Telling your manager you need time off for cancer treatment

This page is for people in cancer treatment who are getting ready to talk with their boss. It covers what NCI suggests saying, asking for, and writing down.

Most people rehearse this conversation as an announcement — the moment they tell their manager something big. NCI's guidance treats it as something more manageable: a request, planned in advance.

It says to plan what you will say about your cancer, and it acknowledges there is no right way to deal with others about your illness. That second half is genuinely freeing. There is no template you are failing to follow.

A practical way to begin is a quiet conversation with your supervisor or HR about the adjustments you need. NCI's guidance is to ask for adjustments that support your continued employment and to document each request and its outcome.

The single most useful piece of NCI's guidance is to request specific changes. The examples it gives are flextime, working at home, and special equipment at work.

Compare two versions of the same conversation. One is "treatment is going to make things difficult for a while." The other is "I have infusions on alternate Wednesdays, I would like to work from home the following day, and I would like my Wednesday afternoon meetings moved."

The first hands your manager an open-ended worry. The second hands them a scheduling task. A specific request is easier to act on.

Turn a health problem into a logistics problem and you make it something your employer can actually say yes to.

NCI advises documenting each request and its outcome. This is unglamorous and it is the advice people most often skip.

A short email after the conversation, covering what you asked for, what was agreed, and when it starts, is one simple way to keep that record.

NCI suggests having your physician provide a written explanation of how cancer may affect your work schedule.

A letter gives your employer a written account from your doctor of how treatment may affect your schedule. Ask your care team about it.

NCI notes that federal law prohibits discrimination against workers with disabilities, including cancer, and it directs readers to the Cancer Legal Resource Center for further detail.

NCI also suggests asking your social worker about employee protections in your state.

Deciding what your manager knows does not decide what your colleagues know. Coworkers may respond in different ways, and some may not know how to help.

It also makes a practical suggestion for keeping people informed during absences — by phone, email, or through a trusted intermediary — noting that colleagues who are kept informed are less anxious. If you would rather not run that yourself while in treatment, nominating one person to do it is a legitimate arrangement. And if a coworker's attitude is hurting you, NCI's advice is to start a direct conversation, and if problems continue, to involve your manager or an employee assistance counselor.

1. Say that you are having treatment and expect to keep working.
2. Name the specific adjustments you want.
3. Say what you will still be delivering.
4. Offer the doctor's letter.
5. Then send the email that records what you agreed.