Cancer Discrimination

A little-noticed survey in a small medical journal may have big implications for cancer survivors.

Dr. Donna Stewart and colleagues from the University of Toronto surveyed 378 breast cancer survivors who had finished treatment and been cancer-free for at least two years. Writing in the journal Psycho-Oncology, they noted that nearly a quarter of the women faced difficulties in their work relationships after they disclosed their cancer history.

The researchers cited lingering misperceptions that cancer may be contagious or that cancer survivors are not as productive as other employees. (Both untrue.) More than 40 percent of the women said that their cancer had altered their priorities or progress at work. Many reported difficulties with insurance issues.

In general, the survey found that about two-thirds of the women disclosed their illness to friends, and about half told their co-workers, supervisors or bosses. Women who did not disclose their medical history gave reasons ranging from not wanting to make others uncomfortable, to fears that it would sidetrack their careers.

Communication is Key

Revolutionary advances in cancer treatments are resulting in thousands-if not millions-more cancer survivors who are living longer, healthier and extremely fulfilling lives. And if they were working before their diagnosis, 80 percent returned to work after their treatment ended.

It is important to realize that many people still misunderstand cancer, especially if the disease has not directly touched someone close to them. Therefore, in the beginning you may have to take some time to simply talk with your coworkers about your illness and recovery. If you need help, ask your manager or someone in human resources for assistance. Your company may even be able to sponsor an educational program, make literature available, or have discussions at staff or union meetings.

If you work for a larger company, chances are there will be other cancer survivors who are employed with you. You may want to consider forming a workplace cancer support group to discuss cancer- and job-related issues. If you feel that you are being treated unfairly because of your cancer, there should be administrative remedies that you can take within the company. If these are not satisfactory, there are legal avenues that you can pursue as well.

The Americans with Disabilities Act

On July 26, 1992, the employment provisions of the Americans with Disabilities Act (ADA) went into effect. The ADA bans discrimination by both private and public employers against qualified workers who have a current disability or a history of disability. The definition of a disability under the ADA is a physical or mental impairment that substantially limits one or more of the major life activities of an individual.

While the ADA does not specifically mention cancer survivors, past legal rulings have effectively granted them equal protection under the legislation. It is estimated that from 2 - 3 percent of the charges filed and resolved under the ADA have been related to individuals with cancer.

The ADA applies to companies with 15 or more workers. Some of the more important provisions include:

• Employers cannot discriminate in recruitment, training, job assignments, tenure, promotion, and other employment-related areas based on a disability.
• Employers cannot require you to take pre-employment exams designed to screen out people with disabilities such as a history of cancer.
• Employers can only ask you medical questions after you are offered employment, and only if the questions are specifically related to the job.

However, the ADA does not unconditionally protect a person's job just because they have a disability. For example, an employer can still terminate an employee with a disability for legitimate business reasons such as a company-wide or departmental downsizing.

If you want additional information about the Americans with Disabilities Act, the U.S. Department of Justice has established a toll-free hotline at 1-800-514-0301.

Other Protections

The Federal Rehabilitation Act of 1973 also provides protection against disability discrimination. It mandates that federal employers or companies receiving federal funds cannot discriminate against handicapped workers, including cancer survivors. This law protects cancer survivors in hiring practices, promotions, transfers, and layoffs at the federal level.

In August 1993, the Family and Medical Leave Act became federal law. It protects the job security of workers who must take a leave of absence to care for a seriously ill family member or because of their own medical condition. (It also provides for the birth of a child or placement of a child into foster care or adoption.) An employee must have worked 25 hours per week for one year to be covered.

SOURCES:
Psycho-Oncology, May/June 2001; 10:259-263
The National Cancer Institute (http://www.nci.nih.gov)
The American Cancer Society (http://www.cancer.org)

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