World Cancer Day, which took place on 4 February, is a one-day initiative aimed at raising awareness of cancer and its prevention, detection and treatment. It also acts as a reminder that many people currently living with cancer in the UK face daily challenges.

A recent survey conducted by the Institute of Employment Studies and Working with Cancer predicts that, of the 14 million people living with cancer globally, around half are of working age. Many employees who have been diagnosed with cancer are able to return to work following treatment. However, earlier research found that 18% of people diagnosed with cancer face discrimination from employers or colleagues on returning to work, 14% give up work or are made redundant, and 15% return to work before they feel ready. The reasons for this are, of course, complex. Many employers are not confident that they know how best to support their employees with cancer or, indeed, even that they know their legal obligations. This article seeks to offer some guidance.

The Equality Act 2010 protects people who are disabled from being discriminated against, or harassed, on the basis of their disability. Cancer is automatically deemed to be a disability under the Act. That means an employee with cancer will be protected without having to satisfy any other legal test about its impact on their lives. Furthermore, the Employment Appeal Tribunal has held that even "pre-cancerous" conditions may be deemed to be a disability. This protection applies to employees with cancer and those who are in remission. Therefore, once a person has had cancer, they continue to be protected under the Equality Act. Of course, at different times on their cancer journey, the condition will impact them more, and require more support from employers than at other times.

People with cancer may experience a wide range of side effects including fatigue, cognitive impairment, decreased mobility or visibility, pain, swelling and loss of sensation. Furthermore, the side effects of both the cancer and the treatment can be as much mental as physical. The psychological impact of a cancer diagnosis can be profound and can lead to anxiety, depression and other mental health conditions, as well as causing a drop in confidence in the workplace. Indeed, a recent NHS England survey found that cancer patients are 1.5 times more likely to report a problem with anxiety and depression than the general population. Under the Equality Act 2010, employers have certain obligations towards disabled employees or job applicants. Not only is it unlawful for an employer to treat a job applicant or employee less favourably in relation to their cancer, but employers also have a duty to make reasonable adjustments where the employee is placed at a substantial disadvantage by reason of their cancer or its side effects. What is reasonable will depend on the particular circumstances of the employee and the employer, but may include consideration of: whether the adjustment will successfully remove or reduce the disadvantage; what the cost and impact on the business will be; whether it is practicable; and whether it can be accommodated within the business.

Examples of adjustments that may be reasonable include: allowing absences for treatment and/or rehabilitation; adjustments to workload, perhaps on a temporary basis; providing extra support; altering the employee's working hours or allowing flexible working to better suit the employee's needs; removing certain duties that are now difficult e.g. physical lifting, or adjusting the level of travel commitments; modifying equipment; and, if needs be, finding an alternative role for the employee that better suits their new circumstances. In addition to making substantive, practical adjustments, employers should also show empathy, compassion and care to ensure the employee is comfortable expressing what changes may support them and feels listened to.

An important step an employer can take is to educate itself, managers and staff about cancer and its impact. By doing so, the employer will be better prepared to support employees, as well as be able to signpost the employee towards sources of both internal and external support. Given the unfortunate prevalence of cancer, it is incumbent for employers to be proactive in taking this step so that they are in the best position to meet their legal obligations and support their staff.

As already stated, the side effects experienced by people with cancer can vary significantly, as can the level of emotional and financial support available to them in their home circumstances. Therefore, it is always important to engage with each employee individually and work with them to establish what adjustments are best suited to support their particular needs. Making assumptions about what might be useful support can cause upset and damage the relationship, even if done with good intentions.

Aside from wanting to do the right thing, there are various other incentives for employers to comply with the law. Firstly, there is reputational risk for the business from any publicity about a successful discrimination claim. Secondly, the financial consequences of a discrimination claim are significant. Not only does a successful discrimination claim give rise to uncapped compensation and an award for injury to feelings, but the cost of defending the claim itself can be significant. Finally, dealing with and preparing for a discrimination claim can consume management time, which in itself can result in financial losses for a business.

In order to avoid such eventualities, it is important that managers are equipped to support their direct reports around the time of diagnosis and beyond, and that HR can in turn support those managers. Indeed, this is important for any disability that employees may suffer from and the protections and support offered to employees with cancer should equally be offered to those with other mental or physical impairments. Employers should review the policies and practices they have in place to support disabled employees, with a focus on providing emotional and moral support as well as reasonable adjustments.