Whether to work during treatment is a very personal decision that depends on a number of factors, including your financial and work situation, how you experience treatments and their side effects, your privacy preferences, and, perhaps, a desire or not to keep your daily routine going.
Facing breast cancer treatment during holidays or when you have a vacation planned can also be tough. Should you cancel the family vacation you planned months ago, even before you were diagnosed? Do you have to schedule appointments around family get-togethers and celebrations?
Before you take medical leave, cancel any plans, or decide not to make new plans, talk to your doctor. You may be able to postpone the start of your treatment or adjust your treatment schedule so you can continue working or have the freedom to enjoy vacations and holidays.
If you're receiving treatment as part of a clinical trial, the treatment schedule can be somewhat rigid. Ask your doctor how much wiggle room is in the schedule, and work around it.
Most people will need to take time off from work when they undergo surgery, whether the surgery is a lumpectomy or a mastectomy with reconstruction. The amount of time you take will depend on what type of surgery you receive and how your recovery goes.
Your doctors and nurses can help give you a general idea of how long you will be in the hospital for your specific surgery and when you can expect to resume your normal activities. If you have a lumpectomy, you will usually be able to go home within a day or two, and full recovery can take up to a week or two. If you have a mastectomy, your hospital stay may be longer. Recovery time after mastectomy may take several weeks, but it depends on a number of factors including what type of mastectomy you have and whether you have reconstruction at the same time.
If you have an important project at work or a vacation already planned, it's often possible to delay surgery up to several weeks if the cancer is not very aggressive.
After surgery, it may be difficult, but not impossible, to travel and stay elsewhere while surgical drains are in place. Keep in mind that the time immediately after a big surgery will be a time of recovery. If you're planning to go away, stick to a familiar place where you know you'll be comfortable and near medical help if you need it. Read more about breast cancer surgery.
Whether or not you will be able to sustain your regular work routine will depend on how you tolerate chemotherapy. Some women will continue to work with minimal interruption, and some women will need time off.
From treatment cycle to treatment cycle, your healthcare team will be able to predict, with some regularity, when you'll be having good days and bad days. They can help you map out how you are going to feel -- and how much you may or may not be able to do -- during your chemotherapy regimen.
For instance, let's say you're having treatment every three weeks. The first week or two after treatment, you may be nauseated, tired, and susceptible to infections. By the third week you will probably be feeling alright for work or travel.
It's important to remember that your treatment schedule can be flexible, especially during holidays or if you have a vacation planned. Talk to your doctor -- you may be able to delay the start of chemotherapy if you already have a trip planned, and you will usually be able to miss a treatment and reschedule it according to what works for you.
For people with metastatic disease, timing of treatments can usually be more flexible. Your doctor can usually work around any vacations you have planned or would like to plan. Though if you have disease that is progressing and causing symptoms, then it's probably best to move ahead with treatment right away. Read more about chemotherapy.
You should be able to work while receiving radiation treatments. While your radiation schedule will usually be 5 days a week for 5 to 7 weeks, the appointments are generally short. Treatment centers work efficiently so that the process only takes 15 to 30 minutes. Many centers open early and close late to help patients fit treatments into their daily routines. Radiation generally won’t affect your ability to work: most people only have mild fatigue.
For the greatest effectiveness from radiation therapy, once you start your treatment, it's essential to keep to a continuous schedule. Rather than interrupting your treatment, it's better to postpone the start of your treatment if you have vacation plans. But if there is a holiday, or you have a weekend trip planned, you have some options. Talk to your radiation oncologist about skipping a day and making it up at the end of your treatment schedule, scheduling an early Friday session followed by one late on Monday, or getting two treatments in one day and skipping one day. Read more about radiation.
Most hormonal therapies are taken in pill form over many years, so they will not interfere with your daily schedule or holidays. Some people experience significant side effects or have trouble managing them, which may affect your routine. If this is the case, you can talk to your doctor about switching therapies. Read more about hormonal therapy.
Different targeted therapies are given in different ways, so how they impact your daily routine will depend on what medication you are taking. Herceptin (chemical name: trastuzumab), the most well-known, is given through an IV, while Tykerb (chemical name: lapatinib), a newer therapy, is taken in pill form. Read more about targeted therapy.
Individual reactions to the different targeted therapies vary. Once you know how you’ll react, your healthcare team can come up with a plan that works best for you and you should be able to plan your weeks accordingly. If you’d like to take a break for vacation, it is possible to skip a week or two, depending on how you are doing.
General planning concerns
If your employer is giving you a hard time about changing your work hours to accommodate your treatment schedule and you feel you are being treated unfairly, remember that you do have rights. Learn ways to handle workplace issues.
Whether you are continuing to work, taking time off, or planning a vacation or holiday, it's important to let your loved ones know how you're feeling. Delegate chores and preparations to someone else. If you do go away, choose a place where you can relax and rest. If you don't feel up to hosting a holiday dinner for 12, let your family know that you'd prefer something a little less rigorous this year. Focus on YOUR needs, and let your loved ones and doctors know your desires and limits, they will be able to help you best fit treatment into your schedule.
If you are not able to take a vacation that is already planned -- tickets purchased, rental agreements signed -- get in touch with customer service to find out how to get a refund. Many doctors are happy to write letters on your behalf explaining your inability to travel. Your chances of getting refunds may depend on the travel agency, airline, or realty firm handling the arrangements. Social workers in cancer centers often help with this problem as well.
If you do go away before, after, or in the midst of treatment, be prepared. Make sure you take important phone numbers with you. Ask your doctor for the name of a doctor in the area where you're going in case of emergency. Also, make sure you take enough of the medications you need: something for nausea, discomfort, skin irritation, etc.