S5 Ep14: Barbara on Working With Cancer

This podcast contains the personal stories, opinions and experiences of its speakers, rather than those of Breast Cancer Now. Welcome to the Breast Cancer Now podcast, providing support and information to anyone affected by breast cancer. I'm Laura Price and I'm the host of the Breast Cancer Now podcast. I'm a food writer and author and I live with secondary breast cancer. Today on

the podcast we're going to be talking about working with cancer, that is, going back to work after a cancer diagnosis and cancer treatment, or in my case, working whilst living with secondary breast cancer. Working with cancer is a huge and often overlooked part of the cancer experience and so often companies and employers are not equipped to know how to best support employees

affected by cancer. Fortunately, there is an organisation called Working With Cancer, founded by Barbara Wilson, to support people with cancer going back to work, as well as giving businesses and employers the tools to help any of their staff affected by cancer. Barbara Wilson is a senior human resources professional with more than 40 years experience. After she was diagnosed with breast cancer in 2005, she set up a group to help people affected by cancer to return to work

successfully. She then set up Working With Cancer in 2014 as a social enterprise providing coaching, training and consultancy services to employers, employees and colleagues affected by cancer, as well as carers and health professionals. I met Barbara on a panel for Breast Cancer Now, where we were both talking about the challenges of working with breast cancer and I was really interested to hear all the amazing work she's been doing to help people like me to go back to

work. I have direct experience of working with cancer over the course of the last 11 years, having been diagnosed with primary breast cancer at 29 and with secondary breast cancer at 39. I've experienced telling my colleagues and managers about my diagnosis on the day I was diagnosed, dealing with fatigue in the workplace, deciding whether to wear a wig at work and most recently figuring out how to work with incurable secondary breast cancer. So I have a lot of questions and

hopefully some of yours will be answered here too. Barbara, thank you so much for joining us and welcome to the Breast Cancer Now podcast. Thank you and it's been lovely to have been asked to come along today. Could you start by telling me why you set up working with cancer and what your main work

involves? Well, I set up working with cancer after my own experience of breast cancer, which you mentioned happened in 2005. I was then working as a human resources director in the city, a very large company. And there was absolutely no support available to help me get back to work. And it was incredibly difficult. And I thought, well, if I'm finding this so difficult, there must be lots of people in the same boat. There were no services. There was nothing around. And I went on the web as it

was then. And all there was was a website that Avon had set up, which was advising women on how to do their hair and makeup after a cancer diagnosis, a breast cancer diagnosis. That was the only support globally. So I kind of thought, hang on, there's something here that I could pursue. So that's what led me to set it up. And I provide with my associates three major services to people with

cancer or affected by cancer, because it's working carers as well. One is one to one coaching support to help people cope with all the impacts of cancer, physical, psychological, the challenges of managing work. Another is providing training workshops, mainly for employers. But we also work with a number of charities, including breast cancer now, which

we've done for several years now. And we also provide consultancy advice to employers to write policies for them around working cancer, provide information, best practice guides, that sort of thing. Okay. And what do you think, aside from hair and makeup, what do you think are the main

challenges that a person returning to work during or post cancer treatment faces in terms of going back to work? I won't take all day. But there are lots. So there's a the fact that recovery from cancer, as I'm sure you know, is not linear. But that I mean, is that it's not like if you've had a cold or even like a broken leg, where each week, each week, it gets a bit better. So the one of the issues with cancer, let's assume a primary cancer treatment, is that you can have good weeks and bad

weeks, have good days and bad days. And the experience is different for everybody. You never know how you're going to be one week to the next. The doctors don't actually know how you're going to be because everyone is different. Everyone has their own physiology, their own sort of psychological makeup. So it's about living in the unknown and not knowing how your recovery is going to be. That makes it very difficult to speak about. So that's the second major issue, which is how do

you talk about cancer in the workplace? Most people don't want to be victims. Most people don't want to damage their career or their opportunity job opportunities. So it's finding the right words that people often find difficult to explain to their boss, their colleagues, actually their family and friends as well, how they're doing. You want to give people a good story, but you may not be

feeling very good. So I think actually communication is one of the most difficult things, particularly in the workplace, because none of us are used about having those very difficult conversations in a work context. And presumably most workforces and companies don't have a specialised, a person who is specialised in returning to work after cancer. I can't think of

any organisation. I mean a lot of companies have, for example, employee assistance programs, which are very good in their own way, but they're very trying to generic services where you pick up a phone and then maybe somebody can provide some counselling. HR professionals can, like any human being, some are good, some are less good. And sometimes one of the critical problems is that people can be quite embarrassed, feel awkward, may have been back at work for some time, but

suffering quite severe side effects. So there's a whole number of issues people are dealing with that makes it just very tough to talk about. Absolutely. I've experienced most of them myself, I think, so very experienced in that area. One of the things that I experienced recently was actually applying for a new job at a company, returning to a company after many years freelance, and now with secondary breast cancer. If a person listening to this podcast is applying

for a new job, do they need to disclose that they have had primary breast cancer or that they perhaps have secondary breast cancer or what stage would you bring that up with your new employer? Right, okay. So this is a classic question. I'm pleased you asked it. So the answer is there is no requirement to disclose anything. That's very much a matter of personal judgment. The issue is, is that if you're, for example, going through treatment and you have to have go to

regular appointments, which you might well do for secondary breast cancer. So we work with many people in that situation they may be having. Weekly or monthly infusions they've got to travel for, you're going to need the time off and you need to let your employer know because you have a right, we might come on this later, you have a right to time off, not to be paid time off, but you have a right to

time off to attend medical appointments. So when you're applying for a new job, if you don't really want to disclose your cancer for a whole number of reasons, then my advice would always be that, and you need to remember if you're on social media and been talking about your cancer, your employer might well know about it. So there is an issue there about what you think the employer may or may not

know already. And you don't want to lie at interview. I would definitely say never lie. But assuming the employer doesn't know what I would say is go through the interview process, if they make a job offer, accept it orally and in writing if you can. But at the point when you accept it orally, say to the employer, look I need to have a conversation with you about my personal

circumstances. Can I come in and see you or can we have a chat on the phone, however it works and tell them at that stage that you're having cancer treatment or whatever the situation is and you need to let them know. And we often help people have those sorts of conversations. But once you've told your employer you have a cancer diagnosis or you're having cancer treatment, you are covered by the Equality Act. So if your employer were to turn around and say, I'm not employing you because

you've told me that, then they're breaking the law. Okay. So if you're really nervous about saying anything up front, hold back until you have a job offer at which point you're secure. Because just to sort of the psychology behind it, you want to paint yourself as the most capable best person for that job. And there's this real push and pull of, well, if I know I'm capable, I know I'm the best

person for this job. But if they know that I'm going to need a certain amount of time to attend these hospital appointments, then I feel if they know that then they, you know, I might be disadvantaged. So it's a very difficult position for people to be in. It is difficult. And what I would also say is it's quite difficult going for job interviews when you're having what I call

quite extensive treatment, because as you've said, you have to be at your best. So if you're still having treatment, but you're feeling under the weather, you know, you're not at your best, but you want to go to interview, then again, you are protected. If you say I've got cancer, I, you know, I need to interview virtually because it's difficult traveling in while I'm having

treatment. You are protected by the law. But the issue becomes is if you're not selected for, let's say for the next round of interview, there's no way of proving that telling the prospective employer you've got cancer has been a reason for them turning you down. Of course. But, you know, there are people who, let me just be clear, you know, very often the employer wants to take someone on because of their skills, that's the reason their skills, their talents, they bring themselves as

it were to the job. And many employers will be, you know, they'll be very sad to hear that someone's having treatment, but they'll still want to do their best to employ them. So I think it's important to recognize that, you know, everyone's circumstances are different, but there are some terrific employers out there who, who they're keen to employ the person and will do their utmost to support that individual while they're having cancer treatment. So don't write

all employers off. Oh, no, absolutely not. I've had wonderful support in my, in my time in employment. So, and slightly off topic, but just going back to social media, to what extent can a

prospective employer look at prospective employees social media? And you know, is that? It's in the public domain. So there's nothing to say. And in fact, most, most recruitment departments these days will probably do a quick search on social media. So anyone who has a blog or

social media, where they talk about it. And obviously, it's a very, you could say a privileged position to be able to go back to work at all with cancer, because many people can't because they are, you know, the chemotherapy is debilitating, or, you know, they're just not physically able, or they might have had quite a physical job before their cancer diagnosis, and they just can't do that anymore. What support or benefits are there available for people who cannot go to work with

cancer? It does depend on everyone's circumstances. And I'm not a benefits expert, can I say, but there are, and what I would say is, I would certainly if in that position, Macmillan have a very good benefits helpline, and Maggies have a pretty good benefits capability as well. So I would always ask them or citizens advice, you know, they have great resources and knowledge. But the classic one, particularly for the self employed is the employment support allowance,

which is not means tested. It's not a lot of money. But if you've been paying national insurance contributions for the last two years, you can apply for that. And for many people, particularly the self employed, it can be a bit of a lifesaver to have that. Yeah, that's great to know. Because, you know, a lot, one of the things that a lot of people don't think about with cancer is the financial burden it has on people. It can be horrendous. And, you know, I think one of the

issues is that very often, people have to work because of their financial circumstances. And it's very tough if they've run out of sick pay. And, and they just can't go in on certain days. So it is a very, it is incredibly tough. So there are benefits available, not as many as one would like to see, I'm afraid to say. Yeah. Is there a first step you could recommend to someone going back to

work for the first time after a cancer diagnosis or cancer treatment? Yes. Speak to your HR department and your line manager. There was some research done some years ago, actually, now, which showed that the individuals who made the biggest difference as to whether somebody returned to work successfully, the individual was the line manager. So if a line manager wants you back, they often move heaven and earth to get you back. If they don't want you back, it can be very

tough. But I would certainly always have a conversation at the point of diagnosis, because you're, because you're protected, if you're employed, you're immediate, even if you're on a short term contract, I would definitely let people know I've had a diagnosis of cancer. And it might build well be you say, look, at this stage, I don't know how ill I am, I'm still having tests, but

I need, I will need the time off to continue with that. And from that point on, you are protected. So it's important to let those people know as soon as. And when you say protected, you mean that they, they, you can't lose your job because of it? Well, if they were, yeah, I mean, absolutely. I mean, there are some, a few evil people out there who might say you're sacked, but potentially, then you should seek legal advice or come to us. And basically, it's absolutely direct

discrimination, breaking the law, uncapped award. Absolutely, you should, you know, not just take that line down. So it's really important to let your employer know ASAP. And what about employers? Because, you know, I sense that that's the area where, because once you've got cancer, you start to learn about, you know, what it is and what your capabilities are. But for a manager who has never dealt with cancer and who doesn't know how it affects you, it must be very difficult to

know how to, how to, how to approach an employee. Oh, it's horrendous. Absolutely. I mean, I know I've been there. I remember one classic occasion when I was sitting at my desk in my previous job, eating a sandwich at my desk. And this guy kind of rushed up to me and sort of sat down in the chair next to me, I'm sort of mid sandwich, I think, tuna and sweet corn at the time, and said, Barbara, I've got

cancer, what am I going to do? And, you know, it's, it's incredibly difficult. I think a lot depends on relationships. The best employers will know that somebody's having tests or there's something up and will understand their employer well enough to say, please tell me what's happening. Not knowing an employee has cancer, and therefore, they didn't know that they were having tests and appointments is not an excuse if there's a sort of legal case eventually comes up.

You know, I didn't know they needed adjustments because they didn't tell me they had cancer. Well, as a responsible employer, it's your duty to understand how how your employee is. It's important, I think, for the employer to sit down in a quiet room, in a private space and say, look, come on, tell me, I know there's something up, you need to let me know. Now, the only thing is, is those

confidant conversations are confidential? So the next question for the manager to say is, apart from saying, thank you for letting me know what support have you got, what support can I give you, is it would be really helpful if I can let HR know, for example. So to basically, for the employee to understand who that person wants to know. So just again, to go back to my own case, I remember telling

my boss I had cancer. And his first question was, do you want people to know the or am well? And I said, well, yes. And the reason being, we were going through a major redundancy program. And I didn't want my colleagues to think I'd been sacked or let go. And he said, well, is it okay to know for people to know it's cancer? And we're all different. But in my perspective, it's not like a sort of social

disease, it was nothing to be ashamed of. So I said, well, yes, I've got nothing to hide. So I think if people, I mean, not everyone's the same. And some people find it very tough, I know that. But if you can be open and honest with people from like, I have to tell you, it makes life so much easier. What

about colleagues? Because, you know, often you go to your manager, your manager knows. But maybe some and the people who were on the team when you were diagnosed know about it, but then new people joined the team and you perhaps have ongoing symptoms. But those new team members don't know about it. But it does affect them because it might mean that that more work is given to them to compensate when you can't do it. I mean, would you advise that the cancer patient tells their

colleagues or? It's really for the person to kind of discuss with the line manager how this is to be communicated. So I mean, you know, classically, at first diagnosis, you might think of the people you need, you want to tell who you might want, your manager to tell. And I always say, agree the message. So what do you want said, you need to be write it down in an email, I want them to know this.

But as new people come on board, I think it's important they should know why. So it's important to again, preempt the problem, if you can, by letting your manager know that as new people come on board, you're happy for them to be told or not. There are two problems that arises with teams. One is that they don't know. And then they get very resentful that somebody's having all this time

off, and they're getting all this extra work, and they don't know why. So that's one problem. The other problem, which is much more complex, is when for good reasons, a cover is brought in while you're off sick. And the person doing the cover resents the fact that this is only a temporary job, they want to do it permanently. So they spend a lot of time building a relationship with a manager.

And the manager might quite like them might prefer them to the person who's off with cancer. So often you get difficult relationships between the person who's off sick, and their cover arrangement and the manager. And it's important for in that sense, for in that case, for managers to realise that the job is the person who's off sick. This is only a temporary arrangement. They have to make that very clear, everyone from the outset, that this person is coming back and will be back.

So, you know, it's lovely to have them cover the job, but the job is not theirs until the circumstances change significantly as they were. It's very similar to a maternity leave, really, when a woman or paternity leave, you know, when someone goes off for a really long time and someone comes in their place. And, you know, I can understand, we're in a place where we're being more and more open, we're encouraged to communicate more, to be ourselves more at work.

And so, if that person, the interim, you know, the acting person in that job is making great relationships with their team and with their manager, it's incredibly difficult for them as well, isn't it? Absolutely. And no, it's a tough situation all around, but you have to understand

the facts of the situation. And, you know, it's like a maternity cover. There are employers, you know, I do, I have several cases where somebody's come back to work after cancer after cancer treatment, you know, they're back on their first day or their first week and the manager says, it's lovely to have you back, we've really missed you. But you need to understand that while you're away, we've had to restructure. And actually, the job you were doing no longer exists. So we'll try and

find you another job if we can, but we'll have to see what we can do. And, you know, I'm afraid to say that does happen. It happens with maternity cover, it happens in these cases too. Thank God, not very often, but I'm afraid to say it does happen. In that case, what should someone do? It's very tough. I

would always seek, again, legal advice and we can put people and Macmillan Cousin touch with lawyers. The issue is, is it a genuine redundancy? Yeah, it's a very tough situation. It doesn't happen as often as it used to, but it does happen. And working with cancer, you don't provide the legal advice, but someone can contact you through your website and you will sort of point them in the right direction. Yeah, we do actually have a non-practicing employment lawyer who provides

advice. Fantastic. She does do that and she provides up to an hour's advice per person. So that's fantastic because I think often when someone when someone sees the word seek legal advice, they think of it as this really scary, huge thing. And you know, is this going to cost me loads of money. So actually having that interim point person, it is really worthwhile. Yeah. So we have

our own in-house person, a wonderful person called Genevieve Isaacson. And also we have relationships with two firms of lawyers who, if things are getting really nasty, where we can seek advice from them and they're lovely people and they're not scary lawyers, I have to say. Hopefully it won't come to that for anyone who's listening to this podcast. I'm Gareth, the editor of Vita magazine. Vita is Breast Cancer Now's magazine for anyone affected by breast cancer.

It's full of inspiring real life stories, expert tips on coping with the effects of breast cancer and articles on health and well-being. In our new spring issue, you can read about a mother and daughter who were both diagnosed with breast cancer 12 years apart. Find out the latest in breast cancer research, get tips on coping with fatigue, read about the benefits of getting outdoors, and much more. Subscribe to Vita Now at BreastCancerNow.org forward slash Vita. You

mentioned at the beginning that cancer recovery is not linear. And that was absolutely the case for me. And I, so after my primary diagnosis when I was 29, I then had 10 years where I was effectively cured. I went back to work. I got up, first of all, I went back to university and did a master's degree because you know, I wanted to do that. But then I went back to work, got a full time job and my hair

grew back. And I looked like a normal employee, a normal person, a contributing member to the team and I was working really, really hard. And the people that knew me before obviously knew my history. But I didn't sort of actively bring it up very often. And there were new people that came into my working life who didn't know anything about it. I used to travel a lot with my job and it was very hard work and intense. And there were times when the fatigue really, really hit me. I was

taking to Moxifen during that time. I had all the paramedic and pausal symptoms, not to mention the knock on effects of chemotherapy, radiotherapy, surgery years and years later and all of that stuff piles up on you and keeps on going and going. So I had times when I really struggled. But because I was, I wasn't a cancer patient, I was discharged from hospital and I found it incredibly difficult to know what I was entitled to. I did have conversations with my managers and with HR over

the years. But because I was supposedly well again, I didn't feel I had a right to ask for time off or working from home. This is before the pandemic. What can someone do to find out? Maybe someone who

has lived for a long time after their cancer treatment but is still struggling in some ways. What can they do? You're covered by the Equality Act for life. So I'm still covered by it and you will be covered by it. Anyone who's had a cancer diagnosis. And you can ask for adjustments or mention that you need adjustments when you need them. You can have them either permanently or temporarily. So in your case, it would just be a question of saying to employer, if you wish to, you

don't have to. We all manage to a certain extent some of the side effects of cancer treatment. We live them forever. I still have menopausal symptoms. But you can say to your employer, look, I have had cancer treatment X years ago. I still suffer the side effects of that treatment, whether it's fatigue or neuropathy or whatever it is. I mean, there are people who have bowel cancer treatment who'll be living with a stoma. And would say then to your employer, there are going to be

occasional days. I'm just going to need to work from home or have a day's sick leave, whatever, or just not come into the office, not any work, do any work that day. Because of that, I will let you know when that happens. But be aware, I will need to do that occasionally from time to time. And then it's a question of just communicating that with your employer and doing it. But you have that right because of your cancer diagnosis to request those adjustments. And what about people who really,

really struggle to bring it up? Like they can't talk about it. Can it suffice just to send an email? Can you do this? A lot depends on your relationship with your employer. I mean, with your manager, and of course, the problem often comes when your manager, you've had a wonderful relationship with, is promoted or moves on, and then you get a new one. But that right continues. I would always have a, I'm a great believer in having an eyeball conversation with someone and letting them know

in person, rather than by email. I mean, you might say, I'm going to have to do this from time to time. And then there's an understanding, as long as you don't kind of take ridiculous advantage of it, that if you're having a bad, a bad week or whatever it is that you can say, look, I'm just going to have to go home. So I think it's important not to just cry on the soldier on. Particularly if you're doing a

demanding or difficult job, because that's when you make mistakes. And, you know, I think it's easy to kind of ignore symptoms sometimes, but equally, it's important to kind of be body aware, you know, be aware of yourself. If you're having a bad day, and you know, you know, it's pressure of work, but the treatment is still affecting you, then say so, and make the time to kind of do what's

right for you. Yeah. Perhaps if you are one of those people who really struggles to bring up a difficult conversation like that, you could send an email saying, I'd like to talk to you about something. And then, and then, and then bring it up so you feel you've sort of paved the way for it. Yeah. I think it's always, what's that phrase, wicket rolling. Oh, I don't know that one. Wicket rolling, it's kind of prepare the ground. I'm a great believer in no surprises. Yes. You know, it

surprises are not good for anyone, neither for you nor your employer. You know, if you're feeling

fatigued or you feel like you just can't go to work that day, or you need to work from home because, you know, your body is telling you that it's had enough, and it can't cope physically. That is one thing you can talk to your team about. But what about mentally? Because actually, the psychological emotional effects of cancer stay forever in varying degrees. But, you know, and you might be suffering from depression, anxiety, lack of motivation. Do you have any thoughts for

them? I think the psychological impact of cancer is totally misunderstood by the wider community. People think of cancer as a physical illness, full stop. If I take my case again as an example, I, when I was diagnosed, I had no idea I had cancer. I went for a routine mammogram, and suddenly it was, you know, stage, wasn't stage two, but I still had chemotherapy, radiotherapy. Now, the issue was the doctors tell you at the end of treatment, oh, we're all done, you're fine. But you don't know

you're fine. There's no test, not really, that can say you're cancer free. They use that wonderful phrase, remission, you're in remission. So one of the issues most people have is depression, loss of confidence, anxiety, often caused by confronting your own mortality, which is not fun for anybody, and the fear of the cancer coming back. And, you know, I still, I know, it was it, how

many years ago is it now? You're coming up to 20, I guess. Coming up to 20 years. You know, I was at a conference the other day, a cancer conference, and a doctor, an eminent doctor was sitting next to me, and he laughingly said, well, of course, cancer can come back over 20 years after your initial diagnosis. And I thought, thanks for telling me that. But there is that issue that that fear never goes away. It might, it might lessen a bit, but you know, aches and pains that can't be

explained are the common issue that people feel have to cope with after a cancer diagnosis. And that fear is very difficult to talk about. But I think it is important to let your family and friends and colleagues know that cancer isn't over when treatment's finished. You know, this is, it's a bit like the iceberg, you know, when you've the treatment is just the very tip of the iceberg, the kind of complexity of the physical and emotional side effects you feel after

treatment is totally misunderstood, not understood. And it takes most people many years to deal with that. So, so when people say to me, and I think I'm going mad, you know, because of the most confident people in the world can suddenly have lost their confidence. They're depressed, they're anxious. And they go to the GP for tablets. Now, sometimes, you know, tablets can be helpful, let's be clear. But these are normal feelings that you can work through and learn how to manage and not

to feel those things after cancer treatment, you wouldn't be human. But I do believe that part of the problem as well is, you know, people who can be very ill can look terrific. And so often people just think you're well, you know, they don't actually realise what's going on within you, not just physically, but emotionally. So, I mean, how does someone communicate that to their employer? I think it's really important if you can to explain some of that. You know, again, we can help people

find the words. It's not that difficult. And there are lots of very, very good articles about the psychological impact of cancer, one by quite a famous clinical psychologist called Peter Harvey, which is called something like Now After the Treatment Finishes, Then What. And there's actually a very good video on our website with a lady called Dr. Jane Clark, who's also a clinical

psychologist about the impact, the psychological impact of cancer. I think talking about these things is important, not only because it gets you to sort of explain it to other people and you feel better for doing that, but it's also about increasing their understanding. I mean, the classic thing is most people, as I said, think that once treatment finishes, oh, it's great, we've rung a bell, you're well. I'm afraid that is very, very rarely the case. Psychological or physical.

This is all supposing that the employer or the HR team are understanding and good communicators and open to listening. But there will be many, many cases where people work for companies that don't have an HR department, it might just be a very small restaurant or it could be a factory or an office where someone's manager just doesn't want to know, just doesn't have the time to listen. What other things people can do when there are their stories about their cancer? It's very tough. I

think it's important to assert your rights. There's plenty of websites and information which states somebody's right. One of the things we try and do is kind of empower people to say it a nice way. Look, you need to understand that my cancer is a recognized disability and under UK law, I'm entitled to these things. There's a way of asserting these things in a way. We're not being aggressive, you're not being antagonistic, but you're telling people what's due to you. That's

what you have to do. There are still some very bad employers out there, but I say particularly small companies, actually some small companies can be terrific because they know their employees really well very often and can then tailor things to suit them. Sometimes it's the big organizations who treat people like numbers, like units of production who are rather less good

at doing the right thing. We do a lot of work, as do many of the other cancer charities, in running workshops for employers, for HR teams on how to support somebody in the workplace with cancer. There's you touched on confidence and how cancer can affect people's confidence and in the workplace, that is everything because people can feel like they can't do their job when they are in

fact completely capable of doing their job. When I was diagnosed with secondary breast cancer in 2022, I've had this real feeling that my career was over, that I was coming towards the end of my life, I was not going to have new jobs and new opportunities. Now 18 months later, I've been very fortunate with my treatment, which has worked really well. I've got a new job, a food magazine, which is a dream job. I'm presenting this podcast. I'm doing in some ways reaching the

peak of my career, but I have really suffered with confidence, I think, over that period. What would

you say to someone who is really suffering with lack of confidence because of their cancer? I think it's realising that fundamentally you're still the same person, that you have the same skills and talents. You may need to manage things like, you know, there's often fatigue, often goes hand in hand with kind of some cognitive problems. You become more forgetful, you're tired, and

therefore you forget more. All of those things can be managed, but the essence of Laura is still there, and it's important that you understand that you're the same person, you're just dealing with a few more things, but you have the same ability. I remember, I mean, I was diagnosed a lot older than you, but I was 53, and I thought, who's going to employ a middle-aged woman with cancer, you know, end of my career? And I remember, you know, having, I was leaving my job at the time for a

variety of reasons I won't go into, and saying to headhunters, you know, am I employable? I said, of course you're employable. And I mean, I had lots of job offers that I never thought I would get, because fundamentally, I had a track record, I was well known at that particular time, but I was still me. I just had days when I wasn't feeling very well, so it's important to recognise that you're the

same person, you're just dealing with a difficult illness. In terms of the services you offer, do you

offer a sort of career counselling, you know, for people who are out of work or look at, because often people will give up their job, you know, they'll say, well, I was having treatment, it was difficult with my, my employer was being difficult, so I decided to give up my job and focus on my treatment. So yeah, we provide career coaching, we don't, we don't get people jobs, but

we help people find jobs. One of, what several of our team, and by the way, all the team members of the team who work with me, we've all either had cancer or a profound experience of cancer as working carers, but several members of the coaching team are career counsellors as well, so they can give people a lot of help in understanding how to do your CV, how to do an interview, how to network, how to

use social media productively, all the kind of ways of kind of getting a job, and we've helped many people get back into work. If you are a manager or an HR professional, for example, or a business owner

listening to this podcast and you think, wow, I need to provide some support to the people in my company returning to work with cancer, what can those people do? Do they approach you? Do you come in and do trainings with them? How does it work? Yeah, we, if they contact us through our website or, you know, then what we will do is that there are three, so three areas where we can focus. One is we can look at policies and practices, make sure they're compliant with UK law. On sickness

absence, policies often aren't really compliant. We can provide training workshops of any length from, you know, half an hour to a whole day. And as part of that, we can help set up things like cancer buddy networks as well within organizations. And we support working carers as well. And then there's kind of our one to one coaching as well. And when we're working with employers, we have absolutely unique service because what we do, if you remember I was talking

earlier about the line manager's role is absolutely essential. So what we do when we're coaching an individual is their coaching is confidential. But in parallel, we provide unlimited support in terms of advice and guidance to their manager and HR on how best to support that person. So there's a kind of three way relationship. And that works really well. Okay,

when it comes to talking about cancer, there are a lot of cliches. There are a lot of things that people do. And people can say the wrong thing, or they can do the head tilt. Are there any general no knows or any things that people should always say in the work environment to someone who has cancer or has had cancer? Well, the classic the classic one is just I want to say how are you now? Now that we

tend in this country to go through a sort of little kind of dance of how are you I'm fine. Great. And by the time you've said I'm fine, the person who's asked how are you was actually walked down the corridor doesn't hear the reply. So I always say, how are you? And then look them in the eye and say, how are you? And then and I want a proper answer as it were. And sometimes people might say out of 10, how

are you? And you say, are you not allowed to say seven out of 10? Because most people say seven out of 10. So it's important. I think silence with cancer, silence is not golden. Okay, it's important. Even if you say the wrong thing is to understand how someone is doing the kind of classic manager approach is often I didn't want to upset them. So I thought I'd say nothing. I thought I'd leave them in peace for six months. Okay. I've told them I only want them to come back to work when

they're 100% fit. Well, when are you ever 100% fit? So I think those are things which, that kind of laissez-faire attitude is not helpful. But I'd always say, but even if you say the wrong thing, best to say something. Absolutely. But the classic thing is you'll be fine. You know, positive. I know someone who had that and they died. Yeah. I know about cancer because my mother oblique father oblique best friend oblique third cousin twice removed had cancer. No, you don't

know about cancer because everyone is different. So there are I mean, there's lots of all the websites they've got kind of howlers. And the classic one, I think we were talking earlier before the podcast was, you know, they lost their battle or they're fighting, they're fighting cancer. Most people I know, we're all different, but most people I know with cancer don't like that kind of metaphor of a battle. We've talked quite a lot about patients. But actually, what about

people, partners of people with cancer, parents of people with cancer, children of people with cancer, what support do you provide to them? We support them as well. So in some for some employees, we're supporting not only the person with cancer, but also their carer. And we support, you know, depends who's the employee. I think carers have a very, very tough time. I mean, it depends on, again, the relationship with the person they're caring for. I think parents with

children have the toughest time of all because I mean, in all cases, the stress is horrendous. And most employers are, I'm afraid to say, less sympathetic. And the rights of carers aren't quite as good as for people with carer as those who have cancer. So the rights of carers are not as

strong. Many carers will just take sick leave and hide the fact that they're a carer. And when you say carer, do you mean carer in the official term or can that also mean, you know, someone's partner who takes them to hospital every time but and therefore needs some time off work is sort of unofficial carer? Yeah. I mean, most, most, most companies will have sort of there are policies around dependent dependence or kind of unofficial carers having time off, you know,

emergency time off to support someone. But most companies don't have carers policies. We're trying to sort of persuade a few organizations now to do that. So yes, we do support carers and supported a significant number. And it's often again, just helping them understand what rights

they do have, what the what the options are for having time off. And for generally making sure they talk to their employer about what's going on. Because again, just disappearing without kind of telling people what's going on in your life makes makes people very jumpy, very nervous about what is happening. So I think it's important to be open if you can, but I can't pretend it's an easy, it's

easy for carers at all. But it's certainly something that people don't necessarily think about when it comes to cancer because it affects couples and families so much more than, you know, it often affects the partner as much as it affects the person with cancer. And they might also have to

take time off work. There might also be a huge finance financial burden. So there's a there's a very good again video on our website by one of my associates, Sarah Dawson, whose son died of sarcoma when he was 17, who had breast cancer last year, and whose husband now has melanoma, and talks about life working and caring, caring someone with cancer and working with cancer. And

it is incredibly tough. And I think it's important for employers to recognize, I mean, there's something like five five million plus carers in this country who are officially carers who are trying to cope with work and cancer, and they need support. I mean, the workforce is we're not exactly overloaded with workforce at the moment. I mean, we're desperate to try and keep people

working and engaged with work. So I think employers owe it to themselves, as much as to the carers, to try and make sure they're providing all the support they can to keep those people, if not actively engaged with work because of what's happening to keep them employed, so they can return to work at the appropriate point. And if someone would like to contact working with

cancer, ask questions, get in touch with you, where can they find you? So they can go to our website, which is www.workingwithcancer .co.uk. And we're also on Twitter, LinkedIn, Instagram and TikTok. Fantastic. Well, we will put all of those links in the show notes. Thank you.

I would just like to ask you one final question that we've been asking all of our guests on the breast cancer now podcast, which is, what would you say is the one thing that needs to change in terms of breast cancer in the coming years? So it might be something to do with finding a cure, it might be something to do with mental health, it might be treatment? Well, ideally, they'd be a cure, but I'm sufficient realist to know that I don't think cancer will ever disappear. I think it'll always

be part of our lives. But I think what would make a difference is to have treatments that aren't so invasive and difficult to live with. So I think the issue is how can we make treatment something that people can cope with more easily? Great answer. Thank you. Barbara, thank you so much for joining us on the breast cancer now podcast. My pleasure. It's been lovely. Thank you for asking me to take part. If you enjoyed this episode of the breast cancer now podcast, make sure to subscribe on

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episode are listed in the show notes in your podcast app. Thank you for listening to the breast cancer now podcast.