I am going to venture into virgin territory for this blog — issues of prostate cancer and the workplace.

A couple of days ago I got a letter from Steve L,. 54, a personable guy with a good sense of humor who lives in the suburbs of New York City and works in sales. When I first heard from him a few weeks ago he was reeling from the shock of a new diagnosis of prostate cancer. I tried to reassure him. Now I got an update. Steve wrote that he had found a doctor he clicked with right away and that he and his wife had decided on a course of treatment — robotic surgery Just making the decision lifted a burden, he said, made him feel a little better. *But,* Steve reported, he had another nagging problem. I’m going to share it with all of you. Maybe you will come up with some ideas.

In Steve’s words:

“Other issues that I’ve dealt with lately: Who in my work world do I tell about this? How do I tell them? I’m a contracted worker for a number of firms. Who will decide to work with my reduced work schedule? Who won’t? I’m not an employee so I have no rights. As someone who lives on commissions when I don’t work, I don’t make money.”

Sounds familiar. Dear husband, who is 56, worked as a freelancer in recent years and had to deal with all of these issues. So before I address Steve’s question I want to take a detour and tell you a bit about DH’s experiences.

DH started a new career as a technical writer at 53. But three weeks after he got his first break, a long-term assignment at Citicorp, he was diagnosed with PC (Aug. ’05). I was afraid of only one thing — and it wasn’t the cancer. It was that the folks at Citicorp would show DH the door. As a temporary employee, he had no rights. DH would be crushed. I bargained with God and for once He cooperated.

Dear husband told his boss he had to take some time off to have surgery. No details. He was lucky in that the boss didn’t ask and he didn’t tell. DH ended up being out for two weeks and even then he was telecommunicating with the job. He went back to work with the catheter still in place. Not pleasant but tolerable. DH was in a rush because he had no paid sick leave and like Jeff, if he didn’t go to work, he didn’t earn any money.

Unfortunately, dear husband’s initial treatment failed, and so he was scheduled to undergo salvage radiation this past August — 40 treatments in all. But what timing! DH was to start a new full-time job the same day as he’d be starting the salvage rad. I was very concerned about all this working out. But DH arranged to have the treatments in the morning so that he wouldn’t have to arrive late to work.  As it turned out, he did come in late a couple of times but the atmosphere at the new job was laid back and nobody asked him any questions.

At the new job, dear husband faced another dilemma: he needed to know whether his new health insurance would cover his treatments at Sloan Kettering. It was unclear from the materials he’d been given.  I advised DH against calling the benefits person in Human Resources to find out — his cancer was not his employer’s business. Luckily, DH was able to get the answer he was looking for by calling the insurance company directly.

So what I would say to Steve and others about disclosure is that yes, times have changed, but not enough: there is still a stigma attaching to cancer. And you don’t want your business associates wondering whether you are up to doing the job. *But the only person who can determine what and how much to tell your business associates is you.*  If you have worked closely with certain people for a long time you might be perfectly comfortable telling them about your cancer. I know a lot of guys who’ve done this and have gotten a lot of emotional support from their colleagues to boot.  And in some cases it might make sense to tell your boss that you have cancer because employees enjoy certain legal protections under the “Americans with Disabilities Act”.  (See my follow-up piece, “WSJ: Taking Time Off From Work”, etc).

So what reason did I advise Steve to give to his business associates about the reason for his having to take time off for treatment?

Dear Husband and I sat down to consult about this one. First, we reassured Steve that he probably wouldn’t have to be out of work for more than a few weeks if the robotic surgery went well. Then we advised him to keep a tight lid on things. Great minds think alike, and so it turns out DH and I came up with the same solution: pick a time when you’re feeling relaxed and tell your colleagues you need to be away from work because we you have to care for a sick relative, a parent or a spouse, maybe. That takes the focus off you and also makes you sound like a nice guy. And it might give you an excuse for answering the phone at a hospital.  Alternatively, I would mention that I need to have surgery, nothing life-threatening, and that I have to take some time off. No need to be specific. Hopefully your pals aren’t too nosy.

That’s my advice, take it or leave it. I would be interested in hearing what you have to say, especially if you’ve been in this situation.

Recently the issue of taking time off for treatment of prostate cancer was discussed in the advice pages of the Wall Street Journal. (Mar. 5, 2008.  “How to Disclose a Recent Illness to Interviewers”.) I discuss that article in the post after next (WSJ: Taking Time Off From Work”, etc.).  Definitely read it and compare their approach with mine.