Should You Tell?

Deciding whether to tell — and whom to tell — is an intensely personal decision. You might feel it is essential to disclose your diagnosis, whether because of personal preference or because you run your own business. Alternatively, you may believe privacy is critical and that, aside from family and close friends, no one is entitled to information regarding your health.

Some things to think about as you weigh your options are: What treatment side effects are you likely to experience? How might the law work in your favor? And what is your work environment like?

Consider the Side Effects

In some cases, cancer and the method of treatment can cause side effects such as fatigue, chemo brain and discomfort, all of which can affect productivity levels, making it difficult to perform your essential job duties. Changes in productivity and/or appearance, as well as any extended absences, may give your boss and/or coworkers reason for concern. These factors may also cause you to think about whether any modifications or adjustments can be made to your job responsibilities or work environment that will help you feel more comfortable and be more productive and effective.

Consider the Law

In order to request a reasonable accommodation or medical leave, you may have to disclose a medical condition — though not necessarily an exact diagnosis. On the other hand, if you are not seeking protections provided under a state or federal law, such as a reasonable accommodation, time off or discrimination protection, you are generally not required to disclose any information about your health to your employer.

Consider the Culture

The kind of environment you work in could be a determining factor when deciding whether to disclose your diagnosis to your employer and/or coworkers. To get a clear sense of your workplace culture and how you fit in there, ask yourself the following:

• Is your company big and/or formal? Is it the kind of place where everyone keeps to themselves? Or is it small, close-knit and friendly?
• What are the different kinds of relationships you have with individual coworkers?
• Is there anyone you feel you can trust with both personal and professional matters?
• Has someone else at work had cancer? If so, how was it handled?
• In general, how do people react when they hear that a coworker is ill or dealing with another serious event? Do they resent having to “pick up the slack” or do they rally to support their team member?

Answering these questions can help you predict how your news might be received. It may also help you decide whom to tell — and how. Although it might sound cliché, this is a situation in which you really need to trust your instincts, because you know your work environment better than anyone.

Whom to Tell

If you decide to disclose information about your diagnosis, the next thing you need to determine is who really needs to know. Then, start by talking to those people with whom you're the most comfortable or who will be most essential in creating a workable solution.

Your Supervisor

Telling your boss can be challenging, but doing so can prove very beneficial in the long run, because generally the Americans with Disabilities Act (ADA) protects you only if you’ve made your employer aware of a medical condition. In other words, what your boss doesn’t know could wind up hurting you.

You may be pleasantly surprised by the reaction you get. A boss can turn out to be far more than just a supervisor — he/she can be a source of hope and encouragement and potentially act as a necessary advocate.

Your manager may have to share your diagnosis with his/her supervisor or with HR in order to make sure you have access to all legal benefits, company policies, etc. However, if you would rather that your information not be shared beyond these parties, be sure to communicate this.

For more help in approaching your supervisor, check out Cancer & Career's Manager’s Kit.

Management/Human Resources

Your boss may not be the only member of management who needs to know — especially if you are part of the management team. Because your supervisor may have to share information with management or anyone who will be affected, if you have good relationships with those managers, you might find it in your best interest to tell them yourself.

You may also want to talk directly to your human resources department — if your company has one — as they will have considerable information about company policies. They may also have experience dealing with other employees who are cancer survivors or who have had serious health conditions, in which case they may be able to offer valuable advice on how to tell people and what to expect.

Your Coworkers

Should you tell them? And if so, which ones? It’s impossible to provide guidelines that apply to everyone. The answer really depends on your company culture and the relationships you have with your coworkers (See “Consider the Culture,” on Cancer & Career's Should You Tell page.)

What to Do When You Are the Employer

If you are one of the thousands of people who own their own business, you obviously don’t have to tell the boss. However, there is the equally difficult decision to be made about whether to tell your employees, which may be complicated by the fact that it’s not merely a personal issue — rather, it’s something that affects the morale and well-being of your company.

Even if you would like to keep quiet and avoid worrying your staff, look at the corporate culture you’ve worked so hard to create and consider how your treatment will fit into that environment. Think closely about how your absences or any changes in your appearance may affect your employees.

If you are regularly out of the office, drumming up business, entertaining clients or monitoring your company’s progress remotely from the comfort of your own home, it’s possible your employees will think nothing of your absences. When you’re in chemotherapy, they may assume you’re in your home office, crunching numbers. If it doesn’t affect their day-to-day duties and activities, there may be no reason to tell.

However, if you have a strong physical presence at your company, that could make it harder to say nothing. Employees who begin to notice your unusually frequent absences may worry. Even worse, they may talk about it, and before you know it rumors far worse than the truth are making their way around the office. If you think that could be the case, you may want to consider sharing your diagnosis with a trusted direct report and let that person handle explaining your absences in an agreed upon way.

Many business owners, however, pride themselves on creating a work environment based on transparency. If that’s the kind of culture you’ve fostered, then you probably have a close enough relationship with your employees to bring them together and share the news. They’ll appreciate your candidness as an expression of trust, and they’ll be grateful for the heads-up on what to expect and how it might affect them and the company. If you do choose to share, be sure to explicitly communicate what your preferences are in terms of how widely (or not) you want the news to spread — for example, just to additional staff or to external stakeholders, such as clients, board members and vendors.

When to Tell

If you have decided to disclose (and remember you generally aren’t required to, for more, read “Should You Tell?” ), then in most cases, the best time to tell is after you and your healthcare team have determined a course of treatment. At that point, you'll have a clearer idea of how your cancer may affect your schedule, job performance and/or your appearance. Then you can decide whether to tell people in advance of your treatment or on an as-needed basis. Just remember that the more notice you give people, the more time they'll have to work with you on solutions.

Sometimes circumstances beyond our control dictate when we need to tell. As a unit secretary in a small hospital, Joanne, 38, of Bradford, Ohio, found it necessary to tell her boss immediately upon hearing her diagnosis of breast cancer, “I told her immediately because I was put on medical leave by the surgeon immediately. I think my surgeon thought that my prognosis would be worse than it was. He wanted me to ‘get all my ducks in a row,’ so to speak.”

Joanne isn’t alone. Karen, 44, of San Jose, California, reveals that her breast cancer diagnosis also necessitated telling her boss immediately: “I was diagnosed on a Friday, and my mastectomy was scheduled for the following Monday, so I had to let him know that I would be off work for about three weeks.”

But take heart, even if the “when” is out of your hands, the “who...,” “what...” and “how to tell” is entirely up to you.

How to Tell

You’ve decided whom. You think you know what. Now comes what some of us consider the most difficult part — how do you tell people about your diagnosis?

Prepare for Misconceptions

Despite all the advancements and innovations in cancer treatment, there are still many misconceptions about what a cancer diagnosis means. Having an awareness of these myths before you start sharing can be helpful so you’ll know how to react. The most common misconceptions are:

• Cancer is a death sentence.
• Cancer means you’ll have to stop working.
• Cancer automatically makes you less productive, less competent and/or less reliable.

Prepare Yourself

First, know that it’s perfectly understandable to be nervous. This isn’t easy information to share — with anyone. No matter how close you are with your supervisor or coworkers, there’s simply no way to tell how they’ll react. However, it’s likely they will look to you for clues; so if you’re open about it, they’ll be less apt to shy away from the topic.

You should also prepare yourself for a wide range of responses. Remember that, most likely, your own reactions to your diagnosis were varied, and if you didn’t know how to react, chances are the people around you won’t know either. Many will need a little time to get used to the idea. Anticipating possible responses can help make it easier to face those moments.

Try making a list of potential reactions — both those you hope to avoid and those you’d like to receive. Some examples include fear, discomfort, confusion, pity, anger, avoidance, support, love, understanding and sympathy.

You may be surprised at the reactions you get — good and bad. Situations like this can bring out the worst in people, but they can also bring out the best in people you would never have expected to count on for assistance. You may, in fact, find that telling people is an amazing relief and yields a tremendous amount of support. Check out Cancer & Career's article on “Addressing Comments at Work” for more ideas on how to handle such conversations.

Other Tips on How to Tell Your Coworkers

• If you’re telling just one or two colleagues, create a comfortable, private environment in which to tell them.
• Reveal only as much as you want to in a straightforward manner. People will take their cues from how you present yourself.
• Give them a chance to ask some questions, if you’re comfortable enough. As you know only too well, some people have no experience with cancer and don’t know what you’re facing.
• Explain to your confidants what to expect in terms of future absences, and let them know there may be times when your mood and productivity will be affected. Don’t be afraid to ask if you can rely on them for help. It’s better to let them prepare for handling a few of your duties beforehand than to spring it on them at the last minute.
• Consider letting people know if you expect your appearance to change in terms of hair loss, skin and weight changes. Explain to them that it’s part of the process of getting better.
• Most importantly, reassure your coworkers that you’re not disappearing on them. You’ll still be in the loop with their assistance and remind them that you’re still an integral part of the team.

What to Tell

If you have decided to disclose, in addition to figuring out whom to tell and how to tell them, you'll want to give some serious thought to what, and how much, your supervisor and coworkers need to know. For some people, the decision to disclose will mean sharing widely at work. While others choose to keep the details to a minimum, which might mean only disclosing diagnosis or even just any side effects that may impact them at work. Remember how much you share is totally up to you.

Tips on What to Tell

• Reveal only as much as you want to, in a straightforward manner. People will take their cues based on how you present yourself.
• Prepare ahead of time what information you want to share.
• If you're telling just one or two colleagues, create a comfortable, private environment in which to tell them. And, be sure to mention if you want them to keep this news to themselves. It might not be obvious to them to do so if you don't say something.
• Give them a chance to ask some questions, if you feel comfortable doing so. As you know only too well, some people have no experience with cancer and don't know what you're facing.
• Explain to your confidants what to expect in terms of future absences, and let them know there may be times when your mood and productivity will be affected. Don't be afraid to ask if you can rely on them for help.
• Consider letting people know if you expect your appearance to change -- for example, hair loss or changes in your skin or weight. Explain to them that it's part of the process of getting better.
• When telling your supervisor, think strategically when mentioning your legal rights; some supervisors might feel threatened by the topic. For support in having this conversation, download Cancer & Career's Manager's Kit.
• You may want to reassure your coworkers that you're not disappearing on them. Let them know that you're still an integral part of the team and that work is important to you and you want to be kept in the loop.

Most importantly, remember that this will be a fluid experience and what you know about your situation may change as you go through treatment. By sharing your diagnosis, you're beginning an ongoing conversation with your manager and/or coworkers; this enables you to discuss things as they evolve and adjust your plan of action accordingly, as well as your team's expectations of you.

Also, it's worth noting that you may find yourself in the position of having to educate your supervisor, because most people haven't experienced this type of situation before or been trained on how to handle it, another instance where the Manager's Kit can come in handy.

Keeping Open Communications

It helps to keep the lines of communication open on the job — particularly if you’re working through treatment. It’s a way of reminding coworkers and supervisors that you’re still an effective part of the team. A lack of communication can cause fellow staff members to question your value and productivity, giving rise to confusion and anxiety — even mistrust. Clear and consistent communication, on the other hand, can create a strong sense of reassurance.

Identify a point person

Assuming you’ve shared your diagnosis, one strategy is to identify a point person at work — someone you trust who is willing to be a centralized source of information about you, your health and your schedule. That person can save you from having to constantly update everyone on how you’re feeling. He/she can also be your go-to person for finding out what’s happening at the office when you are out for appointments.

Communicate regularly

Let your supervisors and coworkers know how you intend to stay on top of your work responsibilities or if there’s any change in your condition or treatment that will affect your performance.

If you need help, ask for it

It doesn’t convey weakness; rather, it shows that you’re invested in ensuring the best outcome for any given project.

Thank them

If colleagues pitch in to help manage some of your responsibilities, let them know that you truly appreciate their assistance.