Going back to work with cancer or post-treatment is a journey fraught with so much uncertainty that it’s impossible for employers to use ready-made solutions to support staff. Rachel Beaujolin, a research fellow at NEOMA, argues for a totally different approach: multi-stakeholder, joint collaboration based on temporary, scalable arrangements rooted in three working principles.

Managing cancer in the workplace faces numerous challenges. Did you know that 160,000 new cases of the illness are detected every year in the working population in France? And that several years after the initial diagnosis, 64% of these employees will still be suffering the after-effects of their treatment, including tiredness, pain and cognitive impairment?

Employees who benefit from adjustments to their working conditions post-diagnosis are more likely still to be in work five years later. What’s more, a 2019 survey by the Haute Autorité de Santé (French Health Authority) found that staying in work helped lengthen life expectancy.

Cancer: an important issue for corporate social responsibility

It follows that balancing cancer and work is an important social responsibility issue for businesses and organisations. The French Cancer Institute has published a Cancer and Employment Charter that has been signed today by 90 companies with 1.9 million employees. Not-for-profit organisations also provide support to workers who have – or have had – cancer.

But we’re still left with the question of “How?”. What kind of solutions are there, who are the main actors, and what methods should be employed to ensure that this support actively encourages “health-building work”? 

Rachel Beaujolin, a researcher in management science, facilitates the scientific committee of an open-innovation project investigating the links between work and breast cancer (directed by Pascale Levet at the Nouvel Institut). Rachel herself has suffered from cancer, giving up work for more than a year before gradually going back. Her article blends academic expertise with knowledge gleaned from her own experience, which she contextualises using an auto-ethnographic approach.

Balancing cancer and work: fraught with uncertainty

If there’s one word that sums up the tricky work-cancer balance, it’s uncertainty. Given the risk of recurrence, we can’t know how the illness will develop. The nature and rhythm of treatment are unpredictable, as are the length and intensity of the side-effects. The productive capacity of the employee goes up and down, and is impossible to predict. With its myriad grey areas, life after (or with) cancer cannot be the same as before, and – most important of all – this new life has to be defined by the different actors involved.

The work environment is also a source of uncertainty: will colleagues and managers react appropriately (or not)? Will it be possible to adjust the employee’s role and re-organise tasks? Will HR be able to think ahead and simplify the process for monitoring sick leave or the transition to part-time employment? When all is said and done, it is the employee with cancer who will redefine the role and importance of work in their life.

In light of these observations and previous research, Rachel Beaujolin rejects off-the-peg solutions: closed questionnaires, databases with ready-made responses, linear decision-making processes based on rigid situation analyses, fixed-term arrangements, and so forth.

Tackling problematic situations and building collective solutions

Beaujolin’s preferred hypothesis is “that everything has to be built from the ground up”. She advocates an on-going, joint approach when faced with difficult, unforeseen scenarios, and companies that tackle and respond to problems with meaningful answers. This combination of action and analysis produces constantly-evolving knowledge. It is organised around three key principles that apply from the initial sick leave to the return to full-time work.

First principle: The organisation must provide positive conditions for this kind of approach. This starts with stakeholders (managers, colleagues, HR, etc.) equipped with the skills to adapt to the practical realities of work(beyond just job titles and tasks): roles in the organisation, the type of work that is feasible, the nature of the different types of contributions, and so forth.

This is a role that managers are often appointed to, but they cannot work one-on-one with staff members in isolation. They need to be supported by the various stakeholders and occupational health (amongst others). And this doesn’t necessarily mean the line manager if, for instance, they aren’t equipped to deal with situations where suffering and death loom large.

An approach based on innovation and transformation

Second principle: Informal conversations between the employee and their managers, colleagues and HR bolsters the dynamic process of “organised” constructive collaboration. Rachel Beaujolin talks about these exchanges when recounting her own experience: “there were no obligations or operational purpose”, and conversations were devoted to her work situation there and then. These discussions brought to light possible ways forward as well as ideas that subsequently turned into temporary solutions. Care pathways are always somewhat chaotic, but this dialogue helped both parties revise and share their views about the current situation, which by its very nature is forever changing.

Third principle: Devise, road-test and fine-tune possible scenarios, and transform the existing state of affairs should be the objective. The aim is to forge new work situations which (you never know) may end up breaking new ground for the entire organisation. This means coordinating experts (health, different job lines, legal department, HR, admin etc.) and employees affected by cancer in order to generate the conditions for their cooperation. It also involves building and sharing the experiential knowledge of these employees on working with and after cancer.

Read more

Rachel Beaujolin, Accompagner la conciliation travail-cancer – Un enjeu épistémologique et méthodologique pour les sciences de gestion, Revue Française de Gestion, 2024.  doi:10.1684/rfg.2024.24