Working With Cancer: One Colon Cancer Patient’s Story

One November morning in 2021, Derrick Edwin woke with pain in his side — as a triathlete in peak condition, he knew something was off. “Two months before, I had completed an Ironman — that’s a 2.4-mile swim, 112 miles on the bike, followed by a full marathon — and I felt great crossing the finish line. I told my wife, AnnaMarie: ‘I know my body. I think I need to go the emergency room.’”   

Imaging scans soon revealed what would turn out to be stage 4 colon cancer. He was just 43 years old. “It was shocking,” he says. “The world stood still for 20 minutes while I tried to figure out what to do.” Derrick’s next step was calling Memorial Sloan Kettering Cancer Center (MSK) at the recommendation of his coach. “I got diagnosed in the ER on Long Island around 11 in the morning and was at MSK in Manhattan by 5. When things finally calmed down and I was able to think, I realized I had to contact my employer.” 

How Cancer Can Impact Your Work Life 

For most of us, work is fundamental to our lives. Whether it’s a job we love or what we do to sustain ourselves (or both), work offers us financial security, access to health insurance, and a sense of purpose and belonging — if we’re lucky. 

In fact, the fear of losing a job because of a cancer diagnosis can be as overwhelming as the fear of dying. One in two cancer patients report being afraid to share their diagnosis with employers, according to research from Working With Cancer, a global initiative co-founded by the Publicis Foundation and MSK that encourages companies to pledge job security and cancer benefits for employees and their caregivers. 

Derrick, a manager for the in-house advertising studio of a global tech and telecommunications company, has continued to work through three-plus years of treatment — including surgeries, chemo- therapy, and immunotherapy — and has gone on to win recognition and awards. “My bosses have been incredible,” he says — offering time off for treatment and making him feel secure in his role. “That’s allowed me to focus on my cancer and on my treatment, so those weren’t stressors. My employer has been amazingly supportive, but I know that’s not the norm.” 

Derrick witnessed the impact of uncertainty at work through AnnaMarie — who as his primary caregiver struggled to find support at her job — and through his friendship with another patient at MSK. “He was a good, good man,” says Derrick, “and we got to be close. He was so sick, but he was going to work and still trying to get the job done, and he was getting beaten up by his bosses, who were completely not understanding his situation. He kept losing jobs. It was an eye-opening experience for me. Watching his struggles at work, I started realizing how lucky I was.”

Support at Work While Facing Cancer Is a Matter of Survival  

Being able to work with cancer — and finding support at work — has a significant impact on patient outcomes, and likely even on overall survival rates, says Victoria Blinder, MD, a breast medical oncologist at MSK who leads several research studies for the Immigrant Health and Cancer Disparities Service. “If you have a job and can maintain an income stream and access to benefits, you’re more likely to have access to the medication you need and to live longer.” 

Early on in her practice, Dr. Blinder found that her patients were struggling to return to work and that there were few resources available to help them navigate those challenges. “We realized this was a place where we could potentially intervene to improve patient outcomes dramatically.” 

How MSK Programs Help People With Cancer Navigate Work   

In 2018, Dr. Blinder and her colleagues developed TEAMWork (Talking to Employers And Medical staff about Work), an app available in English and Spanish designed to help breast cancer patients negotiate with their employers for accommodations. Based on the success of that trial, they expanded to WE-ACT — an app for patients working with advanced or metastatic cancer — and the MSK Program for Cancer and Work, a pilot program that pairs patients with a navigator who screens them for occupational and physical therapy needs and helps them identify and pursue potentially helpful work accommodations. 

In MSK’s Center for Young Onset Colorectal and Gastrointestinal Cancers, most patients, like Derrick, are in their 30s and 40s — and many are living with cancer as a chronic illness. That’s a paradigm shift, says MSK social worker Hadley Maya. People with advanced cancer are continuing to work for many years, sometimes decades — and it introduces a complicated kind of uncertainty for employers. What does it mean to work with cancer over the course of a lifetime? 

How Cancer Impacts Younger Workers

“It’s such a fragile point from a career and financial perspective,” for younger patients, says Maya. “They haven’t necessarily had time to generate savings and they’re in the middle of building their careers. Many of them have young children at home as well as aging parents who rely on them for practical and financial support. They hold on so tightly to their jobs because they mean so much to them from a financial and health insurance perspective. And for many, work is also a big part of their identity, something that gives them a sense of purpose and social connection.” 

Even before treatment begins, cancer patients must weigh the risks of transparency — sharing the news of a serious illness with their employer — against the risks of isolation if they choose to keep their diagnosis private. 

For the individual and their family, a cancer diagnosis is like an earthquake or other natural disaster, says MSK social worker Jacob Maier, who works with newly diagnosed patients through one of the nation’s largest employer cancer benefits programs — MSK Direct — which is offered by more than 275 employers and unions. “People are in shock — and in that state of shock, they still have to make several practical decisions, including how much to share with their employer and with colleagues.”

The Future of Cancer Benefits at Work

Unsurprisingly, research shows that patients who feel supported at work during cancer treatment are much more likely to be working for that same employer two years after they finish their treatment. That support also positively affects the loyalty of their colleagues — engagement and morale go up across the board. “Being in a work environment where you see that your friend or colleague is cared for and is accommodated during their moment of need, that’s going to make you feel good about the place where you’re working,” says Dr. Blinder. 

Derrick says he can understand why employers struggle with how to accommodate employees going through weeks, months, or even years of cancer treatment. “I understand it as a bottom-line issue — I can understand a business owner feeling they’re not getting enough from an employee. But if your employer is giving you a hard time on top of cancer and telling you you’re going to lose work while you’re going through your treatment, it’s crushing to the soul.” 

Cancer is expected to rise by 50% by 2050, according to the Centers for Disease Control and Prevention (CDC), with the most significant increases hitting younger people in the prime of their working lives. Employers will have to find ways to keep pace with a workforce increasingly shaped by cancer. 

“I want to work,” says Derrick. “Work is normal. The cancer world is going to be a part of my life forever, but for eight hours a day, work allows me to put it off to the side and focus on what I get paid to do, which also makes it possible for me to afford my house, my life. Here I am dealing with cancer, but I can still work my craft to the best of my ability and get recognized for it. That’s amazing.”