More than half of unemployed cancer survivors looking for work worry that prospective employers would treat them differently if they knew about their cancer, according to a new online survey.

The Harris Poll, which conducted the survey for Cancer and Careers, an organization that provides assistance to people working during and after cancer treatment, questioned 201 cancer survivors, aged 18 years and older, who were unemployed and looking for work. The interviews were conducted between November 2013 and February 2014.

Sixty-one percent of respondents said they were at least somewhat concerned potential employers would find out about their cancer diagnoses and therefore not hire them.

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While the survey found that financial necessity is the driving factor behind most cancer survivors’ desire to return to work, about four in ten said they feel well enough to work. More than a third of respondents want to maintain a sense of normalcy in their lives. About 30 percent of survey participants said they want to feel productive, and 30 percent want to continue their career paths.

The survey also found that 83 percent of respondents agree that cancer survivors who receive support from employers are more likely to thrive in the workplace. More than three-quarters (77 percent) stated that work provides a routine that aids recovery and treatment; and two-thirds mentioned that working provides a sense of purpose and identity.

Seven in ten respondents said addressing the more practical issues of balancing cancer and work is essential. Sixty-six percent indicated that people surviving cancer need more information, tools, and support on how to balance their health and work life.

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Rebecca Nellis, vice president of programs and strategy at Cancer and Careers, told Healthline that this is the second survey of its kind and although respondents in both surveys indicated that they need to work because of financial and/or health insurance needs, they also indicated finding work was important because, “it makes them feel normal, or they felt well enough to work, or they didn’t feel like themselves when they weren’t working.”

Nellis added, “When we overlook the larger role that work plays, we do a disservice to people going through this.”

Sergei German, who has lymphoma, continues to work at a bank, where he was employed prior to his diagnosis.

Pointing out that he is undergoing an experimental treatment in a clinical trial, German said he doesn’t have too many side effects that affect his ability to work. “I talked to my boss and told him what happened. He was gracious and he scheduled my work to accommodate me,” said German.

German continued, “It doesn’t really matter whether you have cancer or not; there are things that have to be done at work. Having cancer is like having another full-time job because you have to care about yourself, your diet, and you have to exercise. It takes an effort and a toll on everything else that you do, but it is not an excuse to underperform. You have to work hard.”

When queried what advice he has for cancer survivors, German said, “If you are looking for a job, you should not disclose your medical condition. It’s illegal to ask people about their medical history. If you have a good relationship with your managers let them know while you are at work. It’s better to be open. They have a right to know why you are absent. Sometimes you have to have treatment, a test, or do blood work, and that has to be done in the morning or during your lunch break. You don’t have to overburden them with details. More often than not, people understand.”

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Having to explain a gap on their resume in a job interview is one of cancer survivors’ greatest fears, according to Nellis. “They fear it will force them to reveal their health history or stories, whether they want to share that or not. They fear that if they did share it, they would be less likely to be considered for or given the job because of their cancer diagnosis,” said Nellis.

Nellis went on to say, whether cancer survivors need to find a job or they have an existing job, it’s important for them to know how they can strategically work with their healthcare team and their employer to come up with a plan that allows them to work and go for treatment.

“For some people, one of the things we have seen be successful is talking to the healthcare team about what their work demands are, what the side effects of their treatment are likely to be, and scheduling treatment in a way that helps support their desire to be at work,” said Nellis.

If a person is on a treatment protocol where they are likely to feel sick immediately after getting their treatment, having treatment on a Friday so they have the weekend to recover can be very helpful. “Often we find patients are a little nervous about asking their doctor about scheduling, because they feel if the doctor says, we’ll see you at 2 o’clock for the next six weeks, for some reason it has to be that. Maybe it does; but we encourage a dialogue as to why Friday at 2 pm would be better for them,” said Nellis.

Pointing out that some people prefer to never disclose their diagnosis to people at work, Nellis said,“Then there are people, who couldn’t imagine going through a day and not having their workplace know what is going on with them. If someone wants to utilize the Americans with Disabilities Act (ADA), they need to be eligible, and as with any law, there are some hoops to go through. One of those pieces is disclosing at least enough information at work for them to understand why they would be protected by the ADA, and in doing that the ADA offers job accommodations or modifications.”

Teaching healthcare professionals, patients, and employers about the laws that protect people in these cases, helps them use these laws in a positive way. “We consider laws as tools in the arsenal of all of those people, to be able to make the workplace more manageable during cancer treatment and recovery,” Nellis said.

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Pointing out that supervisors can become real advocates in the company to help support someone who has cancer, Nellis said, “They get creative, and teams get really involved in helping to support their colleague. It’s good for morale because it suggests that if this happens to you or your family, the company would similarly rally behind you.”

Nellis is also seeing some employers making accommodations to help their employees who are cancer survivors. “We know a woman who was nauseous every day. Her office was next to the cafeteria. Her reasonable accommodation at work was that her office was moved,” said Nellis.

There are also some employers who have policies that encourage employees to donate leave time and vacation pools, so employees who are ill can draw on their colleagues’ time off when they need to go for their tests or treatments.

Nellis said it is important for cancer survivors to be prepared for their interview, as any job seeker should. “We tell them to practice their responses and to have a good capacity to redirect the conversation toward the fruitful skill sets they bring to the table. It’s about empowering them to be able to go out and sell themselves after a very emotional, scary, and physically draining experience like cancer.”

Nellis said cancer survivors should understand that everyone is experiencing a “power balance in an interview,” whether or not they have cancer. “I want them to be more strategic; not just as every person with a health issue, but more strategic than every other person going out on an interview. Interviews are hard and they certainly have some additional challenges, especially when it comes to an employment gap, and that’s a huge stressor for them.”

Nellis advised job applicants to be diligent in preparing cover letters, resumes, prepping for interviews, researching companies, and knowing their Google and Bing imprint. “Then employers will hopefully be responsive to what they are bringing to the table, and it won’t be focused on their health.”

According to a study by the Centers for Disease Control and Prevention (CDC), published in the CDC’s recent Morbidity and Mortality Weekly Report, U.S. cancer survivors face significant economic burdens due to growing medical costs, missed work, and reduced productivity,

Researchers analyzed data from the Agency for Healthcare Research and Quality’s 2008 to 2011 Medical Expenditure Panel Survey to estimate annual medical costs and productivity losses among male and female cancer survivors, aged 18 years and older, and among persons without a cancer diagnosis.

From 2008 to 2011, male cancer survivors had annual medical costs of more than $8,000 per person, and productivity losses of $3,700, compared to males without a history of cancer at $3,900 and $2,300, respectively. During the same time, female cancer survivors had $8,400 in annual medical costs per person and $4,000 in productivity losses compared to females without a history of cancer at $5,100 and $2,700, respectively.

Donatus U. Ekwueme, Ph.D., a senior health economist at the CDC’s Division of Cancer Prevention and Control, said in a press statement, “Cancer survivors face physical, emotional, psychosocial, employment, and financial challenges as a result of their cancer diagnosis and treatment. With the number of cancer survivors expected to increase by more than 30 percent in the next decade, to 18 million Americans, medical and public health professionals must be diligent in their efforts to help reduce the burden of cancer on survivors and their families.”