Be the Boss Over Cancer

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A diagnosis of cancer can affect the identity often attached with one’s work—especially if you see yourself as a provider, protector and moving-up-the-ladder kind of guy.

Even if you aren't the sole breadwinner in a family--and even if you're single, with no dependents--the diagnosis and dealing with it is likely to make a chink in your work armor, according to mental health experts.

Men, Cancer & Work: What the Experts Say

"Men do define themselves by their work," says Matthew J. Loscalzo, LCSW, a therapist at the City of Hope Cancer Center, Duarte, CA. 

"Most men really identify with their work role as a core part of their identity," agrees Malcolm Schultz, JD, MFT, a clinical supervisor at Cancer Support Community, Benjamin Center in Los Angeles. He facilitates support groups for men with cancer.

For men diagnosed with cancer, two questions often pop up when they consider their often reduced income and its effect on family, says Bill Goeren, LCSW, director of clinical services at CancerCare. They ask: "Have I disappointed? Have I failed?"

The loss of identity many men experience when dealing with cancer, Goeren says, is similar to that experienced when a man retires. However, the loss during a cancer diagnosis can be more difficult, because it is unexpected.

Men with cancer tend to become more depressed than women with cancer, according to Tetyana Pudrovska, PhD, a researcher at the Population Research Institute, Penn State. That, of course, can affect work performance and recovery. In her words: "Cancer poses a threat to the masculine identity because it entails lack of control over one's body and other consequences incompatible with traditional masculinity."

Here, three case histories of men in different circumstances coping with cancer, the issues they faced on the job, and how they coped.

Besides Loscalzo, Goeren, Pudrovska and Schultz, our experts include cancer patients.

Issue: Dropping the Ball

Bill, an attorney, had a traditional marriage with a stay-at-home wife. They were raising four young children. With his excellent income, they were used to the finer things.

Then came the cancer diagnosis. He recovered enough to work three days a week, but was used to working five-plus very long days. He was making less much, his thinking was foggy due to the chemo and, even worse, his wife was not understanding. Instead of being happy he was around home and their children more, she was stressed out that the reduced income was already changing their lifestyle.

At work, people he mentored were now treating him differently, he noticed. He felt as if he had lost his position of respect and power. He felt abandoned and used.

How he coped: With help from his counselor, Bill gradually realized his work expectations--that he could return to his long hours and work more than full time--were not realistic, at least not for the time being. At home, he learned to support his wife and confront her about being unrealistic at the same time. Key to that: telling her they must work as a team, both to get him back to work and to raise their kids.

When he examined the lack of respect he was seeing from coworkers, he realized some resented having to carry the load left when his work hours declined. He addressed the issue by acknowledging their resentment, talking to them and telling them he felt badly about it. That lessened their resentment a bit.

He also gave the coworkers and his boss an estimated timeline of when he might be up to full speed, so they could make tentative plans about their schedules.

Other strategies: For high-powered types, the major threat is having to stay home or slow down. Within reason, you may opt to try to increase the pace as your health allows. Consider taking an office nap, for instance, instead of barreling through, then finishing the day's work once you are more refreshed.

Issues: Not Feeling Needed, Holding onto 'Normal'

Blair, a well-respected cardiologist and university professor, learned in 2004 that he had kidney cancer that had spread. He had surgery as soon as possible.

Six weeks later, he was back to work.

"[My] patients were asking, 'What are you doing?'" he says.

He was trying, he knows now, to get everything back to normal. And that meant, among other things, feeling needed by many patients.

His fantasy, and that of many other cancer patients, is that everything would return to how and what it was before.

It won't, he discovered, even though he is now cancer-free.

"It destroys the myth of invulnerability that you carry around," he says of cancer.

How he coped: Before letting go of the fantasy, Blair says he got depressed, angry and bitter.

Slowly, he made the transition to what many call ''new normal." He says: "I can only count on today. Cancer changes your perception of who you are."

For him, that meant paying even more attention to his patients. "I am more interested in making people feel better instead of meeting goals set by the administration," he says.

He came to realize, he says, that he is ''more than just my job." However, clearly the job is important to him. 

Also critical, he says, is the ongoing support of the Jewish community, where he and his wife, who also has been diagnosed with cancer, obtained much help. He now feels strongly about giving back, and does so often.

Other strategies: Being screened for depression is wise, as research shows men with cancer are at higher risk than women. Another way to get help managing the new normal and its impact on your psyche and confidence is to join an in-person or virtual support group led by a licensed clinical social worker or run by a reputable cancer organization.

Issue: Missing the Structure of a Job

Larry, 58, had worked at a government agency for 23 years when he found out he had prostate cancer.

He and his wife had both worked for many years. Financially, they would be OK.

He first dealt with the issue of treatment choice. After much debate, he chose surgery.

Then came a surprising issue: the lack of structure in his day.

"This was the first time I had that much unstructured time," he says. His doctor advised six weeks off from work to recover.

At loose ends, he found himself antsy at the start of his day. 

How he coped: Thinking about his long-held wish to be creative in photography, he picked up his camera and walked around the city. As his energy allowed, he photographed whatever looked interesting.

''I created a new structure," he says.

Along with it came a new game plan. While he had thought, before the diagnosis, about retiring in a few years, his reignited love of photography has made him more eager.

He figures it will be just 2 to 4 years before he is snapping pictures part time, or maybe full time.

Other strategies: Career counseling can help men decide if they want to return part time, full time, or transition to another career.