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Question: I've just learned that I have lymphoma. I will need several months of chemotherapy. My doctor says my prognosis is excellent and that I can continue to work, even during treatment. Would it be better if I take time off from work and concentrate on getting well?

Answers:

Dr. Ruth Oratz:   There are many factors that contribute to wellness and healing. The chemotherapy treatment prescribed by your doctor is critical in treating your lymphoma but so is her prescription that you continue working. Continuing to work, and maintain as much as possible of your normal routine will help you cope with your diagnosis, the treatment and side effects. Staying active is very helpful for physical, mental and emotional healing. Work is part of our sense of self, our identity and purpose. We have social support networks among our colleagues; many of us count our closest friends amongst our co-workers. We share so much of our time together that we also share much of our lives. If it is possible to keep working, then try to keep working. But be aware that you may need to make some adjustments.

Chemotherapy can cause fatigue, nausea or queasiness, and achiness flu-like symptoms. Some chemo treatments are also associated with a decrease in mental acuity some short term memory loss, a feeling of not being sharp, mental tiredness. Chemo brain is generally mild and temporary but sometimes can be more pronounced. Each individual reacts to treatment differently. Certainly chemotherapy is often difficult, with side effects and sometimes complications, but we have made many advances in managing toxicity and minimizing the disability caused by treatment. New anti-nausea treatments and adjunctive therapies to prevent low blood counts (which can contribute to fatigue and infections) have dramatically improved quality of life for individuals on chemo.

So I would encourage you to continue working. If you find that it's just too much for you then take some time off, or see if you can work flex-time, part-time or from home some of the time. But try to stay active and involved!

Mary Shannon Little:  As your doctor has explained to you, lymphoma requires long-term treatment. What do you want to do with your life in the meantime? Do you want to continue working? Do you have to continue working? You can continue working while undergoing chemotherapy if you are honest with your employer about your treatment, your health, and your needs over the next year or so. You may have to scale back your responsibilities, job-share, pass up a promotion, or turn down more exciting, but draining assignments, during chemotherapy because you are tired, anemic, and immune-suppressed. But you remain the same talented, energetic, and competent employee you were the day before you were diagnosed with lymphoma.

For most people, work represents more than a paycheck. It represents another family, a place where you can use intellectual and other talents not used or appreciated at home, or a vacation from the often mind-numbing tasks of housework or childcare. My daughters were 1 and 2 years old when I went through chemotherapy. I had an exciting and challenging job as a private investigator. My employer offered me every possible accommodation from a paid leave of absence to a laptop computer. I accepted none of them. I maintained the same schedule and workload I had before my diagnosis. I even scheduled my chemotherapy first thing in the morning so I could return to work by noon and still put in a full days work.

Looking back I realize I charged ahead because I was in denial and afraid of death. I believed if I behaved as if nothing had changed, nothing would change. Eventually, I was very tired and worn-out from the chemotherapy and evasion of what had become my reality. By the middle of my chemotherapy, I only had enough energy to work. There was nothing left for my small children and husband at the end of the day. Most evenings I went to bed at 8 and spent most Saturday afternoons napping. After my treatment ended, the physical and psychological stress of working so hard all those months caught up with me. I was exhausted, depressed, unhappy at work, and unhappy at home.

I went to my boss and requested the leave of absence I'd refused during chemotherapy. Under the Family Medical Leave Act, I was entitled to an unpaid leave of absence, not the overly generous paid absence I'd been offered the year before. I took three months off and spent the summer with my family and friends. When I returned to work in the fall, I felt more like the old me and gratefully resumed the job I loved.

If work represents a safe haven, by all means, continue working throughout your treatment. Similarly, if you want to take time off to care for your body and soul, take advantage of your rights under the Family Medical Leave Act and take a leave of absence from work. There is no right or wrong decision.

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