Working Through Treatment?

Ishara · August 2005

I am 32 and have just been diagnosed with invasive ductal carcinoma this past week. I do not know the stage yet (will see surgeon & oncologist on Tues & Thurs), but I do know that my 2.9cm tumor scores 9 of 9 on the Modified Bloom Richardson and displays lympho-vascular invasion. I think this means that it is aggressive, and at least to some degree in my lymph nodes. My nurse-practitioner was willing to read pieces of the biopsy report to us over the phone even though she could not legally interpret it for us. But when I asked about time away from the new job I just started last week, she told me that I could likely expect 3-6 weeks of recuperation from surgery followed by chemotherapy at minimum.

I feel really overwhelmed right now... more by fear of how to handle things with my job then the cancer. I went back to collage about four years ago after at home motherhood and a divorce. I just recently graduated with honors. This IS my first REAL job, and although I am still deciding whether to go back to grad school in a year or two, I don't want my experience with cancer to harm my long term work goals any more than it has to. I want to take plenty of time to meet with several surgeons and oncologists before making a decision, but I feel that I can't ask for more time than just the bare minimum of appointments are taking right now. I want to take time to study all this in depth so that my decisions are informed, but I am also racing to learn all I need to know to succeed in my new job. Sometimes I think it would be best to quit and just go straight to grad school after cancer treatment... but I have read that many people felt that their job kept them going at times when without the busyness they would have become too depressed... which would be bad since, I have a history of depression (major depressive episode with suicidal ideation after my divorce... the really stupid part is now, I've reworked many things, remarried, graduated, and I've never been happier in my life!).

So here's the questions...

For everyone: How did you navigate work and cancer (and what stage cancer where you dealing with)? How much time did you take off and when? How much family/extra help did you need after surgery or at other times to maintain basic household stuff and kids needs (mine are girls 17, 10, and 7)?

For those who had Chemo: Can you work through Chemo? If you did, do you have tips etc. and would you do it that way again (also was it high or low dose, what meds if you know, and how long did it last)? If you didn't, why not and would you choose not to work again?

For Everyone: During and after treatment (if you took leave, when you went back to work) how were you treated at work? Do you think that your work record/supervisor's impression of you was harmed by how you handled things while in treatment?

I know I asked a lot of questions, so THANK YOU very much in advance, for taking the time to go into detail with me.

Ishara

live42day · August 2005

Ishara,
Yes, you do have a lot of questions, but that is normal. And this is the place to ask them. I had a mastectomy followed by 8 chemo treatments, but no radiation and was stage II B. I have a desk job and was back to work in 3 1/2 weeks, and was able to work through chemo. I had 4 adriamiacin/cytoxin and 4 taxol. One every 3 weeks, and I didn't get sick from chemo. I scheduled my treatments on Fri. and took Sat off so I would have the weekend before I had to go back to work. I work in a bank, so I worked 5 1/2 days a week. I was exhausted, but the work was therapy for me. I was among people every day and it was such a good feeling to know that my customers really cared about me. Some of my co-workers were great and others didn't know how to react to me after diagnosis. I was so tired I would go to bed around 9:00 ( I usually don't get to bed before 11:00). But I also had trouble sleeping through the night. That seems to go along with cancer treatment too. Your children are old enough to help you with housework and meals. Your husband will come through for you too.
This is something you need to remember! If the anti-nausea meds don't do the trick for you, call your Dr. IMMEDIATELY! There are several drugs they can give you if the first doesn't work. Don't let it get ahead of you or you will get dehydrated and it will be harder to get the nausea under control.
Everyone reacts differently, but it is possible to work through treatment.
Janet

SusanAnne · August 2005

Hi Ishara. So sorry about your dx at such a young age. I was 45 and dx stage IIIa (1 positive node) 2 1/2 yrs. ago. I was HER2 positive and entered a clinical trial which entailed 18 mos. of treatment (AC + taxol w/herceptin). Although I could have worked thru treatment, I had the luxury of being able to decide not to, so I didn't. I am back at my P/T job and see/feel no evidence that my diagnosis and time off impacted things negatively. Instead, I believe I am appreciated more.

I have 2 girls who were more than able to handle housework (13 & 15 at the time), but I chose to not burden them with that responsibility. I contacted my local breast cancer coalition and thru their "Lend a Helping Hand" program a cleaning company came every two weeks to clean my house (free!). My girls pitched in in between. I highly recommend that.

It seems to me like you've got your act together and are handling things well. I would proceed as if you intend on working thru tx and if you find it too difficult when you're in it, make consessions at that time. Meanwhile, we are always here for support. My best to you.

Susan

LorettaB · August 2005

Hi, Ishara,

We've all been through that initial diagnosis and it just scares the heck out of you. But here are my answers to your questions:

I was diagnosed stage 2a, HER2 neg, estrogen neg, 3.3 ct. invasive ductal, sentinel node positive, no other nodes positive. Lumpectomy, chemo, rads. I have finished chemo and am in my third week of rads.

I am on a voluntary 4 day work week so during my chemo weeks, I would take Thurs and Friday off and work 5 days the next week so technically, I didn't take time off for chemo. I took 1 week off for my first surgery and 3 days for additional lymph nodes.

I don't have children so family help, though offered, wasn't needed too much. My husband was my hero. He was with me every chemo day and that made a huge difference. So if you can, take someone to chemo with you if you have to have chemo.

I did work while on chemo. I had the weekend to recover and that was generally enough when going through the first phase of chemo. However, when my chemo changed to Taxol, it took longer to recover and I definitely had some bad days at work. I have neuropathy now from the Taxol but hopefully that will diminish in 6 months. My onc gave me "Emend" for the nausea during chemo. You took it the day of, the day after, and a third day for the nausea. It worked great for me. This was during the A/C chemo and I did not have nausea during the Taxol. Many people here have said drink lots of water the day of and the day after chemo to get it out of you system. I would eat more frequent and smaller meals. You may find that your favorite foods no longer are appealing but that will resolve itself after the chemo.

I was treated with a lot of respect at work. Most people were amazed at my attitude. But I love my work so much, it would have been much worse dealing with the process if I wasn't there. Many people who were just aquaintences are now friends. Everyone was concerned, even though they may not have asked me directly how I was doing.

My work quality did not change. I never experienced "chemo brain" but everyone reacts differently to chemo. My work record remained the same.

You're not alone so hang in there. I relied heavily on this group of people for support and continue to do so.
Sending positive thoughts your way,
Loretta

Idalia · August 2005

Dear Ishara, take a deep breath! You have a lot on your plate but you don't have to decide all these issues immediately or alone. You need to talk things over with your boss, husband, children, doctors, etc. You don't know what stage your cancer is, what kind of surgery you will need or what type of chemo you will get. Fear is the worst thing you have to face and reality will almost always be easier to deal with. We have all been where you are and we are still here, coping, so you can do it too! Right now, your health is more important than long term career goals or graduate school. You don't need any more pressure or stress until you know what you are dealing with with your cancer. Your husband is a grown man and your children are not babies - they will be able to support you and pitch in around the house. Your job is just a job, you will have many! Explain the situation and give them a chance to be understanding. If they can't accomodate you, don't take it as a personal rejection. They are being honest and professional with you and it won't reflect badly on you at all. No one ever plans on getting cancer! You are not at the same place you were when you were depressed and suicidal - you have grown, remarried, accomplished goals. You will have bad days and good days, but no one can predict how you will react to treatment. I use to have anxiety attacks and I've never had an attack since dealing with cancer (diagnosed 2/03). It's natural to feel overwhelmed, just take your time, ask your questions and be open to what comes. Good luck.

Future · August 2005

As you can see, everyone responds differently. I was diagnosed with Stage IIIA with 3 positive lymph nodes. I was off work for 4 weeks after my mastectomy. Had chemo every other week for 8 treatments. I would have treatment on Thursday, tele-commute the day after and then work full time the next week. My clinic didn't do treatments on Friday but sounds like some do. The radiation oncologist worked with me and would schedule me in the early am -- I did treatment before work. My radiation oncologist told me compared to chemo, radiation would be a cake walk. Can't say it was that, but was easier than chemo. Don't be afraid to tell your employer what is going on -- you will be surprised how many people have been impacted by Cancer. I was in a meeting a few weeks ago and there were five women in the room and three of us were breast cancer survivors. Also have someone in our senior leadership who's wife died of breast cancer, found out when I had to discuss an issue with him. If your boss is not responsive look up the American Disabilities Act, not sure but you/we may fall under that - sure someone in our group may have information on that. Let us know how it goes.

epgnyc · August 2005

Hi, Ishara. This period where there are so many questions and uncertainty makes it especially hard. You'll know much more when you see your surgeon and oncologist and have mapped out a treatment regimen.
My diagnosis was different from yours - I was Stage I with no nodes but my tumor was Grade 3 (the most aggressive) and was ER/PR negative. I am single and totally dependent on my salary so there was never a choice about my continuing to work. Then again, I have no children so things were simpler for me. As it turns out, I was really glad I continued to work. It kept me focused on things other than my disease and I think that helped to keep me sane (well, semi-sane anyway LOL). I had 3 surgeries (lumpectomy, a re-excision and a bi-lateral oopherectomy to remove both ovaries) before starting chemo. I took several days off after the lumpectomy and took 2 weeks off after my re-excision and oppherectomy, which were done at the same time). I started chemo 17 days after the double surgery. I had chemo every three weeks for 6 months. For some reason, despite the great drugs they have now, nausea was a problem during the first several treatments, but then they got a grip on the problem. On those few days that I wasn't feeling well, I'd leave early or go to work late and that made a big difference. I missed only two days of work during the 6 months of chemo, and that was because I was running a high fever which landed me in Urgent Care at the hospital. I too managed to have my radiation early in the morning so I only got to work about 20-30 minutes late and I'd work later in the day to make up for the lost time. I found radiation much less exhausting than chemo. My office was extremely understanding, so I was lucky, but I've heard many, many stories of companies being terrific to their employees dealing with cancer treatments. Once you've decided how you want to try and handle the work situation, you should definitely speak to your boss and explain the situation -- I believe being open and direct is always the best policy. If you've decided you do want to try and continue working, you can tell them that's your intention. And then if it proves to be too difficult, you can always leave at that point. I do sympathize with you....trying to get through treatment with a brand new job is much harder than with one you've been a for a long time.
Good luck to you. You sound smart and are asking all the right questions. Believe me, it will get easier as you go along.

tsilk99 · August 2005

Hi- I'm 31 and was diagnosed back in June, mastectomy on July 25th and back to work on August 8th, but then started chemo on August 9th (once they got in, the determined that there was more lymph node involvement than anticipated). I just completed my second round and have been taking the day of chemo and the day after off. I understand your concerns about the job- I just started a new, pretty high up position in January. I know that I've felt this sort of upspoken pressure to keep work, treatment and life all together (planning my wedding in March 06 before my active duty fiance goes overseas). I'm evaluating for myself how the balance is on a daily basis. I think it is possible, just ask for help (which is often the hardest part).

Working Through Treatment?

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