Returning to Work after Transplant

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Returning to Work after Transplant

July 14, 2020  Part of the Virtual Celebrating a Second Chance at Life Survivorship Symposium 2020

Presenter: Rachel Becker LMSW, Senior Director of Programs, Cancer and Careers

Presentation is 49 minutes with 11 minutes of Q&A.

Summary: Twenty percent of cancer survivors report limitations on their ability to work one to five years after diagnosis. Disability laws requires employers, in many cases, to make reasonable accommodations to a person’s job, schedule, or workplace environment to enable the person to continue to work.

Highlights

• The Americans with Disabilities Act (ADA) provides protections for employees with disabilities who work for a company with 15 or more employees.

• You are not required to disclose your cancer diagnosis to a current employer or a prospective employer, nor can they ask.

• You should be careful about what you share on social media, since prospective employers may review that information and take it into consideration when deciding whether or not to hire you.

Key Points

03:07     Cancer survivors are 1.4 times more likely to be unemployed than the general population

06:06     The Americans with Disabilities Act offers some protections to employees during and after cancer and requires that employers provide reasonable accommodation in the workplace for employees with disabilities. If you need to ask for accommodations, you will need to disclose some basic information about your health to access your legal rights.

11:26     Cancer and transplant patients should be cautious about social media and consider making accounts private since employers can easily access this personal information.

14:16     It is important that transplant patients create a disclosure plan and outline what they wish to share with their employer or potential employer and how they will manage sharing that information.

20:17     Coworkers may have questions about your cancer and be well meaning, but you have the right to openly discuss your experience or steer these conversations back to work related topics. Anticipating and planning your answers ahead of time is helpful.

32:12     It is recommended to hold off on revealing personal information, such as cancer history until you have had at least one in-person interview with a prospective employer.

38:33     Networking is a great way to find out about job opportunities, think about your network as broad as possible, use LinkedIn, reach out to neighbors, friends, and your religious community.

42:24     Gaps in employment can be addressed by engaging in education, professional organizations or volunteering which can be included on your resume.

43:51     Anticipate potential interview questions and be prepared to answer questions in a way that highlights your strengths and steers to interview to your best attributes.

Transcript of Presentation

00:00     [Moderator] Welcome to the workshop, Returning to Work after Transplant. My name is Marla O'Keefe and I will be your moderator today.

It is my pleasure to introduce today's speaker, Ms. Rachel Becker. Ms. Becker is the Senior Director of Programming at Cancer and Careers. Before joining Cancer and Careers, she was Head of Client Services at CarePlanners, where she designed and implemented a technology-based infrastructure for delivering and monitoring support services. She is a member of the Association of Oncology Social Workers, and a proud recipient of the Zelda Foster Fellowship in Palliative and End-of-Life Care. Please join me in welcoming Ms. Becker.

00:47     [Ms. Becker] Thank you so much. I am thrilled to be here today, very happy that BMT InfoNet was able to pull this all together, so that we could be together virtually. So, glad that all of you who've tuned in and are listening are here to get this information. I hope you find that helpful. So, name of the presentation is Returning to work after Transplant, as we said.

Cancer and Careers provides a number of resources to empower people with cancer to thrive in their workplace.

01:15      Just to give you a little bit of background on Cancer and Careers, we are a nonprofit organization for those of you who may not be familiar with us. We are headquartered in New York City, which is where I am right now, but we are a national organization. We travel all over the place and our mission is to empower people with cancer to thrive in their work environment. We do that through a number of programs and resources, all of which are offered for free. They are listed here on this slide. They include webinars and publications that can be downloaded or ordered in hard copy. We have a resume review service and job search tools, lots of great resources and happy to provide you more information about those offline. So, that we can get to the meat and potatoes of today.

02:06     So what I would like to start with is some data points that have to do with work and cancer, and what the landscape kind of looks like as we start to think about these topics. And why it's important to have conversations about work and the way that it changes and shifts, and maybe feels a little different once people have received a cancer diagnosis., and certainly, when we're thinking about transitioning back after having gone through transplant.

So, to start with, we know that more than 70% of cancer diagnoses are made in adults between the ages of 20 and 74. The particular study that we pulled this from, they find those years as prime employment years. Obviously, 70%, that's a pretty high number. So, we are seeing a lot of people with many different diagnoses who are thinking about the challenges related to finding work or staying at work, etc.

Cancer survivors are more likely to be unemployed than people who have not had cancer.

03:07     We know that cancer survivors are 1.4 times more likely to be unemployed than people who have never been diagnosed. Also, that 20% of cancer survivors still report work limitations affected by cancer-related problems one to five years after their diagnoses.

03:24     With this statistic, I think it's important to point out that anecdotally, just based on the work that I've been doing in the cancer space, and I've been in the cancer space for over 10 years now, I think that that might be a low percentage. I think that the one to five years is probably a low time estimate. It's very, very hard to kind of generalize the way that cancer treatment impacts people and their abilities after they've passed the point of diagnosis and treatment. After that bell kind of get rung, but that's the statistics that we have that we were able to find. That's why it's on this slide.

This fourth data point comes from a survey that we at Cancer and Careers actually did ourselves last year in 2019. We found that 75% of employed survivors reported that working during their treatment helps them to cope. We also saw similar points that returning to work, that being somehow engaged with their professional life has all kinds of positive benefits that extend beyond just getting a paycheck or getting health insurance, which is not to say those things aren't important, but there's this very personal aspect to being a working person that we connect to our job.

Discrimination in the workplace due to cancer

04:51     And then finally in 2019, we saw that the EEOC, which is a body of the government. It's the Equal Employment Opportunity Commission. They oversee one of the key laws that we're going to talk about today. In 2019, they received 807 cancer discrimination claims from people who felt that they had experienced discrimination in their workplace. This is a fairly small percentage of the overall claims.

 I think of course, it's important to point out that these are just the people who stepped forward. Thankfully, this is a relatively small number, but we bring it up because it's important to know that while we wish it weren't the case that we lived in the world where discrimination happens. It is the case that we do see some discrimination happening in workplaces around people who have received a cancer diagnosis.

So the idea today is to really help give you some information and empower you, so that you can make good choices, that you can feel strong in your transition back to work and you can be kind of moving towards the navigating good outcomes in the workplace, which again, we know is a very possible thing, very manageable thing to do.

The Americans with Disabilities Act (ADA) provides employment protections for people who have had cancer.

06:06     So, I mentioned the EEOC oversees one of the key laws that we're going to discuss today. This is actually the only law that we're going to talk about today, in part, because I myself am not an attorney. I do want to say that up front, because often, when I do these presentations, I get a lot of detailed questions about legal rights. Because I'm not an attorney, I always kind of hedge on going into too much detail, but I do want to give you an overview of this law because it is often a key tool for helping people to navigate work after a cancer diagnosis or returning after transplants.

So, the ADA is a federal law, which means that it applies in all 50 states. The part that is relevant to work specifically comes from Title One of the law. Like all laws, it has certain requirements that need to be met in order to use it. So, in broad strokes, they are that your employer must have a minimum of 15 employees in order for the law to apply to them. You, as the employee, must have the necessary skills, certifications, and qualifications to do the job that you're doing for your employer. Most people automatically fall into that category, because it's very uncommon for people to hire somebody who's not qualified to do the job.

 And then the third is that your disability must meet the criteria of what a disability is as it's written in the ADA. So, for people who meet these requirements, what the ADA does is it provides protections from discrimination, and it may also provide access to reasonable accommodations. We're going to circle back later to what reasonable accommodations are as we move through the presentation. Again, this is just a quick overview, so you know what the ADA is, and that it's something to consider.

Some state laws provide additional employment protections for people who have had cancer.

08:09     It's also important that you know that... Of course, we're virtual. So, I don't know where all of you are geographically located within the United States. Some of you actually might be outside of the United States, but this is obviously an American law. Wherever you might be, it's important to know that in certain states, you may have further protections by a State Fair Employment Law. So, that's a state specific law that would only apply to people within your jurisdiction.

So, for example, in some states, the minimum employee requirement is less than 15. So, it's just an example of one way that it might be more protective depending on where you live. But again, if you are interested in learning more about the law, learning about whether it's something that you might want to call on, I do encourage you to speak with a legal professional to try to determine if you're eligible for any of the protections that it provides.

Whether or not to disclose your cancer diagnosis at work is a personal decision, and is not required by law.

09:04     Okay, so this question that you see up on this slide is one of those that are most commonly asked at Cancer and Careers and that specifically is "Do I have to share the news of my diagnosis at work?" The rest of the decisions about sharing news in a work environment or really in our personal lives in general, it's an incredibly personal decision. It's one that requires a lot of thought, and it is also typically not an all-or-nothing scenario. But just so we're all on the same page with this You are not required to provide information about your health or your health history to any employer, whether it's a current employer or a prospective employer, nor can they ask.

That said, there can be situations where you might have to share some information in order to access your rights under the law. So, this doesn't mean sharing every last detail about your diagnosis or your prognosis. It just means you might have to provide some support for why you're eligible to ask for whatever it is that you're asking for.

So, for example, it would be very difficult to credibly file a complaint against your employer for discrimination under the ADA protections if they don't know that you have a condition to discriminate against. So, as you're thinking through whether or not to share, it's important to consider all of those angles. Of course, it is also the case that the way that we kind of put information out into the world is kind of like getting toothpaste out onto the toothbrush, right? You can put it on, and you can always put on more, but it's hard to get it back in that tube once you've squeezed it out.

So as you're thinking about the way that you talk about what your cancer journey may have been to this point, or what side effects you're experiencing and whatnot, it's important to consider, do I want to share everything all at once? Do I want to share a little bit at a time? Do I want to share as little as possible, for as long as possible? There are a lot of nuances to making those choices.

Employers look at a person’s social media when deciding whether or not to hire an individual.

11:26     Now, I want to talk very quickly about the social media space, as we're talking about this disclosure piece of the conversation, because we do know that people of all ages are talking about their health on social media, right? So there was a point in time where we kind of thought, "Oh, it's only millennials that are really using social media and having these conversations," but we've seen some studies in recent years that really show social media has just become so popular for everyone throughout the lifespan, really, probably now more than ever with everything that's going on with COVID-19, with all of us being at home. It's a wonderful way for us to connect with people who aren't in our space on a day-to-day basis.

For people going through a cancer experience, it creates a sense of community, which is incredibly valuable. So, I want to be very clear that I'm not saying, "Do not post on social media," but I do want to call out quickly that employers do look at social media. This includes both current employers and prospective employers as well. Usually, prospective employers were looking for information or doing so because they like the job candidate who's sitting in front of them and so they just want to find out more about who that person is.

Again, with current employers, it's usually the case that they're looking because they're trying to figure out ways to make conversations with people that they supervise, so that they can have more human-to-human interactions. But if you've been documenting your journey on social media. Or if you've really been sharing all sorts of personal information on social media, it's important to recognize that of course, this may be public to your employer if they're looking. So, it may come up in conversations in the workplace, and it's something that you want to be prepared for.

Obviously, there are privacy policies on social media platforms. It's a good idea to review them on any site. You can of course make your profiles "private". If you could see me, you could see me making air quotes right now. But regardless, it's a good idea to kind of know what those policies are before you start sharing as you're thinking about sharing. It can often be a good idea to pivot over to MyLifeline or CaringBridge, which are sites specifically designed for people who are going through a medical experience so that they can communicate with the chosen group of people. They are more protected. So, those can be great options.

Make a plan about what and to whom you will disclose information about your cancer.

14:16     And then when we think about disclosure, and this applies not just to your online presence, even though this is the title of your slide, it is important to have a disclosure plan, right? So, take some time to sit down and sort of deliberately think about what information you're comfortable having public and what information you'd prefer not be public and then know that not just for yourself. So, you sort of have a plan of attack as you're going back to work and thinking about what you are and are not comfortable sharing in the workplace, but also communicating that with the people that you are connected to on social media.

So, for example, let's suppose you've made the choice to not really talk publicly in your workplace about what you've been going through in terms of your transplant and in terms of your cancer journey along the way. So, maybe there are people in your workplace who don't know that that's something that you've been living through. And then your very well intended and very wonderful sister decides to put a post up on Facebook saying, "Congratulations to my wonderful brother who's going back to work for the first day after his bone marrow transplant. I'm so proud of him," right?

That's a wonderful cheerleading move and it reads like support to the person who's putting it out there. But if that's information that you didn't necessarily want to be public, that can feel a little uncomfortable. So, again, it's about really communicating out those decisions as well.

Managing your professional image online

15:44     I'm actually going to skip over this slide about building a professional online brand. But what I will say is that if you are interested and if you're somebody who is looking for work, and I know that we're seeing sort of increasing numbers of people who maybe are, given what's going on in the world right now, there are a lot of choices that you can make and steps that you can take to leverage your professional presence in the work that you're doing.

If you have been sharing your cancer story online and you maybe don't want that to be the thing that's at the top of your profile in case a current employer or a past employer is looking at your information online, there are ways to strategically develop your presence so, that things that you are comfortable having be really public are up there in front and center. You can reach out to us after this event. We can have conversations with you about that and point you towards some resources that we have built around building a professional online brand.

It may not be possible for a transplant survivor to fully resume work activities at the same level of intensity as in the past, when they first return to work.

16:44     So, getting back to the actual physical workplace. When you're considering returning to an existing job, there are a number of questions that you want to be asking yourself, right? We are going to talk a little bit later on in the presentation about those of you who may be looking for a new job because perhaps you no longer have the job that you did prior to going through your cancer journey, or perhaps you've decided that you're ready to make a career change. We hear about that a lot from people after they've experienced treatment.

But for the time being, as we talk about returning to an existing job, there are pros and cons to doing that. Probably the biggest pro is that it's a familiar landscape, right? Once we've worked someplace, we've had some time to figure out what the landscape is, what the culture and quirks of the organization are, who our colleagues are, what responsibilities are associated with our specific role. So, we kind of have this sense of how we can be successful at doing that. That's something that can really feel like it works in our favor if we're moving back to work after some time away.

But with that said, one of the biggest cons to going back to an existing job is this rather insidious "before" picture that often accompanies people after they've gone through something like a bone marrow transplant. Which is to say that we may find ourselves maybe not being able to move as quickly as we did previously, or perhaps there's some more trouble focusing, or we get tired. We get fatigued more easily. So, these things are all normal. But if we're not careful about monitoring them and taking care of ourselves, they can kind of get in the way and it can be very distressing. So, it's a good idea to remember that easing back into the routine is acceptable. It's a good approach to take.

Think about how you can be kind to yourself if you start to discover that maybe things are a little different now than they were, and don't assume that just because you're a little slower today, you're going to be slower, forever, right? We can build back up, people. We continue to evolve in our jobs for the entire time that we have them. So, be kind with yourself around any of those challenges.

We also hear stories from survivors who are concerned about colleagues who may see them as the cancer person in the office. They're concerned that that's always going to be their brand going forward, or that they're going to have to navigate a lot of comments and questions from the people that they work with about their cancer journey.

Typically, questions of this nature are very well intended. It's usually an effort to make a connection with somebody, but if you are not particularly interested in spending a lot of time talking about what's now behind you, it can be kind of stressful. So, what we recommend in these moments is an approach that we call the swivel. The swivel involves acknowledging the cancer-related comments that are made, and then putting a nice big end in the middle there, and then pivoting the conversation back around to a topic that you feel more comfortable discussing.

How to manage coworker’s questions after a stem cell transplant

20:17     So, we have two examples on this slide right here that we have heard come up very frequently across the years. The first is someone saying, "My uncle had cancer," or "Oh, my mother had that type of cancer." Again, it's usually an attempt to connect when somebody makes a comment like this. But if it's not something you want to discuss, you might respond by saying, "I'm sorry to hear that. That must have been very challenging. While I have you standing here, do you have a couple of minutes to talk about the meeting that we had yesterday? Because I had some thoughts and I'd actually love to bounce them off of you."

So, taking an approach like that to answer your question really allows you to kind of take back control in the conversation. People tend to follow through with responses based on where the other person has left off. So, when you swivel back to this discussion about work, you're kind of conditioning people to understand that "I'm not just my diagnosis, I'm also my job. I'm also so many things that make me who I am. That's what I would rather talk about right now." People tend to follow through.

Another example is this question, "How are you feeling?" which may on the face of it seemed like a pretty benign question, a pretty common one, but often you get cues from the person who's asking. You can tell that what they're saying is, "How are you feeling after all that you've gone through medically?", but you will always have the option not to answer that question. I think a lot of times, we hear from survivors who really feel like there's some sort of obligation to comment on that. There's not. If you don't feel like talking about the fact that you're still really fatigued all the time, you are perfectly entitled to answer that question however you want.

This example says, "You know what? I'm really excited to be back and I have a few questions about the new time card system." Maybe your response is, "Actually, I'm kind of hungry right now and was thinking about going over to the cafeteria. Would you like to have lunch with me?" And then just take the conversation from there. So, remembering that when you're hearing questions coming at you, even though they may sound like they're coming through a filter of asking about your cancer, it either is an option that exists for you to discuss whatever you feel more comfortable talking about.

This slide acknowledges the fact that sometimes there are comments that are well intended but don't land in a particularly comfortable way. This is another way that's sort of an adaptation of how we might use the swivels. So, if your boss were to say, "You've been looking really exhausted recently, I didn't want to overwhelm you by adding more work to your plate." This might be their attempt to try to feel like they're giving you a hand or helping you out, but maybe you want more work on your plate, right? We hear a lot about assumptions being made. This is in all areas of life that people make assumptions about who we are and what we're bringing to the table.

It's sometimes on us to say, "Actually, this was where I am, and this is how I'm feeling" to kind of clarify that point. It's not a rude thing to do to say, "I really appreciate your concern, but work is a key part of my overall well-being. I actually have some ideas that I'd like to share with you." So maybe that doesn't mean in this particular person's example that they get back that project that their boss assigned to somebody else, but it does send a message that I'm up first, I'm up for the challenge. I'm up for taking on more. Please don't make assumptions about what I can do. Let me tell you what I can do.

Similarly, we do hear about some insensitive comments that happened as well, usually coming from people who are uninformed about what cancer is or what a transplant is or what it means. So, again, on this slide, we see another example of a question that was probably well intended by the asker but may come across as insensitive with an example of how you might address. So, I'm not going to read this one out loud because it is kind of long. But it's a good model to look at to think about how you might frame an answer for yourself, what language you might come up with ahead of time in order to address any sort of questions that come your way that might make you feel uncomfortable.

Think about questions co-workers may ask you, in advance, and plan your answers.

24:49     I often encourage people who are returning to work ,if they're feeling nervous about the way that they might be approached by others in their workplace, to take some time to write down the questions or comments that they're concerned about being asked or have directed at them. To come up with potential responses that feel good to them, that feel natural to them that are easy to say, and that allow them to continue to communicate in a professional way without going down the path of accidentally sharing more information than they intended to, because we do hear about that too.

We do hear about people who get caught off guard by questions, and then find themselves kind of spilling information that they wish that they hadn't beforehand, but a little bit of preparation ahead of time thinking through it, kind of having those in the back of your mind can, first of all, help calm some anxiety that you might have about returning to work and also help you to actually be more prepared in the moment if questions come up.

Examples of reasonable accommodations in the workplace after cancer treatment.

25:53     So now we're going to move to talking about reasonable accommodations, which as I mentioned earlier, are one of the protections that might be available to people who qualify for protections under the Americans with Disabilities Act. So, what are reasonable accommodations? Well, they are modifications to your job, your schedule, or the environment that you work in that make it possible for you to perform your essential job duty.

I also want to point out here that reasonable accommodations may be available during the job search process. I'm not going to go into reasonable accommodations during the job search so much today, because we are talking about returning to work. Rather than kind of unpack what that definition in the first bullet point means, I'm going to give you a couple of examples because I think that that's often the best way to communicate what specifically we mean when we talk about modifications to a job or schedule or environment.

So, the first example comes from a woman who we worked with a number of years ago. She was a social worker. She was somebody who loved her job, incredibly passionate about her job. She was able to work during treatment. She was not required to be isolated during her treatment, but one of the side effects that she was feeling from the chemotherapy regimen that she was on was nausea. When she was at work specifically, she would experience incredibly debilitating nausea.

What was odd about this was she was not nauseous on the same level when she was at home in the evening. She also was not nauseous on the same level on the weekends when she was home during the same hours that she would have otherwise been at work. So, it was a bit of a mystery as to what was going on, clearly something related to the workplace.

We went back and forth with her. We asked her a number of questions and what we ultimately discovered was that her office was located right outside the cafeteria. So, all day while she was sitting in her office, smells of cooking food were wafting in through her door, and that was causing her to feel overly nauseated.

So, for her, the reasonable accommodation was just switch offices with a colleague who sat further away from the cafeteria. It's a relatively simple change, just a couple of hours, no money laid out by the employer. It obviously didn't take away all of the side effects that she was having as a result of being in active treatment, but it did help address that specific one and it made it possible for her to stay at the job that was so important to her and help her to cope with everything that was going on.

Our next example comes from a gentleman we worked with who was in the finance department of a large organization. His job involves printing out a lot of papers. He needed to have a lot of hard copies of things physically in hand in order to meet the essential functions of his job. Whomever had designed the office in which he worked had connected his computer to a printer that was two floors down from where he sat. So, every time he printed his document, he needed to go down two flights of stairs and then up two flights of stairs again to get back and forth to his desk.

One of the side effects that he found himself confronting was some extreme fatigue. So, it became more and more challenging to go up and down the stairs as the day went by. So, for him, the reasonable accommodation was for the workplace to purchase a printer to fit near his workstation, relatively inexpensive, a simple solution. It ended up saving time. It ended up saving energy and was a very simple fix that allowed him to continue doing a job that previously had been quite taxing.

So, as you're transitioning to work, what are some questions that you might ask yourself to help you identify some potential accommodations for your specific roles? Well, first, thinking about your schedule, right? Can you maybe work the same number of hours every week but at different times? So, if you know that you wake up in the morning and you feel really refreshed and productive, can you maximize the hours by shifting your 9:00 to 5:00 job to being a 7:00 to 3:00 PM job? So same number of hours, just taking advantage of the time that you feel better.

Can you do all or some of your work from home? This question was much more groundbreaking in 2019 than it is now, because I think so many of us are learning exactly during this pandemic, what we are able to do in terms of doing our jobs from home when maybe we didn't know previously. Thinking about moving to a different workstation, asking for special furniture, so it's not just Frank's printer, but maybe you have some ongoing back pain and so having an ergonomic chair would be something that's beneficial for you.

We worked with a woman who had, as a result of her treatment, she had developed a profound sensitivity to light. So, she needed an anti-glare screen for her computer monitor at work. She needed to sit away from windows because too much light coming in from the window made it hard for her to focus and she would get bad headaches throughout the day.

So again, really looking at the specifics of your job. If you work a job that has shifts, can you take more breaks to help manage fatigue? If you're a teacher and you have recess duty, but it would be more beneficial for you to have another period, can someone cover recess duty for you, etc, etc. So, it's really about looking at the practical needs of your job, and then kind of addressing where the challenge lies and figuring out how that can be solved.

Cancer survivors worry that prospective employers may treat them differently because of their cancer diagnosis. Studies confirm that in some cases, this is true.

32:12     So, we have about 10 more minutes before we're going to move to our question and answer period, maybe a little bit less. I do want to spend a little bit of time talking about job search for those of you who may find yourself in a situation where you're currently looking for work, or who think that maybe that is going to be something that you have to do in the future, or even if you don't.

Over the years, I've come across many people who thought that they were in a position where everything was going to be great. They really liked their supervisor. They really liked their colleagues. They thought that they were going to basically retire from the job that they were in and then their supervisor moves out. A new supervisor moves in, and suddenly it just becomes really intolerable to be in that job but they're not quite ready to retire. So, they find themselves looking for work when they hadn't before. Bottom line is this is just information that it's good to kind of have at hand and to know where to go and to dig into more should you find yourself in a situation where you're looking for work.

So, bullet points at the top of the page coming from that same survey discussed at the very beginning of the presentation that we did with Harris Poll back in 2019. Amongst cancer patients and survivors who were looking for work, we found that 49% felt that prospective employers might treat them differently if they were to share their cancer diagnosis. 31% felt that their diagnosis limited their job prospects and their ability to get hired, and 50% expressed at least some concern about getting hired if a potential employer found out about their diagnosis. So, really what that showed us was that that people think about looking for work differently once they've been through a cancer journey, which is completely understandable.

When we look at these two sides of the bottom of the page, these come from external studies from peer reviewed academic journals. There were some researchers who found that in a study with fake cover letters, employers expressed 26% less interest in candidates who disclosed a disability than candidates who did not. Researchers in a different study found that applicants who disclosed a cancer history received fewer callbacks for managers than applicants who did not disclose the cancer history. So, really, what those bottom studies show us is that some of the concerns that people are feeling about how a public disclosure and open disclosure of their cancer status might impact their job searches concerns are actually founded.

I will also say that I've certainly heard stories over the years from people who have disclosed their cancer status during a job interview because they were able to gauge that it was an okay thing to do. They were hired and it was not an issue, and that worked for them. So, I don't want to ever say that there is one way to do it, but it is something to consider. The disclosure piece is an important thing to consider if you are going to be looking for work.

When we think about the job search overall, one of the things that I think it's really important to emphasize, particularly if you are transitioning back after something that is so emotionally and physically challenging as a transplant, is that a job search comes with emotional challenges as well. Sometimes things feel very, very up. Sometimes things feel very, very down. What is true is that this experience is universal to job seekers from all different walks of life and all different backgrounds and all different age ranges and educational experiences and job experiences. Looking for work has challenges.

I think it's often the case that for people who are transitioning back into the workforce or continuing on in the workforce after cancer diagnosis to kind of hold themselves to a higher standard, to have a concern, to feel like somehow this is all happening because I got the cancer. So, this is kind of an extension of a string of bad luck, for lack of a better way to describe it. That's not necessarily the case. We can have very false perceptions of our job search.

Often, it's very easy to think, "This is never going to go well for me." And then two days later, there's a turn and things start going better again. So, knowing how to manage those down moments is very important. Being strategic in terms of thinking about how to look for opportunities and carry out the search itself are all very important.

Again, as we were discussing on that last slide, considering what you reveal and when are important, just like when you build any relationship. So, maybe you don't disclose a cancer diagnosis when you are sending in a cover letter or on a resume, because that's just a piece of paper. If it's really important to share that this piece of your life and who you are and what makes you, it's very important for you to share that with a prospective employer which we often hear from people that it is important to them, what we recommend is that you maybe think about sharing that information once you've had at least one in-person interview.

So that the hiring managers can get a full sense of who you are as a human and what you're bringing to the table beyond just what you can capture on a piece of paper, because personality and culture and fit factor so much into hiring decisions. Those things just don't always come through on a resume or in a cover letter particularly for somebody who maybe has a big stack of resumes and cover letters that they're trying to get through. So, that in-person conversation can really be a game changer.

Only a small percentage of job seekers find employment through job boards. Networking with others to find a job is a more effective strategy.

38:33     Now, the top takeaway from this slide is really to emphasize that it is only a small percentage of job seekers who find employment through job boards. So, if you are somebody who has been looking for work and has been sending out 50 resumes a week and you aren't hearing anything back, when someone comes to me and tells me that that's the experience that they're having, my first question is "Where are you finding these 50 jobs a week that you're sending your resume to?" It is almost always the case that they're finding them exclusively online.

Job boards are great for research. They're great for articles and surveys. They're great for helping you think about what kind of roles you might want to take on at some point. But when it comes to actually finding opportunities to getting a job, we find that networking... Again, this is various studies that have been done. A number of the career coaches that we work with have all bring up the statistic that about 85% of job opportunities are found through networking.

Networking is something that I think a lot of people often find intimidating. They think that maybe they don't have such a large network of people, that people tend to limit themselves to thinking that someone that they worked with previously or someone that they went to school with. Those are the folks that comprise a professional network, but the reality is that anyone can be part of your network. Usually, when I'm doing this presentation in a room full of live people, I'll say look to your left, look to your right, the people next to you could all be part of your network.

Again, these are some sort of pre-pandemic examples, but that person that you stand behind in Starbucks every day could be the person who has the next potential job opportunity for you. Maybe it's people in your religious community that you want to be having conversations with about the fact that you're seeking work, that you're looking for something new and what that is and do they know anybody. The world moves on connections like these.

So, networking is really about being open to and putting yourself out there to say, "Hey, I'm looking for opportunities, do you know of anything?" and then being open to being reciprocal as well. Saying back to people, "Well, if there's anything that I can ever do for you," or "Keep me posted." Just kind of making it an ongoing conversation rather than thinking of it as something that is super formal and challenging.

LinkedIn can be an effective online tool for finding employment opportunities.

41:09     Most are going to put a plug in for LinkedIn, which is an online networking platform, professional networking platform, similar to Facebook but specifically for professional networking. The link at the bottom of the slide is to a webinar that we did at Cancer and Careers on building an effective LinkedIn profile. It is archived on our website. So, if you're interested in learning more about how to network through LinkedIn, you can go and check that out.

Cancer and Careers has a free resume review service to help people write an effective resume

41:37     I'm not going to spend a ton of time talking about writing resumes, because there are so many resources out there, but I did want you guys to have this slide as part of your handout to have some basic general tips on writing a resume. I will also mention that Cancer and Careers has a free resume review service where you can upload a copy of your paperwork. We will pass it along to professional career coach and she will take a look at it. She will give you some personalized feedback on how to get your resume into the best fighting shape for your circumstances and your background and what you're looking for. It's a really great program and I encourage anyone who is thinking about looking for work or actually looking to take advantage of it.

How to address gaps in employment, due to cancer, on a resume

42:24     I apologize. I forgot that this slide is in here and I spoke to it earlier, disclosure on your resume or cover letter or during an interview. We obviously covered the fact that it's much more preferable to make disclosures once you've met someone in-person. While we're on the topic of in-person conversation, we often get asked about "How do I address an employment gap if I have one? If it's on my resume and it comes up in an interview, somebody asked me about it." So, there are a couple of approaches that you can take.

In advance of an interview, you're concerned that this is something that you might get asked about. We encourage people to fill the gap with educational activities, join professional development courses or doing some volunteer work. So, that it gives you something to talk about. So, that if somebody says, "What were you during, during this gap in your resume?", you can say, "Well, I was doing X, Y, and Z thing to continue to stay engaged with my professional space or to stay engaged with my community and making sure I was out and part of the world."

It allows you to be able to have a dialogue rather than kind of staying focused on this, "Well, I wasn't well, so I wasn't working." Volunteer work can often be done remotely. It can often be done for an hour or two a week, but you can still talk about the things that you learned during that work as a way to fill in the gaps.

How to steer the conversation during interviews to showcase your strengths.

43:51     Similarly, mastering swivel for interviews is a really important thing to do, because you want to drive the attention of the interviewer back to what makes you a great candidate. So, going back to that example of volunteering again, let's say that you were mentoring young kids online that maybe you were tutoring during that time.

You're an accountant, and perhaps that you were doing some math tutoring volunteer work. You might say, "Well, I had to step back from my job because of some things that were going on in my family, but I took that opportunity to give back to my community and work with young children. Here's what I learned about mentoring. I noticed that you have an intern program here. Can you tell me more about that?"

So it's all about coming up with creative ways to address that particular question and drive it back to the point that you are a qualified candidate, that you're interested in doing the job, because that's really what the interviewers want to hear during these conversations.

Again, here's some more examples. I'm not going to walk through all of these swivels, but I will say that in both of these cases, you will notice that the word cancer, the word transplant are not anywhere in the responses, right? They've said, "Can you tell me what you were doing?" "Well, I was dealing with a family issue that's resolved." "I realized that what I was doing didn't fulfill me," because that might be true. Maybe you got a cancer diagnosis and you had to leave your job, so that you could go through the treatment that you needed to have in order to have a good outcome. But it could also have been true that your job didn't fulfill you and so you wanted to take a step back and reevaluate, right?

There are so many facets to what makes us. In interviews, we want to be talking about why we're the best candidate for a job. Just like when we go back to a workplace if we don't want to talk about the cancer experience that we've just left behind, we can talk about what we're bringing to the table as an employee, as a human, as a well-rounded individual with lots to offer in the world.

Carefully research prospective employers for past history regarding discrimination and whether they have a good health insurance plan.

45:54     Actually, more swiveling examples. Again, I encourage you to download the slides. Researching an employer is always important when preparing for an interview process as well. Again, it can be used to offset any anxiety someone might be having about potentially, maybe you've been discriminated against to the past job and you want to make sure that you're not working for an employer where that you might be at risk at that again. Well, you could Google to see if that employer has any history of discrimination lawsuits as a way to help kind of offset that concern that you're having.

Finding out whether or not they have a good health insurance plan. Probably not a question that you want to ask an interviewer in real time, but maybe if you've networked into the job, you can ask the person who helped you get that interview and they'll have some good advice to give. So, important to research an interviewer.

46:48     And then I think the key takeaway for people to remember when they are starting work with a new employer is that well, it can take some time to reintegrate into a work environment or to integrate for the first time into a work environment that's new. So, you don't fully know what the requirements of the job are, and you don't fully know who your co-workers are and who your colleagues are, how it's going to get by, is that employers hire the people that they think are going to be successful and the people that they believe in. So, they want to support you.

So if there are challenges that you're facing, things that are taking you time to learn or questions that you have, ask them, reach out for help, look for that support, because really employers for the most part are invested in watching their people succeed, not interested in watching them struggle.

If, what and when to disclose information to an employer about a prior cancer diagnosis is a personal choice and may evolve over time.

47:41     And then the point that I'm going to leave you on before we move over to Q&A is just to remember again, that disclosure is a spectrum. That it is up to you to decide if you're going to disclose information about what you've been through medically, how you're going to disclose it, when you're going to disclose it, how much of your story you're going to share because it is not required for you to share information in your workplace. The amount that you disclose may evolve over time. So, consider whether how you feel about maybe you do want to share everything up front, but if you don't, that is fine. You can always share more later.

And then again, consider timing and circumstances, etc, before you start a conversation. So, specifically for this presentation, we talked about timing in the job search, but of course, opening up the idea that that might be relevant for those of you returning to work as well. When do you want to have conversations? How do you want to have conversations and in what way? So, a little foresight can go a long way. I encourage you to ask any questions that you might have about disclosure right now, and then you can also reach out to us after this event as well.

So, I'm going to skip the resource slides that I included in here, because you can go back and take a look at them, but that is my contact information, our contact information at Cancer and Careers. If you do have any questions going forward after today, please do feel free to reach out and we'll see that we get you some responses, but I think we've got time for a few right now.

Question and Answer Session

49:19     [Moderator] We absolutely do. Thank you, Ms. Becker. That was an excellent presentation with a lot of great information, and we have a number of questions here. First is, "Is working from home a reasonable accommodation if a parent has a child with a cancer diagnosis during this time of COVID? The employer has the ability to accommodate work from home."

49:45     [Ms. Becker] So, that is an excellent question. It is one that I'm going to start by saying you definitely want to talk to a legal expert about your specific circumstance and what you legally may or may not be entitled to particularly, because caregivers have different access to protections than the people with a diagnosis themselves. I'm going to be very frank with you because I don't want to give you the wrong information. I don't know if it would be considered a reasonable accommodation under the ADA for a caregiver specifically, but this actually brings up a very important point.

Just because you wouldn't necessarily have access under the ADA, it doesn't mean that your employer would not be willing to accommodate you anyway. This is not just for caregivers. This is for patients and survivors themselves who maybe work for a company that has fewer than 15 employees or whatever the case might be. That means that they don't qualify for an ADA protected specifically, often, employers will accommodate just because it's the right thing to do and they want to keep good employees.

So, it's not necessarily that they're getting an accommodation under the law. They're just getting an accommodation because to your point that you made in the question, it's possible. The employer can accommodate, and so they want to do the right thing. So, worth asking the question. If you want to know specifically if it's an ADA entitlement, definitely reach out to a legal expert about that.

51:26     [Moderator] Thank you. Our next question is, "I am three years out and on long-term disability for my job. My company is sold, and I am not sure I can return to work full time ever again. I don't understand my rights regarding the long-term insurance I have. What is the rule for part time and knowing I may not work full time again? Mostly concerned about my medical coverage as I have Ocular GVHD."

Yeah, so again, another really, really wonderful and important question to be asking, and another one that because I'm not an attorney, it's outside of my purview. So, I don't want to give the wrong information here, but I will shift back to this resource slide that I didn't speak to directly when we were going through but we've got some resources and also here as well. Here are the legal assistance resources.

So, these are some free legal resources that you can reach out to get some more information specifically about long term insurance and disability insurance and how that may or may not apply in your situation. I also encourage reaching out to Triage Cancer, which is the organization listed on this slide as they have a lot of really valuable legal information available as well.

52:47     [Moderator] Thank you. "I am six years out from transplant, and I've been dealing with cancer since 2010. I had posted on social media back then but haven't posted in the past three to four years. Do I need to go back and scrub my social media pages like Facebook?"

53:08     [Ms. Becker] So, that's a great question. So, first of all, I'm going to say that there is no need with social media at all, right? This is all a personal choice. There are people that I have met over the years who have been very public about their survivorship on Facebook, and they are completely comfortable with anyone who might want to talk about it with them, including potential employers. They are not concerned if it means that they don't get a job because somebody saw on social media that they have a cancer history and they don't want to hire them because of that.

For some people, it doesn't matter and they're completely comfortable being out. So, it's never about need. It's about how you feel. If you have concerns about somebody finding this information, it might not hurt to go back and delete it. But given how long it's been since you've posted that information, I would guess... Again, this is going to depend on how active you are on social media. But I would guess that's not going to come up at the top of your profile on Facebook, right? The things that I posted about 12 years ago, someone's going to have to go deep into my profile to find those.

So, most employers who are looking aren't going to take the time to scroll back through 10 years of posting in order to learn more about who you are. They're going to want to see what you've been posting about recently. So, one of the things that we talked about in terms of building a professional online brand is posting about things that you would want an employer to see, that you think is going to represent you well and catch their attention. Because those are the things that they're going to be looking to inform them about who you are.

So, my answer is kind of it depends. If you feel that you really want to get rid of those posting, so they're not up there and that's going to make you feel more comfortable, fully support it. If you feel that you have enough postings that they're up there and that there's more to it that's going to draw somebody's eye, or that you're comfortable saying, "Yeah, I had it, but it was 10 years ago," saying in an interview, "This was 10 years ago and now there's so much more that I want to talk about," that is also an approach you can take. So, there's never a should, but you certainly could.

55:33     [Moderator] Thank you. Next question, "What standing does an employee have if reasonable accommodation is available? For example, private office to work in away from an open office plan. The employer says no to the request."

55:50     [Ms. Becker] Okay, so this is a great question. Again, I'm going to encourage you to go to legal resources for a more in-depth answer to this question. But the kind of overview that I will give you knowing what I know about the law, and again, I'm not an attorney, is that employers are not supposed to say no and then end the conversation. There is supposed to be a back and forth discussion about what's going to work for both of you.

So, if you asked for, I think an office was one of the requests and the employer says, "Well, we don't have an office right now," they're supposed to come back with another solution that might work. So, maybe they say, "Well, we don't have an office, but we could let you work from home," right? So, they're not supposed to just say no, but again, I encourage you to go to legal resources for more information on what specifically this back and forth process is supposed to look like.

I don't know if this question is coming from a place of having an employer repeatedly saying no to your request, which may be more complicated, and you may need to take legal action for. But again, I don't know if that's the case. I don't know the full details of where you're coming from with all of this. So, it might be a good idea to reach out to a legal expert if you feel like you've been having some direct struggles with an employer around this issue.

57:22     [Moderator] Okay, and this is going to be our last question. We're getting short on time. "What do I do if I go back to work and then get sick again?"

57:34     [Ms. Becker] So, yeah. So, I think that that's a question that a lot of people have when they're returning to work, and it's an understandable one to have anxiety around. With that said, I would encourage you to think back on what did you do when you first got a diagnosis? How did you think about it and how did you approach it and what works for you?

Obviously, if you've taken time away and you're concerned that you might need to take more time away, that's a specific piece of the puzzle that's going to be a little different than when you first got the diagnosis. But I would encourage you to think about the specifics of the situation and ask your medical team questions and figure out if it's going to be possible for you to work during all or part of treatment. Figure out what entitlements you might still have through your job, in terms of available time off or FMLA or anything like that, if that is something that's going to be needed. Think about how you may want to have conversations with your employer if necessary.

Again, I think it's a very understandable concern to have and a very understandable concern to potentially have anxiety about. I don't want to assume that you have anxiety. We can't have a back and forth conversation right now, so I don't know how you're feeling. But if you are, all of that is completely understandable, but I would also encourage you to remember that we can't know how to handle circumstances until they present themselves to us. So, kind of the big overarching piece of advice that I would give here is if that happens, reach out to us. We can have a conversation about decision making and steps to take and places to go for more information and how to think about what you can actively do.

I'll also say that we have a webinar that's archived on our website that's called Disclosure, Privacy and Online Brand, but it walks through some of the key considerations in detail to think about if you're thinking through how to make decisions about work and cancer. We're also going to be doing a webinar later this year on newly diagnosed patients, which is going to talk about again some of those details, and I recognize that this question is about if it happens again.

Those are specific resources that we've come up with that kind of provide some information that could also be applied in this situation where you're talking about a second diagnosis. Again, you can always reach out to us. I'm going to go back to my contact information again, so that you all have that if you want to follow up with any questions.

01:00:34 [Moderator] Well, thank you so much, Ms. Becker. On behalf of BMT InfoNet and our partners, I want to thank you for your very helpful remarks and thank you, the audience, for your excellent questions.