In May 2018, my life changed overnight. I found out through a regular mammogram check-up that further tests were required. When my doctor later read the ultrasound report, she said she didn’t like the results compared to my previous exams.
The words “possible cancer” rang in my ears as I tried to comprehend how this could have happened.
When I informed my doctor of my family history — with a grandmother who died of ovarian cancer at 79 years old and an aunt recently diagnosed with stage 1 breast cancer — she quickly got me into Sunnybrook Hospital in Toronto for a biopsy.
I brought my friend and oldest daughter with me to take notes when I heard the diagnosis, as I wasn’t sure my hearing would be 100 per cent and I worried I may misinterpret the results.
The doctor said there was no lymphovascular invasion but there was invasive lobular carcinoma and lobular carcinoma in situ. This meant the cancer was non-aggressive and the largest tumour measured 3.5 cm, with a second one at 18 mm. The third site was benign.
The good news? It was detected early, at stage 2, and the HER2 test was negative. This meant I was estrogen- and progesterone-positive. I requested a double mastectomy as there was 8 cm of calcification which could turn into cancer in the future. I was informed I would need genetic testing first before deciding on getting both breasts removed.
Genetic testing took place on May 22. On June 8, it was confirmed that 17 genes showed negative results. Therefore, only the left breast would be removed. I opted out of having reconstruction as it would take an additional six to eight months of recovery.
Once I knew the surgery date, I was able to determine my return-to-work date. My boss and I have a good working relationship, but it was one of the most difficult conversations to have.
In interviewing 30 women with similar journeys, 85 per cent did not share their journey with their work or, in some cases, their immediate families.
Reasons included: “No one will understand,” “It’s a private matter” and “There’s still a stigma associated with the word ‘cancer.’”
The leaders and colleagues at AGS were supportive when I chose to be transparent. One of my colleagues started a GoFundMe page, conducted a bake sale in our building, and raised awareness within our company that extended to clients, suppliers, friends and strangers.
The power of social media got me on the bandwagon to start a private Facebook page called “Jackie Cabildo’s Journey” where I shared my daily ups and downs to raise awareness and help me get through the difficult times, but also as a reminder to celebrate the good days.
Returning to work
HR was supportive and provided the steps required for short-term disability. Forms were completed by me, my doctor and my employer as soon as the surgery date was confirmed. The insurance company was quick to follow up with confirmation of receipt and provided next steps. Detailed information about my benefit package was found on our intranet.
With deep faith and a positive attitude, I was determined to get back to work sooner than later. The project plan was simple. The dates were defined with the last day of work and return-to-work date.
But things don’t always go according to plan. On Aug. 1, I learned that two of the three lymph nodes had a small trace of possible cancerous cells. So it was recommended I undergo four aggressive chemo treatments, three weeks apart, followed by one month off before 16 days of radiation.
I decided the first chemo would be Aug. 13, which was supposed to be my return-to-work date.
I immediately informed my manager, HR, and the insurance company of the changes and they worked together to help me get through the upcoming challenges. Weekly touchpoints with my manager helped me feel connected with work. Visitations, phone calls, emails, text messages and Facebook comments kept me going and helped me remain positive and optimistic.
When the dates of radiation, Nov. 19 to Dec. 11, were confirmed, I informed everyone I would return to work in January. My oncologist told me it would get worse before it gets better, and he was right. I was not prepared for the side effects of radiation. I was fortunate the chemo treatments went smoothly despite the fact I was in a chair for six hours each time wearing a cold cap.
The insurance provider and I kept in touch regularly as I wanted to come back sooner than later. I came back to work on March 18 on a gradual work schedule of 20 hours per week and I was determined to work full time as of April.
Luckily, my manager and the insurance provider knew better and pushed me to continue to work part time until my body had adjusted. It took another two weeks of 20 hours, followed by 30 hours, then 35 hours, before I came back full time on April 29, 2019.
Advice for employers
Having gone through this challenging journey, I feel companies can help employees going through life-changing news by listening and being supportive, maintaining regular communication, and providing updates on what’s happening. It’s also important to offer support and provide flexibility when possible.
How HR can help employees:
• Be proactive and annually review the benefits package with employees, including changes that directly impact them.
• Provide a checklist of items required to expedite claims.
• Ensure the website information is easily accessible or provide a booklet, as family members may need to go through it on the employee’s behalf.
• Reiterate the company’s benefit package as it may have changed over time.
• Provide additional resources including a phone number for the EAP (employee assistance plan) if it exists.
• Ask the employee how much they want their manager or colleagues to know, and how they want the news communicated to them.
• Respect their privacy if they don’t want anyone else to know.
• Discuss the type of messaging HR or the immediate manager can provide to colleagues and those impacted.
• If the company doesn’t have short-term disability (STD), discuss the employment insurance (EI) process and waiting period.
• If the company is willing to top up pay, discuss how this will be applied.
• If the company has a STD plan, discuss the process, forms required, waiting period, percentage of payment, and frequency of payment.
• For employers with STD and long-term disability (LTD), ensure employees are aware of the tax implications at the end of the year — these benefits may be classified as additional income and may require employees to pay additional taxes.
• Connect with the insurance provider and partner together to help employees go through a smooth transition.
• If applicable, discuss the impact on incentive plans, bonuses, merit increases and other perks associated with the individual employee.
Tips for insurance providers
There are also several ways insurance provides can ensure they support employees. For one, they should acknowledge by email when forms are received and follow up if required if forms are still missing information.
Insurance providers should work to build rapport and regular communication, and provide next steps and timelines with realistic expectations. They should also inquire if the person needs additional resources.
If inquiring about drug plans, be clear on exact coverage options for each drug type (for example, branded drugs versus generic).
Insurance providers should be flexible and compassionate when post-treatment reactions occur, and treat individuals how they would like to be treated if the same diagnosis happened to them. There are no two cases nor two treatments alike.
In today’s world, the word cancer is no longer taboo. It’s important for people to talk about it and seek help as needed — knowing this too shall pass.
Jacqueline Cabildo works as an operational excellence (OPX) consultant for Allegis Global Solutions (AGS) in Mississauga, Ont.
© Copyright Canadian HR Reporter, HAB Press. All rights reserved.