Supporting Cancer Survivors at Work: We're There When You Need Us

The May 2010 theme of Oncology Nursing Month is “Oncology Nurses: There When You Need Us.” We are certainly there for our patients throughout all phases of the cancer experience, by providing clinical care, support, education, and practical guidance not only during the difficult periods of treatment but also throughout the survivorship phase.

In the current issue of ONCOLOGY Nurse Edition, Barbara Hoffman discusses an important practical concern that causes many cancer patients and survivors considerable worry: the fear of employment and workplace discrimination. She addresses in her comprehensive article the ways that legal protections for cancer survivors in the workplace have evolved since the Americans with Disabilities Act (ADA) was passed by Congress in 1990, and highlights benefits and potential implications of the ADA Amendments Act of 2008 (ADAAA), which went into effect in January 2009. As Hoffman notes, and as Victoria Thomas and Arnold Potosky underscore in their excellent commentary, healthcare providers seeking to support and protect their cancer patients in the workplace have until recently been faced with a dilemma: Following a 1999 US Supreme Court decision, Sutton v United Airlines, Inc., the definition of a disability was considerably narrowed and the ruling stated that a court must consider whether an individual used mitigating measures, such as taking medication, in determining whether he or she had a disability.

The result was that a court could find a patient whose cancer was in remission because of successful treatment not to be disabled despite the existence of long-term side effects such as fatigue and cognitive dysfunction.

Before the ADA Amendments Act of 2008, Thomas and Potosky explain, “medical experts who testified regarding whether a person's cancer qualified as a disability under the law were often placed in the difficult position of establishing two possibly conflicting facts: first, that a cancer survivor was sick enough to meet a very demanding standard of disability, and second, that the person was not too sick to do his or her job.”

The ADA Amendments Act, which eliminates the mitigating measures requirement, provides a specific definition of “major life activity” and expands the list of major life activities to include bodily functions that are commonly affected by cancer treatment, such as digestive, neurologic, and respiratory functions.

Since oncology nurses are the cornerstone of cancer patient education and support, it is an important responsibility that we educate ourselves about employment rights so that we can educate, counsel, and assist our patients regarding return to work and workplace accommondation issues. To help us, Thomas and Potosky outline strategies that we as healthcare providers can use to help our patients with cancer receive fair treatment in the workplace.

As Brad Zebrack notes in this issue, “job lock,” or staying in a job only for the insurance benefits, has always been common among cancer survivors but is even more prevalent today. “Attending to the employment rights of cancer survivors,” he writes, “is an important step toward protecting their current and future health and well-being.” This is perhaps more true than ever. We can help and there are 12 million cancer survivors depending on us.