Going back to work after cancer treatment: a UK guide

There is no set date for going back to work after cancer treatment. St George's University Hospitals NHS Foundation Trust says "Everyone's experience is different, and there is no right or wrong timeline for returning to work or education" [4].

St George's suggests asking yourself "How is my energy level throughout the day?", "Can I manage travel to and from work or education?" and "Are there physical aspects of my role or course that may be challenging?" [4]. Breast Cancer Now notes "You may have ongoing side effects from treatment such as fatigue and cognitive impairment (chemo brain)" [5].

If your employer has an occupational health service, Prostate Cancer UK says the service may be able to assess your role and "recommend practical changes to help you continue working safely" [8]. For getting active again, see our guide to exercise after cancer treatment.

A phased return means building your hours back up over a period of time instead of going straight back full time. Breast Cancer Now defines a phased return as "when you gradually build up your hours or workload when coming back to work", adding that "It might include starting on reduced hours or having a lighter workload" [5].

Breast Cancer Now says a phased return "may be particularly helpful if your job is physically or mentally demanding" [5]. St George's suggests discussing with your employer "A plan for gradually increasing your workload", "Adjustments you might need" and "Time off for medical appointments" [4].

Agree these with your manager:

• your start date and your hours for each week
• which duties come first, and which wait until later
• any adjustments that carry on after the phased return ends
• regular check-ins, so the plan can change if fatigue or side effects get in the way

If you want to keep shorter or part-time hours after your phased return, Breast Cancer Now says "you can make a flexible working request" [5].

Yes. In England, Scotland and Wales the Equality Act 2010 treats cancer as a disability from the day you are diagnosed [1][7]. In Northern Ireland, Cancer Research UK explains that "The Disability Discrimination Act still applies to people with cancer in Northern Ireland" [9].

Schedule 1 of the Act says: "Cancer, HIV infection and multiple sclerosis are each a disability" [7]. Cancer Research UK adds that "The Equality Act applies to people with cancer or those who have had cancer in the past" [9].

You choose what to share. Cancer Research UK says "You don't have to tell your employer you have cancer", but adds: "But if you don't tell them, they can't make any changes to your job or workplace" [9]. You can also "ask your employer to keep the information confidential" [9].

Reasonable adjustments are changes to your job or workplace so that you "are not substantially disadvantaged when doing" your job [2]. Cancer Research UK explains that "any changes or adaptations must be practical for your employer" [9].

Examples from GOV.UK and cancer charities include:

Type of adjustment	Examples
Working time	"allowing employees who become disabled to make a phased return to work, including flexible hours or part-time working" [2]; "time off for hospital appointments" [8]
Duties	"reducing your workload or giving you lighter duties" for a period of time [5]; "amended duties: changing duties to take account of a health condition, such as no heavy lifting" [6]
Where you work	"working from home where possible" [8]; "Hybrid or remote working" [4]
Practical support	"easy access to toilets" [8]; "Moving your desk closer to the toilets" [5]; "Additional breaks throughout the day" [4]; "changing their equipment" [2]

Agree adjustments before you go back, in writing if you can. For free advice on your rights, Breast Cancer Now points to Acas (the Advisory, Conciliation and Arbitration Service), which "provides free and impartial information and advice to employers and employees" [5]. Cancer Research UK says "You can also get advice from Citizens Advice if you can't resolve the problem by discussion" [9].

A fit note can recommend a phased return, altered hours, amended duties or workplace adaptations [6]. Prostate Cancer UK notes a fit note "can be provided by your GP or hospital team if your health is affecting your ability to work" [8].

The government's fit note guidance describes the four options [6]:

• "a phased return to work: a gradual increase in work duties or hours"
• "altered hours: changes to the times or duration of work"
• "amended duties: changing duties to take account of a health condition, such as no heavy lifting"
• "workplace adaptations: changing aspects of the workplace, such as working from home"

Fit notes can be issued by "a doctor, nurse, occupational therapist, pharmacist, or physiotherapist" [6]. You do not need a fit note "if you are off sick for 7 calendar days or less" [6]. The suggestions on a fit note "are not binding on you, and you should feel free to discuss other options" [6].

Access to Work is a government grant that can pay for practical support at work if a health condition or disability affects your job, and the grant "will not affect any other benefits you get" [10].

Access to Work can help pay for "specialist equipment and assistive software", "support workers", and "costs of travelling to work, if you cannot use public transport" [10]. To be eligible you must "be 16 or over" and "be in paid work (or be about to start or return to paid work in the next 12 weeks)" [11]. Self-employed people can apply but "must have an annual turnover of at least £6,500" [11].

Access to Work covers England, Scotland and Wales. GOV.UK says "there's a different system in Northern Ireland" [11], called Access to Work (NI) [12].

Plan your working day around your energy, build in rest and some activity, and ask for adjustments such as extra breaks [4][13]. St George's lists "Fatigue or reduced energy levels" among the effects you may still have after treatment [4], so you may still need some changes after a phased return ends.

Macmillan suggests "planning your day so that you have energy to do the things that are most important to you", and says to "Pace yourself, take short naps and rests but try to balance them with some activity or exercise" [13].

Our guide to cancer-related fatigue covers its causes and when to call your care team.

Gradually increasing your activity before you return may help, because a Cochrane review found that physical programmes such as walking, yoga or exercise likely increase return to work after cancer [3]. Start slowly and get advice first [14].

The Cochrane review, updated in 2024, included "15 RCTs involving 1477 people with cancer" [3]. RCTs are randomised controlled trials. The review found that "Physical interventions likely increase RTW compared to care as usual", based on moderate-certainty evidence from four trials with 434 participants [3]. RTW means return to work. Multidisciplinary programmes, which combine support from several professions, also "likely increase RTW" [3].

The evidence has limits. Most trials "were aimed at people with breast cancer (nine RCTs) or prostate cancer (two RCTs)", and all were in high-income countries [3]. The same review found that these programmes "may result in little to no difference in QoL" (quality of life) [3].

St George's, a London NHS trust, advises: "Start gently and build up gradually, particularly if you are new to physical activity" [16]. Before you go back, practise the physical parts of your working day, such as the journey or time on your feet, and build these up week by week.

A clinical exercise physiologist (CEP) can turn that into a structured plan. NHS Health Careers describes CEPs as "prescribing and delivering evidence-based exercise to help patients prevent, treat and manage their long-term conditions", including work "with patients with different types of cancer and at different stages of treatment" [15]. See cancer rehabilitation in the UK and cancer rehabilitation in London for how exercise support fits into cancer care.

Request a match with a verified clinical exercise physiologist through The Health Nav.