When Angela Perez of San Diego was diagnosed with multiple myeloma in January 2017, she was fortunate to work in the same building as her union’s president, who explained her workplace rights. Perez, who was diagnosed at age 38, became wheelchair-bound as multiple myeloma, which forms in the bone marrow, attacked her right tibia. She had no way to hide her diagnosis from her supervisor at the San Diego Unified School District, which can be the initial desire of those with cancer, as they fear they will otherwise lose their jobs or will not be able to find another one.

The number of cancer survivors in the U.S. is growing—there is expected to be 20.3 million survivors by 2026, up from 15.5 million in 2016, according to the National Cancer Institute. This means there are more survivors of the prime employment ages of 25 to 54. However, cancer survivors are 1.4 times more likely to be unemployed than those who have never been diagnosed, according to a 2009 study in the Journal of the American Medical Association. HR and Employment Law News reported in 2015 that just 21 percent of job applicants who disclosed their cancer diagnosis received a call back from managers during the hiring process; 37 percent of those who did not disclose were called back.

Fortunately for Perez, her boss was understanding and made the necessary accommodations to allow her to work as she received treatment. When Perez did get sick, she learned she had workplace protection offered through the Americans with Disabilities Act, or ADA. The ADA defines cancer as a disability and requires state and local government employees, as well as private employers with more than 15 employees, to make reasonable accommodations for those with the disease, unless doing so would cause undue hardship, such as a significant expense. Additionally, the Family and Medical Leave Act, or FMLA,
provides employees the right to take up to 12 weeks of unpaid leave due to an illness or as they care for an ill dependent, without losing their job.

For Perez, receiving reasonable accommodations meant she was able to leave work early on Friday for treatment and take the following Monday off to recover. For others, reasonable accommodations can mean employers provide them periodic breaks, a private area in which to rest, or the flexibility to work from home.

“I think this is one of those things that you don’t think about until it happens to you,” says Rebecca Nellis, the executive director of Cancer and Careers. Cancer and Careers is a nonprofit offering resources such as webinars and conferences to help diagnosed individuals.

Nellis says most people diagnosed with cancer do not know that the ADA will protect them. And, depending upon where one lives, there are state laws that also provide protections.

But, according to Nellis, looking out for oneself begins with deciding whether to disclose a diagnosis. “Before it’s about advocating for yourself, it’s about making a decision about whether you want to tell, and if you do want to share anything, how much and to whom,” she says.

In order to receive certain protections, one would need to disclose their disability to their employer. Nellis suggests before employees do anything, they speak with their health care team to discuss what their job entails and how treatment could affect their ability to work. “ Think about what the solutions are,” Nellis says. “If you walk in knowing what you need and also how you can get what you need in a way that supports the goals of your workplace and your role, then you have already kind of taken the conversation to the next level in terms of advocating for yourself.”

Assess the workplace. Who are your allies? Who will be supportive of you? How were others treated when they took maternity leave? Thinking about these things can help you know how to address the situation.

If additional concerns or more formalized questions linger, they can be addressed by those within the legal community. Pro-bono assistance may be available for those with cancer.

If you feel you are being treated differently because of disclosure of your diagnosis—for instance, if you were fired, passed over for a promotion, or taken off of high-profile projects—then it is time to reach out for additional help. An attorney may advise you on how to handle the situation.

Nellis recommends keeping a work diary, especially if you are concerned you’re going to be treated differently, so you don’t have to rely on memory to know when specific events happened. For instance, a log might include: “This is the day when I was supposed to be working on the X account, but I got moved to the Y account, and this happened, and then this happened,” Nellis says.

Ultimately, the ideal situation would be one where those who have been diagnosed with cancer and wish to remain working would have a supportive workplace like Perez did. The courage that Perez gained from fighting multiple myeloma and the knowledge she acquired from Cancer and Careers has inspired her to apply for a promotion. “It was something that I had always wanted before I was diagnosed […] I’m just not scared of the certain challenges that the position holds. Challenges don’t scare me.”