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Change in work priorities

Ms. Maureen Parkinson, Vocational Rehabilitation Counsellor, M.Ed. C.C.R.C

Ms. Maureen Parkinson is the province-wide vocational rehabilitation counsellor at the BC Cancer Agency. She has also been vocational rehabilitation counsellor at a public rehabilitation hospital and vocational rehabilitation consultant to insurance companies and the court system. She has instructed and facilitated Service-Canada-funded programs on job searching and career exploration. Ms. Parkinson has a Masters in Counselling Psychology, is a Canadian Certified Rehabilitation Counsellor, and completed the Certified Return to Work Coordinator Program through the National Institute for Disability Management and Research. She has developed return-to-work and job-search seminars for cancer patients and created the guidebook “Cancer and Returning to Work: A Practical Guide for Cancer Patients” as well as on-line articles about returning to work and school. She also co-authored a paper commissioned by the Canadian Association of Psychosocial Oncology, “Cancer and Work: A Canadian Perspective”.

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Melanie McDonald, Social Worker, BC Cancer Agency

Melanie McDonald, MSW, RSW is a social worker at the BC Cancer Agency. She works to support patients and families cope with cancer from diagnosis to post-treatment. She facilitates numerous group programs including mindfulness-based stress reduction, relaxation a children/family group. She has previously worked in university and hospice settings.

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A special thanks to the Patient and Family Counselling Department at the Vancouver Cancer Centre at the BC Cancer Agency for their inputs for an earlier version of this document.

After a cancer diagnosis, it is common to think differently about work. Many patients re-evaluate the kind of work they are involved in and the amount of time spent at work. Research has identified this as a “change of priorities” and it has been found to be a motivator and deterrent for some in returning or staying at work.1 2

A change of priorities can encompass many emotions and processes for cancer survivors. For some, this is due to the fact that during cancer treatment most of their energy is used to move through treatment and cope with side effects. Research shows that it is common for the emotional impact of cancer to come to the surface after treatment.3 Emotional processing of a cancer experience often happens at the same time someone is considering returning to work. Internal struggles and shifts in priorities often make it difficult to make decisions about work. This may result in some hesitation to move forward with returning to work and may be interpreted by others as loss of interest in working.

Below are changes in priorities that may impact decisions about work.

Time is more important

Time has more meaning for many cancer survivors. A critical illness often makes one aware of their mortality. It is common for people to become more focused on how they spend their time which includes how much they work and what kind of work they do. Some may feel they would like to spend more time with their family and want to cut back on work. Others may want to focus more on engaging in meaningful work.

Desire to live more mindfully

Some may feel that up until diagnosis, they were working without thinking about how they spent their time, or “living on automatic pilot.” It is common for cancer survivors to desire to live more mindfully. Living more mindfully may also include being more aware of living in the moment at home and work. Learning to live more mindfully is an area that takes practice and compassion. See mindfulness at work.

Desire to live a healthier lifestyle

It is common for cancer survivors to want to live a healthier lifestyle. Wanting to live a healthier life may come from the hope of preventing recurrence or the advancement of cancer. It can include wanting to focus on healthy living like exercising, eating better and working towards better mental health and wellness. Prioritizing physical and mental health is a common shift for cancer survivors. Survivors often express fears of stress causing cancer and are concerned about stress at work. While the research in this area is mixed, there is the case to learn good mental health strategies in order to live a more contented life and have a better quality of life. Moreover, it is important to remember that stress will never go away entirely in one’s life, as it is a part of living. However, it is possible to shift one’s relationship with stress through greater awareness and adopting a healthier balance of day-to-day obligations. Read more about workplace wellbeing.

Desire for a balanced lifestyle

Concept of work and life balanceSome survivors may want to live a more balanced and simple lifestyle. A balanced lifestyle, often represented by a balance wheel, involves ensuring that you are working towards each aspect of your life such as career, finances, health, family and friends, romance, personal growth, fun and recreation, and physical environment. The balance wheel implies that work is only one part of your life and by fulfilling other aspects of your life, you are in more balance. Some may view a balanced lifestyle as equally tending to all these activities which may result in unrealistic expectations of themselves. Trying to attend to all activities at once can be particularly hard for those who are already fatigued from cancer and treatment and are having difficulty doing basic life activities, such as cooking and meal preparation. It may be more realistic to see the balance wheel as something to work towards or as a reminder of the things that you may be neglecting in your life so that you can re-assess them and develop goals towards each area. One way to view the balance wheel is to consider that, at the very least, you need three spokes to maintain a wheel. Therefore, a good place to begin would be to consider the three most important spokes to support you in your life. One of the most important spokes is developing social/family support for yourself. Having a support system has been shown to help people through many stressors including cancer and to improve health outcomes.4 For some who have worked many hours, work may come at the expense of maintaining or developing a support system for themselves.

Reflection on meaning and purpose

Following cancer, reflecting on the meaning and purpose of one’s life is common.  Life meaning can come in many forms such as quality of relationships, work, spirituality and connection to the environment. Finding meaning can include questioning the meaning and purpose you experience in your work. Some may want to do work that they feel can make a difference while others find they would rather focus on finding more meaning in other areas of their life. This is a personal process that takes time to assess and move through.

Reflection on work values

After a diagnosis, some may find that what once motivated them at work is not as important initially or over the long term. Some who prized economic gain, promotions or prestige may now feel they are n0t as meaningful. Alternatively, many cancer survivors want more control over their way of life by having more flexibility and freedom at work. This can often be at odds with work values such as economic gain or advancement, which typically demand investing more time at work. In many ways, this conflict resembles a competition between the old and new self, especially in the early stages of the cancer experience and post-treatment. It is important to give yourself time to find a new balance in your life.

A grief reaction: losses and changes

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Grief is a multi-faceted response to loss and change. Cancer can cause many losses and changes in one’s life. A change in priorities can be a way to heal or move through the grief of a cancer experience.

There is no “right” way to grieve. However, it may be difficult or in some cases unrealistic to expect yourself to work through grief before returning to work. This is especially the case if you are under pressure to return or are starting to feel financial strain. Some may feel uncertain about how to move forward and be concerned that if they make an early decision about retiring, returning to work, or changing work, they may regret it. Give yourself as much time as possible before making any dramatic work-related changes until you work through the grief and consider in what direction you are headed. However, job security and financial pressures may force you to make a decision quickly, requiring you to make the best decision for yourself at the time. It would then be important to remind yourself that this is what you need to do to move forward. If this is the case, consider finding ways to shift priorities or lifestyle outside of work in the areas mentioned above.