Cancer patients should not need to choose between work, treatment

I've spent much of my career in community and academic oncology treating a variety of patients with diverse cancers.

When you spend each day caring for people with cancer, you learn of the unique ways cancer diagnoses and treatments affect patients and their families. No cancer diagnosis is the same. No treatment is the same. Each person with cancer is an individual.

As they journey toward better health, the effect of treatments on their daily lives and how these affect their normal home and work routines will be unique.

As an oncologist, you set forth a treatment plan and schedule to give each patient the best chance of remission or cure, but often a patient's story involves more than just the medical treatment they receive.

Today, more than ever, people across Ontario are facing a cost-of-living crisis, with everything from groceries to housing costs, gas and utilities increasing. Imagine facing a cancer diagnosis on top of all the stresses of life, including worries about economic and job security for patients and their families as they require time off work to receive and recover from treatments and surgery, as well as attend appointments with health-care providers.

Those who are already socially disadvantaged or struggle to make ends meet face an even steeper hill to climb during a cancer diagnosis. They may work in temporary and contract jobs where they don't have adequate benefits, and they likely don't have a short- or long-term disability plan to rely on for that time off.

Instead, patients like this face a stark choice: go to work and jeopardize your treatment outcome or get treatment, at the risk of losing your job and income.

A patient's first thought after receiving a diagnosis should be focused on recovery.

One man I treated had Stage 3 melanoma and worked a precarious cash job with no benefits. His employer wasn't happy to have him take time off for followup appointments and blood tests. In the midst of a life-altering cancer diagnosis, he was forced to quit his job and seek alternative employment, resulting in needless strain, both personally and financially.

People should not have to choose between having the security that they will be able to put food on the table and a roof over their heads, and receiving the treatment they need. Sadly, this dilemma is far from unique: we see it every week in our work.

I've seen the benefits of better cancer treatments over the last few decades that are increasing survival rates. Curative treatments are allowing more and more patients to live full lives with and after cancer. While effective treatments are improving outcomes, the economic dilemmas for patients are amplified, sometimes with tragic outcomes.

Another young patient of mine was a 19-yearold carpenter with no benefits, diagnosed with a very curable Hodgkin lymphoma. I recommended chemotherapy every two weeks for six months.

Unfortunately, his employer wasn't flexible enough to allow him to attend enough of his scheduled treatments. In addition to this, his job was physically demanding, and he often skipped many cycles of chemotherapy. This young man lost his life, unfortunately.

A patient's first thought after receiving a diagnosis should be focused on recovery, not on whether they are able to keep their job or how they will pay their bills.

With changes made in 2022 by the federal government, a person who can't work for medical reasons qualifies for federal EI payments for 26 weeks. But in Ontario, an employer is only required to provide three days of leave for medical reasons. This means that after three days off for medical reasons, you can be fired in Ontario — while undergoing cancer treatment.

By changing the provincial Employment Standards Act to ensure that job-protected leave in Ontario matches the federal government's EI changes, Ontario could protect cancer patients and their families, ensuring they could not be fired while off work for medical treatment for up to 26 weeks. And during that time, they could go on EI.

No one expects cancer. No one deserves to struggle through difficult treatments while their job security is uncertain.