Brain fog impacting my ability to cope with work items

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So, long story short I have finally finished my round of chemo, surgery and radiotherapy for breast cancer. I have received my NED but still have to be followed up and every 6 months have a bisphosphonate infusion.

I have returned to work, full-time with no phased approach (as that would impact me financially). Mostly my work is done remotely with some days that I go to the office.

However after two months or so I really finding myself struggling to get through to the end of the day. The whole day is just exhausting, I reach the end of my working days just wishing I could lock myself in a dark room. But I have my family, house things, my son that I want to enjoy and right now I struggle to. Is it ok to ask for my workplace to accommodate changes now? My brain is not the same since chemo and I really get confused and even have "blanking" episodes, like I don't remember at all what I was doing a moment before.

Even with my non evidence of disease, am I still covered by the equality act to be able to ask HR for changes? Whatever the financial impact now, I guess it is best than saying I can work for 35h a week and not have energy for other things in life and potentially being so tired that I do wrong stuff and harm my performance.

Also any advice of what could I do to recover from brain fog faster?

Many thanks!

  • Hello

    Thank you for contacting Macmillan. My name is Stacey,  I am a  Work Support adviser and I can advise you on your rights at work which hopefully will be able to help you in your return to work.

    I am sorry to hear of the side affects you are suffering whilst returning to work. I will refer your communication  to our team of nurses who can provide some advice about your health and the brain fog that you are suffering.

    With regard to your question about your protection under the Equality Act 2010 (Discrimination Act 1995 in Northern Ireland.) I would like to make you aware of the following.

    A cancer diagnosis is automatically classed as disability under the Act and remains there as long as needed. That means if you are still struggling from any effects of the condition or treatment and it is having an affect on your work, you would still have that protection. Your employer has a duty to provide reasonable adjustments to help you in your return to work.

    It is also worth knowing that you have protection against discrimination at work if it is related to your disability and I have included our ‘Your Rights at Work’ booklet as a link that discusses this in more detail:

     “Your Rights At Work”

    Many people who have been absent from work for some time receiving treatment don’t know what they will be able to manage on their return. Some take on too much or too little and their phased return has to be adjusted later. A number of employers refer their employees to Occupational Health on their return to work for that reason, and you could request a referral. They are useful in assessing your health as well as looking at your job and suggesting to the manager/HR any changes that might be made to support you. They may ask for your permission to access your medical records in order to provide a more detailed assessment. It is not too late to ask for any reasonable adjustment you might need but you will have to think about what would work best for you to enable you to balance your home and work life successfully. If your employer cannot refer to Occupational Health you might ask your GP/Oncologist/clinician for a Fit Note suggesting the adjustments you might need.  The Equality Advisory Support Service also has a template letter to help you put your request for reasonable adjustments in writing to your employer.

    You say that you returned to work full time for financial reasons. I wonder if you used any accrued holiday towards your return that you had not been paid for/unable to take? This would enable you to initially work part time and top up the additional days. Or did you receive/exhaust  any company sick pay to top up your days?  Sometimes it is possible to use days in the week taken as sick to claim a sick pay benefit if your company sick had ended. You can ring our Welfare Rights team (on the number given below) for further information on this.

    If you decided to work full time are there any reasonable adjustments that could be made to help you? For example, do you need longer rest breaks, starting later/earlier? Do you find travelling into the office tiring for you and if so, could you work more days at home? If you work to targets in your job – could they be decreased? Would you even need a temporary  change in duties that might relieve the stress/workload? If you ask HR for any such adjustments, it is worth bearing in mind that this would be a temporary arrangement until you are able to return to your normal duties. Your substantive post would be there for you to return to when you are ready. 

    I hope that you can use some of the ideas suggested when talking to HR or it might prompt you into thinking about other aspects of your job that could be adjusted to make things easier for you. If you need any further advice, please contact us again by replying to this message or alternatively you can contact the Work Support team either via emailon webchat or over the phone on 0808 808 0000 option 1, then 2, then 3 from 8am to 6pm every weekday.




    Work Support Adviser

    Remember, you can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am – 8pm) or by email.

  • Dear IBCTN Fighter

    Thank you for reaching out for information and support here at Macmillan Cancer Support.  My name is Rae and I am one of the cancer information nurse specialists.

    I am sorry to hear that you are struggling with juggling work, family and house.  It can be difficult to manage everything even prior to a cancer diagnosis and treatment.  I can totally understand how overwhelming it all feels right now.

    Firstly can I say, that with any new or worsening symptoms, we would always ask you to be checked out either by your oncology team, GP or 111.  It may be chemo fog, but it is wise to get symptoms such as ‘blanking episodes’ checked to ensure it is not due to another reason.

    Cognitive changes (chemo brain) has been widely reported, and yet researchers are unable to pinpoint the exact reason it happens.  There are tips for coping with cognitive changes.  You can inform your cancer doctors and they may be able to refer you to a specialist to help you.  Research is being undertaken to look at cognitive changes.

    An American website states that chemo brain generally improves within 9-12 months after completing chemotherapy.  It is important to visit your GP to have blood tests to see if your thyroid, vitamin D and B12 levels are within normal limits.  All sources of information mention that chemo brain can leave you with a feeling of anxiety and depression and if you are feeling like this to seek help

    Macmillan Cancer Support have partnered with BUPA and can offer up to six sessions of counselling to people who are struggling emotionally.  Please contact us if you would like to access this counselling.

    Please do call our support line if you would like to discuss any of the above and seek further support.

    Best wishes

    Rae, Cancer Information Nurse Specialist

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email.