A plan for cancer – dealing with serious illness

2 December 2015

When cancer strikes, it can have a devastating impact no matter who you are, writes Professor Gordon Wishart, medical director at Check4Cancer. But as a CEO, what does it mean for the company? And what action can you take to protect yourself, your business and your workforce?

Robin Stanton-Gleaves describes himself as a very hands-on CEO. "I'm a man who has 100mph energy levels," he says. "I drive the business very hard, and my involvement is very personal."

When a routine health check turned up some unusual results, he was referred for further tests. These revealed aggressive prostate cancer. "It had got to the stage where I had to have the radical prostatectomy - where the prostate is taken out - and I didn't have a lot of time before that had to happen." It was immediately clear this was going to have a huge impact on him personally and the whole organisation.

This was not simply about taking time out of the company - Balreed, a managed print service provider. Even if the responsibilities and workload can be covered by deputies - and every company should have measures in place to ensure they can - a CEO like Stanton-Gleaves will be missed, which can shake confidence and undermine morale. It also raises questions such as: Is the boss coming back? If the worst happens, what does that mean for the company? Are jobs secure?

Although his illness was deeply personal, Stanton-Gleaves decided to inform the workforce, by first announcing it to the board, and then to staff via email. The news had an immediate impact on the mood of the workforce, which his PA Natalie Miles describes as "quite sombre".

His message to staff was simple: "Please, just continue doing what you are doing in my absence." Stanton-Gleaves was just 46 at the time.

He had the operation, made a full recovery and returned to work - but his example is interesting. Despite the initial negative impact of the news, Stanton-Gleaves' decision to share his diagnosis and keep staff informed brought everyone within the organisation closer together.

Impact on staff

Published in May 2015, a Check4Cancer study of HR professionals called 'Cancer in the Workplace: What Does it Mean for HR?', asked what they thought would be the impact of cancer on their organisation in the near future, and 63% said the greatest impact (rated as 'very high' or 'high') would be on staff planning. Next was absenteeism (59%), followed by medical insurance premiums (58%), other insurance premiums (50%), and client relationships and management (50%). Further implications included lower productivity, negative effects on staff morale, and a need for more services and long-term support, such as counselling and family support services.

Showing support

This brings us to the first rule in supporting any employee with cancer, at whatever level in the organisation, which is not to be reactive: it's far too emotional a situation for everyone to make up a response on the spot. People want sympathy and understanding, but they also want a sense of normality and control, not crisis.

HR should prepare policies and templates for conversations for themselves and line managers that can be used at each stage of the situation - from when a diagnosis is made to when the employee wants to return to work. A cancer care policy needs to include stock questions for sensible and objective conversations, such as 'How are you feeling about work?', and 'What changes have you noticed in yourself?' Managers need to be briefed on the importance of listening and not getting caught up in the rush to get a valued member of the team back into work.

There also needs to be transparency. The nature of the typical leader/follower relationship can be a personal one, involving a sense of admiration, even affection, with leaders being seen as senior members of a family. It means employees will feel excluded and let down if there is secrecy around such a serious issue, at a personal level for the individual and potentially in terms of the future of the organisation they work for. But communications always need to be preceded by a thorough phase of planning and consultation at senior levels. It's not about a single, formal process being followed, but about exploring and determining the preferences of the individual with the cancer diagnosis. What do they feel physically and psychologically about the coming months and what will they be capable of doing, and want to do? How do they want the difficult news to be communicated, and what detail should be provided on how the business will be run during any periods of absence? The major risk to an organisation in terms of the absence of a leader comes from any lack of planning. This is where early diagnosis is, again, so important. The severe pressure of a late diagnosis leads to a lack of time for consultation and the sudden sense of a need for knee-jerk action.

Around a quarter of people treated for cancer in the UK continue to need particular NHS care, even after being entirely cleared of the disease. A returning employee may have undergone extensive medical procedures: surgery, chemotherapy, radiotherapy, mixed with prescribed drugs with short, medium and long-term effects on cognition and physical abilities. The employee might look normal and well enough, but may not be able to function properly, unaware of the side effects and just how long some of them can last.

Important changes

Psychological consequences can be just as damaging and restrictive. Even when a patient is in remission, their sense of the world, its stability and security, will have been seriously shaken. It's likely to lead to a loss of self-confidence, a lower threshold of tolerance for dealing with any problems, more exasperation with colleagues. In particular, there can often be a change in values, which can be more marked at senior levels. Cancer makes people reflect on what is important in their lives, and it's possible that working long hours and taking on the burden of driving the organisation forward can seem trivial and meaningless when faced with your own mortality. It's also fairly common for cancer survivors to be diagnosed with depression post-treatment, once the focus of fighting cancer within the hospital environment is taken away and they have to start dealing with issues they've put on hold.

Keeping to ordinary work routines can be an important part of coping, particularly during the recovery phase. The challenge is making sure, at the same time, that senior executives (with their culture of independence and 'toughness' in the face of adversity) are also given the option of scaling back their level of responsibility to take time to recover.

Free screening

The Check4Cancer survey found that the majority (95%) of HR professionals questioned believed employers should provide free cancer screening for all employees in response to the growing prevalence of cancer among the working population and the rising numbers of cancer survivors returning to work. Currently, 63% actively plan to introduce cancer awareness programmes and/or screening in their organisation.

Meanwhile, HR professionals tend to overestimate the role of the NHS in providing cancer checks. For example, 42% said the NHS offered checking for bowel cancer generally when, in fact, it is only available to 60-69-year-olds. Meanwhile, 39% said prostate cancer was checked, 29% said the same of testicular cancer, and a quarter named lung cancer (26%) and skin cancer (24%), of which none are actively checked by the NHS.

At Balreed, it was agreed that a cancer-awareness programme and free testing for staff should be introduced.

"The point was that I paid to have that medical," explains Stanton-Gleaves. "Had I not done that, I would never have had a clue about the cancer inside of me." At the time of discovery, he had no symptoms whatsoever.

"The sooner it is detected, the better it can be treated, with fewer side effects," he adds. "My side effects are life-changing because I had to have the prostate removed, and had I found out earlier, perhaps I could have had a different treatment."

Prostate cancer workshops and individual tests were run at Balreed during January 2015 because, as Stanton-Gleaves' PA Natalie Miles explains: "In January, people are thinking about New Year's resolutions, and are a bit more mindful about their health."

The workshops were held at each of the company's locations within working hours, so it did not impact on lunch breaks. The testing clinics were immediately after for those who had decided to take them.

Stanton-Gleaves offered free prostate cancer testing to male relatives of employees, too. This decision was a personal one for him, and echoed that made by computer firm Hewlett Packard, which recognised that cancer can impact upon partners of those diagnosed almost as severely as those with the disease, causing stress, fatigue and requiring them to take extended periods of time off work.

Less tangible is the effect the offer of such broad testing has on the way staff view their employer, but during Hewlett Packard's cancer campaigns employee engagement went up 13%. It also detected at least 65 cancers early. One employee - whose cancer was picked up in time for treatment - said simply: "Working for HP saved my life."

Overall, 94 prostate cancer tests were carried out at Balreed. Of these, four were referred for further tests and it is likely that here, too, lives have been saved - and it's a powerful way for an employer to demonstrate that it cares about its staff and their families.