Cancer: employers need to facilitate confident conversations

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October is Breast Cancer Awareness Month and to mark it we spoke to Mental Health Trainer Sharron Moffatt, who was diagnosed with breast cancer in 2023, just 18 months after losing her mum to the disease.

As a result of her experiences, she wants to break down barriers in conversations around cancer and believes that employers have a central role in helping their employees to feel more confident when having conversations about the disease at work.

Given the fact that research now predicts that one in two people will develop some form of cancer during their lifetime, we must as a society get better at dealing with cancer in the workplace, as work can be so beneficial to mental health and giving someone a sense of purpose; two things potentially under threat when dealing with the disease.

As you’ll see from Moffatt’s words below, we are still a way off from normalising conversations around cancer at work and, in her opinion, colleague perceptions can be one of the most challenging aspects of living with the disease.

Cancer patients have enough pressure to deal with without the added, unspoken pressure of needing to make colleagues feel more comfortable around cancer.

Read her thoughts below.

You wrote a post on LinkedIn recently about colleagues’ expectations of what someone with cancer ‘should’ look like. Can you tell me more about this?

Yes. Often, people expect you to look sick all of the time, yet ironically feel uncomfortable if you go bald and bare. It’s as if, for some people, you don’t look sick enough, for others you look too sick. Either way, someone will make assumptions based soley on your appearance.

Why is that, do you think? Have people got a preconceived idea of what someone with cancer ‘should’ look like?

It’s basically stigma. 

As a self-employed person, one of the challenges is clients assuming I’m not well enough to work . Sometimes they’ll say ‘we’ll contact you in six months when you’ve finished your treatment’, even if I’m perfectly well enough to do the work. 

They genuinely mean well, but it’s about having an open conversation and having the right policies in place (if employed) to support someone . 

And, yes, I think people do have preconceived ideas, although it’s much better than it was.

If you look at images around cancer that were being used even a few years ago, it’s very much images of old people and/or someone with a bald head or scarf looking pale and thin. They were certainly not looking vibrant or smiling. Images are more inclusive now but I think there’s still alot of misguided views about cancer. 

What can we do about reducing stigma? 

Stigma comes from lack of understanding and knowledge. I think people believe  cancer, regardless of type or treatment are all the same, and they’re often  too scared to acknowledge cancer, hoping it won’t affect them .

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It reminds me of how we thought about mental health ten years ago.  We just didn’t talk about it. People felt ashamed to admit they were struggling and the stereotype of mental illness and lack of understanding was so stigmatising. No one wanted to discuss it. 

Cancer very much fits into that category of ‘I don’t want to talk about it, I don’t want to acknowledge it’.

I suppose the difference between mental health and cancer is that, to a certain extent, you can potentially hide the former more easily? Is that right? And would you even want to hide it?

Well, not all side effects are visible. I’ve got no eyelashes and no hair, not out of choice.  I make a real effort to make myself look well.  I don’t want others to feel uncomfortable or sorry for me and I don’t want them to assume they know what I’m experiencing just by looking at me. 

We interviewed Louise Boston, Strategic Health & Wellbeing manager at E.ON, about working with cancer and she said she realised at one point she was wearing her uncomfortable wig to make her colleagues feel comfortable. Do you relate to that?

Yes! I totally relate to the pressure to make colleagues feel more comfortable around cancer.

In the beginning, I found it difficult to look at myself in the mirror, whereas now I’m more comfortable taking my wig off in front of family, close friends and a few people I work closely with.  

It’s when I’m on my own and other people can’t help staring at my bald head, that I feel my least confident. And then you get the head tilt from them with the question ‘ah, is it cancer?’. It’s uncomfortable for them, and awkward for me. 

I think the discomfort others feel is around lack of understanding not knowing what to say. 

How would you prefer others to relate to you?

Don’t avoid me. 

Alot of people don’t know what to say, so they don’t say anything, a bit like grief. So will avoid you, or instead of starting an open conversation they will say something cliched like ‘you’ve got to stay positive!’, ‘keep fighting!’ or ‘you’re so brave’.

That kind of language can make some people who have cancer feel really uncomfortable. Firstly, no one is positive all the time and I don’t feel brave at all. Cancer doesn’t give you a choice.  Secondly, for me personally,  I’m not ‘fighting’ cancer, my oncologists is. There are no winners or losers when it comes to cancer, and it’s not about trying hard enough. 

Also remember that people who have cancer want to talk about normal stuff too. We want to hear what’s going on in colleagues’ lives, including moaning about mundane stuff. I really don’t want to be talking about my cancer diagnosis 24/7. There is so much more to me than that.

It all comes down to not being afraid to have a conversation with someone. Employers can help employees become more confident when having that conversation around cancer.

What would that look like for employers?

Employers need to put cancer on the wellbeing agenda, which in many cases, it isn’t. That would be really beneficial because you’re educating people and giving them the facts, such as on prevention, what to look for and how to support someone etc.

There is so much misinformation out there. Recent research by Working with Cancer reveals that 71% of workers fear telling their employer about their diagnosis. This should be very alarming to employers. They need to look at why that is.

Again, cancer is in a similar position that mental health used to be, and now we’re talking about it openly. We’re even talking about things like menopause, gambling harm and neurodiversity in the workplace. 

But where is the awareness around cancer? there’s very little shared in the workplace on prevention either, or how to support others. 

Having training for managers and having the right policies in place can improve this.  

Children treat the unknown with more curiosity, perhaps?

I don’t have children, but I have five nieces.

I guess the difference with children is that you know it comes from a very genuine place. They say what they think and aren’t afraid to talk about the elephant in the room  Adults, by contrast, are very quick to give you their opinions, or feel awkward and avoid you. So, it’s about educating people to be more open minded and share guidance and information, creating environments where people don’t feel afraid to talk. 

I mean, employers have done it with the menopause. Would you ever have imagined so many people today to be talking about menopause at work five years ago?

What do you think could be holding some organisations back from talking openly about cancer? Fear?

What I’ve come across is organisations saying ‘our employees are too young’, or ‘no one has cancer here’. But the number of under 50s being diagnosed with cancer has risen massively in the last 3 decades. Cancer doesn’t discriminate when it comes to age or gender.

One in two of us will  get cancer in our lifetime and someone gets diagnosed with breast cancer every 10 minutes in the UK. But it’s not just the person who has the diagnosis that’s being impacted. It’s their loved ones around them too;  friends, family and even colleagues . 

What’s the most difficult thing about working with cancer?

Other people having a preconceived idea that I won’t be able to do the work, followed by not knowing what to say to me, so avoiding me. That can be very isolating and lonely.

What can employers do this Breast Cancer Awareness Month? 

It’s important to go beyond pink symbolic gestures . Organisations can take meaningful action by educating their teams on evidence-based prevention strategies and promoting the importance of regular self-breast exams for everyone, regardless of gender. With 40% of cancers being preventable (source: Cancer Research UK), and 44% of women in the UK not checking their chests regularly (source: Breast Cancer Now), this kind of awareness can truly make a difference.

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