When someone is diagnosed with cancer, they often think of two subsets of people first: their friends and their family. It isn’t until later that they realize they also have to tell their place of employment about their recent diagnosis as well.

In some cases of illness or surgery, telling your place of employment is avoidable. It’s possible to take a sick day, schedule an appointment and be done with it. When it comes to cancer, more often than not it’s unavoidable. It would be a constant elephant in the room — cancer patients going through treatment usually go through a drastic change in appearance, from losing weight to losing their hair.

Cancer patients going through chemo must also come to terms with the fact that their health is likely going to fail. Chemotherapy can really take the wind out of a person, and while patients are told to exercise and continue to live life as normally as possible, sometimes work doesn’t fit into that equation. Thus, cancer patients will eventually have to discuss a leave of absence with their boss or talk about how they may be gone more than usual as a heads up.

Coworkers will also notice these changes, and cancer patients can either tell them or choose to keep their medical issues private. How they handle these things — how you may handle these things — is up to the patient. We have some advice for how to start conversations, when to tell and what may happen after they find out.

Talking to a Boss

Depending on the patient’s relationship with their boss, the process of discussing a cancer diagnosis with them can be very clinical or much more personal. Those with closer relationships to their employer can find that the emotional investment is much more present, while employers that have a strictly business relationship will keep things professional.

In any case, the most important thing that the boss in question needs to know about is the treatment plan in order to discuss any absences and to explain why the employee may be gone so frequently. It’s important to also discuss the severity of the cancer in the context of how long this may take — is it not so serious and only requires a few rounds of chemo? Or is it terminal?

During this conversation it’s also important to discuss changes that you may have to make with regards to work schedule or capabilities. For instance, a part time worker in a grocery store who is diagnosed with cancer may request to be moved from stocking to register work because lifting and moving boxes can become too strenuous.

It may also be wise to keep a record of any conversations had with an employer. Bosses are not allowed to discriminate against cancer patients as required by federal law. If an employer is potentially discriminating against a cancer patient, this is illegal and human resources or a legal counsel should be contacted ASAP. Keeping evidence can help support any discrimination claims that may pop up.

Talking to Coworkers

Coworkers are a different breed altogether. Many employees often have a more personal relationship with the people that work around them, which makes their empathy and potential insensitivity all the more important.

Telling coworkers can be like telling friends in that it’s more honest and casual — it focuses more on the experience and not the clinical outlook. It’s still important to tell coworkers in order to ask for their potential help, but the relationship is likely to be much more focused on emotional support.

Some coworkers don’t know how to handle a cancer diagnosis in the most productive ways. Some get too upset or overly invested in the diagnosis, often infantilizing a cancer patient to the point of offensiveness. Others will forget themselves or don’t want to treat the patient differently. It’s important to keep the human connection the same, but some changes do need to be made. For instance, there’s no a heightened sense of importance when it comes to things like cleanliness or fatigue.

In the case that a cancer patient is uncomfortable in any way with what a coworker is doing, regardless of whether their heart is in the right place, it’s important that they start a dialogue with said coworker. In fact, setting up an impromptu meeting to discuss how they want their diagnosis to be handled isn’t a bad idea. This idea can be quickly run by a boss so they can sit in if they wish.

Cancer isn’t a death sentence in many cases, and a large number of patients continue to work through parts of their treatment. If you’re a cancer patient who is going to work during treatment, don’t be afraid. Just be communicative and aware.