This article first appeared in the St. Louis Beacon, April 1, 2009 - After surviving colon cancer, Brenda Kalemis of Creve Coeur thought her toughest fight was over. But repercussions of her cancer surgery have complicated another daunting challenge: finding a job.
Cancer survivors like Kalemis are 1.37 times more likely to be unemployed, according to a recent analysis of studies by the Coronel Institute of Occupation Health at the Academic Medical Center in Amsterdam. Those who have had breast or gastrointestinal cancers are most apt to face unemployment.
After Kalemis, 64, had a cancerous polyp removed in January 2004, she worried more about her health than her marketing job with St. Louis Community College. But while her position remained stable, the cancer spread and grew with surprising speed. Its progression and the new possibility that it was an extremely aggressive type called Lynch syndrome prompted the removal of her entire large intestine, reproductive organs and most of her rectum the following November.
In 2005, another surgery spared Kalemis from wearing a permanent ostomy bag but left her with a frequent need to go to the bathroom, especially in the morning before her medicines start to work. The pressure to beat the clock only makes things worse.
"The more you have the stress to get out the door you more your gut decides to act up," Kalemis said.
For three years, her understanding boss didn't care what time Kalemis arrived at the office. Excellent performance reviews testified to her dedication, she says.
"It wasn't like I goofed off or anything," Kalemis said. "I had duties at work and I performed them."
But in July 2008, after her boss retired and was replaced, Kalemis lost the job she'd held for eight years. Told that her position was no longer necessary, she wonders if she was booted because of her late arrivals.
Second-guessing explanations for being let go is common among cancer survivors, according to Charlie Prather, program director of St. Louis' Wellness Community, which offers free support, workshops and education for those with cancer and their families.
"Someone may get through cancer and all of a sudden find themselves downsized, and they feel pretty strongly it was because insurance premiums jumped for everyone in the workplace because of them," Prather said.
Prather sees many clients coping with the irony of winning their bout with cancer only to feel like a loser in a highly competitive job market. Embarking on a job search that coincides with Missouri's worst unemployment rate since 1984 -- more than 8 percent -- can intimidate even the healthiest of job seekers. For those who need flexible hours or struggle to explain long gaps in employment during which they battled cancer, the stress can be overwhelming.
"It's one more thing on a really big plate full of a lot of things that affect you when you have cancer," Prather said.
Ever-increasing survival rates mean more people with a history of cancer will be staying in -- or returning to -- the workforce. Several of the 36 studies examined by the Coronel Institute show cancer survivors experience up to three times the unemployment rate of the general public. Barriers to full employment include difficulty fitting treatments in with work schedules, physical or mental limitations and discrimination -- which is illegal.
State and federal governments protect cancer survivors with several laws, including these provisions of the U.S. Equal Employment Opportunity Commission:
- Applicants do not have to tell a potential employer about their disease.
- Hiring managers cannot ask about an applicant's health or medications.
- An employer can ask whether the job seeker can perform essential functions of the job description, such as the ability to lift a specified amount of weight.
- Discovery of a cancer history cannot be used to justify revoking a job offer or firing an employee unless it reveals an inability to perform job duties.
In many work settings, Kalemis' situation would not prevent her from performing tasks, said local employment attorney Ann Plunkett. Kalemis has a legal disability because it affects "one or more of life's major activities," according to the EEOC. Plunkett said an employer would have to accommodate Kalemis in one or more of several ways: locating her near an office bathroom, changing her start time or having her work at home in the mornings.
If an employer balks at accommodating a cancer-related (or other) disability, the employee should first try to work it out through their human resources department, if there is one.
"Responsible employers work pretty hard to make reasonable accommodations," Plunkett said. "The bigger the company and the more sophisticated it is, the more likely that is."
If the company still refuses, the next step is to contact the EEOC, the Missouri Commission on Human Rights or a private attorney.
An ideal workplace may be one in which a supervisor has also had cancer. Mary Wright, a breast cancer survivor and social worker, enjoyed tremendous support in her job at St. Anthony's Hospital in south St. Louis County, because both her boss and a coworker had fought the disease.
"They would understand if I was grouchy, if I was tired, if I got a little forgetful from the chemo or if I had to leave a little early because I was exhausted and I had to go home and sleep," Wright remembered.
Meanwhile, Kalemis gets by on unemployment that runs out in a few months. She doesn't want to be classified as unemployable and receive a monthly disability payment, as Missouri Division of Vocational Rehabilitation has suggested; she wants to earn a paycheck.
As Kalemis searches through the want ads and thinks about going back to school, she worries about losing her home. Still, she's as optimistic and persistent as the healthiest of job seekers.
"It's kind of like selling," Kalemis said. "The more people you approach, the better your chances."
Nancy Larson is a freelance writer.
