Really Need Career Advice with Metastic Cancer

QuarantineAndMe‍
Your situation sounds so similar to mine that I had to respond. I, too, had a crazy stressful job as a project manager with a large, national company. 12hr days and weekends were the norm.
And, yes, I would not be surprised if someone pointed to my stress levels as a contributor to my cancer!

My situation differs, though, in that I was eligible for early retirement with a pension when the time came for me to return to work.
I'm 57 now and decided early retirement was the right thing for me to do. 
Also my cancer is not metastatic (as far as I know), and am not on any meds at this time. 

I get the feeling though of wanting to stay with a company for the sole purpose of continuing to receive the meds covered by insurance that are probably quite literally keeping you alive and functioning. 

With that said, I don't have any answers, but have these 3 thoughts:

1. Some wise person on this site once made a comment about "if you think you have a shortened lifespan, do you want you want to spend it working in a stressful career?" (for some, this answer may be 'yes' especially if there is still joy coming out of that stressful career.) 
2. Depending on your insurance company's coverage (is it through your employer? Or private?) you may be eligible to go on permanent long term disability until retirement age, and then move to your pension, and/or CPP Disability. 
3. This link from Canadian Breast Cancer Network offers some tangible ideas and options on Facing Financial Issues. Some of their points don't apply to you, but maybe some do? 

There's a lot of options out there depending on your personal situation and preferences. 
Being only 41 I can certainly understand your desire to keep your sense of purpose and level of activity up there! 
 

QuarantineAndMe‍ I know there are a few folks working with Mets Mammabear‍ and Beespecial‍ who may have some advice.

It sounds like your current workplace is good, with a good manager and you enjoy the work, but you just might need to do less hours in the future if I hear you right?

After my treatment finished I had a return to work program that was directed by my workplace insurance company, based on information from my oncologist. It took me about 3 months to get back to working 35 hours a week, and I have to say the person who used to be able to work 60 hours a week and travelled a lot is long gone. I find if I overdo things for a day or two, I have to rest up and recover. And I don’t have any remaining cancer...

A couple of questions about your workplace...

Do you have someone who deals with employee wellness, occupational health issues, return to work? In my workplace we rely on medical advice to know if someone needs any accommodation or allowances to enable them to work. For example, if you have Mets in your spine then you may find you can’t sit at your computer for long periods or might need a special chair (I’m brainstorming here). You will need time to attend appointments and treatments etc.

How has your workplace managed without you while you’ve been through treatment? If they have reassigned some work or brought in new staff to cover part of your work could your role be reduced to a more reasonable size? Does your manager accept you’ve been working more than fulltime? 

Putting my manager hat on for a moment, if you were my staff, I would be so happy you wanted to come back to work and I would be doing whatever it takes to make it work for you so I could retain your skills for as long as possible. 

Looking for a new position seems high risk, but there may be other options such as going freelance WestCoastSailor‍ may be able to chime in here.

As to the question about stress and cancer - There are so many factors that contribute to someone getting cancer - hereditary, environmental, lifestyle. Who knows what the trigger is. Thing is that now you need to take care of yourself and it sounds like you want to.

I hope I’ve helped. I wish you well deciding what’s to do, Essjay

QuarantineAndMe‍  You have received great advice. If your medical coverage and extended medical coverage is tied to your current employer,  I would hesitate to make any move where you jeopardize your coverage.  Most insurance coverage has a pre-existing condition exclusion so your new employer may not offer coverage for the medication you need. 
What I would do is take advantage of this gift you have been given and take care of yourself.  If you wish to return to work find out how that will impact your benefits and what happens if you need more time off?  Will you qualify for benefits after having returned to work?  Many questions!  Best wishes. 

QuarantineAndMe‍ 

Such a great question as I am sure this is a reality for many people.

I just wanted to tstop by and tell you about a great resource called Cancer and Work https://www.cancerandwork.ca/ that may help you think through a few things you have been thinking of .

Hope it helps

Lianne

QuarantineAndMe‍

This is a really difficult situation! Before I was diagnosed with colon cancer (at age 35) I had just started working in a new workplace and a high stress job. My coworkers had not been particularly supportive and there were many hurdles and roadblocks (I just about had to threaten to quit in order to get someone to cover for me so I could go for my colonoscopy - where my cancer was diagnosed!) but I'm pretty easy going and figured I'd just do my job and push through.

Since my diagnosis (and my cancer was stage 1, treated with surgery only) I have been off work and am now trying to return to work. However, any issues I had before leaving seem to be magnified and my perspective has shifted. My cancer is statistically unlikely to return, but I was also statistically very unlikely to have colon cancer in the first place, so I'm now looking at it like, if I did only have 1 year left or 5 years left, or however many years, do I want to spend a great deal of my time in a workplace where I feel unsupported, unvalued, and also working my butt off in a stressful job? Trying to figure out what to do right now myself!

It's difficult to sort out the logistics of changing jobs and particularly if you have great benefits. One thing I learned from my insurance company is that - if I did need chemo - to ask about different names for the same drug as some benefits covered it under one name and other benefits covered the same drug but under the generic name or brand name.

I know some insurance (ie life insurance or travel insurance perhaps) won't cover for pre-existing conditions, but I've never had to show anything to say I didn't have a pre-existing condition for a prescription. My benefits just get billed through the pharmacy (as long as there is a prescription, I have coverage if the drug is covered.) I guess it depends on how your medication and benefits work.

Is there a specific place you'd be looking to go? Or some way you could find out about the benefits plan before you accepted a different job? Or as others have said, perhaps just be very clear about what you can manage and keep the communication open to decrease hours if you need to. I hope you get some clarity on this decision!

QuarantineAndMe‍ , I was about your age (ahem) when I learned that so much of life is all about balance. That was the age when I finally went from reading books like “Superwoman” and “You Can Have it All” to reading books like The Artist’s Way and the writings of Louise Hay. (I was a bit older when I discovered Jon Kabat-Zinn and his book Wherever You Go, There You Are.) To me, it’s important to find and maintain a balance between work and home life, between healthy eating and enjoying junk food, and many other things in life.

Have you stopped long enough to ask WHY you are putting in so many more hours than the other BAs? Is it because you don’t know what they’re doing outside of the workplace? Is it because you feel the need to emulate your boss’ work pattern? (I will not refer to it as an ethic, in this case.) Is it simply because you like your job that much?

Perhaps if you can get clarity with some of these factors, you will be able to find your own balance. 

QuarantineAndMe‍ I have triple positive MBC and I work more than full time (FT). I am an IT exec working in Healthcare in BC. I worked through most of cancer 1.0 taking days off around treatment as needed. Took some sick time when cancer 2.0 popped up Aug 2019. Was just getting back to FT hours and going into office part time when covid hit so FT hours remote. I am having new symptoms so while I still work 8-10 hours I do rest for 30 min in the afternoon. In hind site... I should have gone on LTD when I was diagnosed with MBC (liver primary with small spots on bone and lung). LTD can bridge me to full pension at 65 if I live that long (currently 56). I have limited energy and spend 80% of working and 20% on yoga and walking the dog. Probably not an ideal balance. I am being checked for spread to brain due to headaches and if that is the case LTD here I come for my remaining time. 

So if you can financially manage LTD/Disability - stay there. You don't need the stress of work. There is no cure for MBC. Enjoy your time. 

If you want to work, think of consulting. I have a friend who is MBC (triple positive bone and liver) and she is a consultant Senior BA. I feed her as much work as she can manage - not FT. But consulting work is never a guarantee income but does give you flexibility and you don't have to be local. 

If you want FT with benefits, we are hiring. Positions are both non-contract and bargaining unit. Most new are bargaining unit (union). We do even have some .6 FT roles. Staff do work extra hours during a project activation and do an on-call rotation depending on the position and we pay OT for those hours. Benefits, LTD, sick leave are all good but being gov't salary not as high as private sector. PM me if you want more details on positions. We won't hire out of province even though we are remote right now because we do go onsite to hospitals. Located in lower mainland - Vancouver. 

Happy to have more discussion. 

Mammabear‍ Wrote:

So if you can financially manage LTD/Disability - stay there.

And I agree. When I talked about balance earlier, I failed to point out that said balance can be in different decades. For example, my balance was to work FT for 37 years and retire early, but one of my siblings chose to work PT while her kids were growing up and now feels obliged to work well into her 60s because she wasn’t able to save for retirement.
 

QuarantineAndMe‍ 

Challenging question. We are all different with different needs so it is really difficult to give a direct answer. I can share a little of my experience though.

I am more than a cancer diagnosis. In the months following my initial diagnosis I was reeling from all the changes. I knew my life would never be the same and I seized it as an opportunity to restructure my life around things that were important to me.  A book that was really helpful for me in sorting through that maze was  "Picking Up the Pieces: Moving Forward after Surviving Cancer." by Kathy Scalzo and Sherri Magee. As a metastatic patient we didn't really "survive," but I still found it helpful in developing a well rounded picture of my life and how to do design a new life with my new reality.

As Essjay‍ mentioned I was a freelancer working in web building. I shed the majority of my clients, keeping a few favorites and made sure that I had succession plans in place for them. At the same time I was doing First Aid on high hazard job sites. While I gave that up initially, I recertified a year after my diagnosis and took on some weekend work and a few specialty events. It gave me some pocket money on top of my disability. More importantly I enjoyed the social interaction and the physicality of the work. Unfortunately with the risk of covid transmission, I have had to give it up.

I am not an insurance expert but I have been fortunate (mostly) with BC Cancer finding compassionate access for one of the drugs that I was on (unsuccessfully but at least I had the chance) and other supports being available. There are programs like Blue Cross available for freelancers or being grandfathered into a program are also possibilities to be explored.

If you are generally comfortable in your current role just looking to reduce the crazy hours and the stress in general then I would have that discussion as part of a return to work plan. Don't be afraid to negotiate. Clearly you are valuable and while you may be replaceable, most employers are concerned about the cost of bringing in a replacement. Not just the sheer monetary cost but the energy requirement for training and lost productivity are significant factors and provide a valuable leverage point for the negotiation.

Don't forget to have fun and enjoy this phase . And good luck!

Angus



 

Thank you all for your much needed insight. My thoughts were running in circles but your shared experiences have given me some new perspectives to think about. 

One thing I did not consider was discussing my new needs with my current employer. And while I know my manager runs at 150%, I know I can't keep up with her anymore and need to have a realistic conversation with myself first and her on what I can manage. 

She has a history of cancer in her family both her father, father-in-law passed from cancer, and her younger sister is a lung cancer survivor so I know she will understand more than most what I am facing. 

For now, I'm extending to LTD trying to wrap my head around all this new reality. Thank you again. 









 

Hi QuarantineAndMe‍ 

My name's Belinda and I think Essjay‍ tagged me in this post.  I am 55 and have metastatic breast cancer with bone mets. I was diagnosed in Dec 2016, treatment through 2017 and recurrence in Jan 2019 - so cancer for 4 years, mets for 2.  I work full time. I live in Ontario. I have private benefits (follow me/Manulife) because I work for a charity/non-profit. 

I'm on Xeloda/capecitabine - it's been about 8 months now, and most of that is covered by my benefits. I tried Ibrance for 2 cycles and I just couldn't recover my white blood cells so it wasn't worth continuing. My benefits had a $ limit so Ibrance couldn't be covered by that -- but rather the Ontario gov program plus support from the drug co.  I had to actually max out my benefits to be able to access the other, which put a cramp in some of the other drugs I was taking. I found it a lot of paperwork for 2 cycles of treatment. However, if Ibrance was working I would have been happy to keep jumping through the hoops.  It's an extremely expensive drug - about $8000 per month, so most benefits plans wouldn't be able to cover it or you will hit your lifetime limit quickly. 

I used to have a different job - with a lot of responsibilities and travel and stress and ball juggling. It just so happened that I had made that career/life change just before I was diagnosed the first time. I had no idea that I was going to be diagnosed with cancer when I left that job, in cancer research actually! That left me as an independent consultant without benefits, without the ability to travel and to work for a period of time (during treatment).  I was a bit screwed, to be honest. I was lucky to have savings and a home and a partner and a cushion to get me through without any financial support along the way. 

When I was ready to get back to work, I ended up as an executive director of a medium-sized charity in Toronto. I work from home most of the time (now all of the time) and I love it. It's a great job with a great board of directors. I have been very quiet about my recurrence, in fact most people in my life don't know. The board knew that I had cancer before they hired me, as my hair was about an inch long at the time and I was very open about my cancer the first time around.  I have told them (because report to them), and they are absolutely fantastic. I actually live a regular life these days, besides a lot of appointments, I feel really well. My job is full time but flexible so it works for me. 

Now...to the point!  If I had a job that had benefits and longevity and LTD and potentially a bunch of other support, I would not be leaving or looking for another job. If you hate your job or are miserable, then by all means...go for it. But if you like your job, and you can get accommodation (which is the law in fact), I would stay. Sounds like you've got a great group of people around you. Don't worry about not being able to do all the things you could do before. If you want to work, then work!  If you need to be accommodated then just ask.  I'm sure everyone around will be very supportive. 

I don't think you should make decisions based on what benefits you have, or what caps are on benefits. But there is a reality to life and changing jobs in the middle of cancer treatment and the middle of a global pandemic may not be the best choice right now. I think you're a little younger than me and I remember that drive to keep overachieving and climbing the ladder... I reached the top of the ladder in a competitive and complex industry.  Although it can be very rewarding it's a lot of work and is not everything in life!!   I'm very happy in my charity role and a much better work life balance.

Good luck and let us all know how things go for you!

You don't know till you ask right? You may find yourself surprised. I read a few excellent replies, the only thing I would add (if someone has not already done so) is that when you do go in to discuss, I'd make sure you prepare in adance much as one does for an interview or even doctors appointment. Take a moment to jot down your throughts/feelings/reasons and approach the manager with a clear concept. Hopefully avoiding the whole "dang I should have said that," scenario.