “chemo brain,” nutritionists can show you how to boost your energy level, and an occupational therapist may be able to modify your workplace setup. And don’t forget a massage therapist to get the kinks out of your neck after staring at a screen all day. If you’re not sure who to tap, start with a hospital social worker, who will tell you what’s available and make sure insurers cover it.

Sheila M. Eldred
Meet Our Writer
Sheila M. Eldred

Sheila Mulrooney Eldred is a graduate of Columbia’s School of Journalism and a former newspaper reporter. As a freelance health journalist, she writes about everything from life-threatening diseases to elite athletes. Her stories have appeared in The New York Times, Nature, FiveThirtyEight, Pacific Standard, STAT News, and other publications. In her spare time, she and her family love running, cross-country skiing, and mountain biking in Minneapolis.