Managing cancer if you are self employed

Introduction

Receiving a cancer diagnosis is challenging enough. With the additional complication of being self-employed, it can be financially and professionally devastating. Being self-employed may mean that you don’t have access to the same kind of support or health benefits that someone working for an organisation might have. You may also face the uncertainty of how your diagnosis will affect your business in the short- and long-term. Self-employment takes many different forms. You may be running your own company or work as a freelancer, contractor or entrepreneur. You may be working on your own, with a business partner or employ other people. A major concern when you are diagnosed with cancer may be whether and how you can keep your business running.

Managing the emotions and anxieties of work and treatment 

When you have cancer and are self-employed your concerns and feelings may differ from those who are employed. You may feel:

• Angry that you might not be able to work as usual

• Frustrated that you may have to take time off

• Worried about keeping your business going 

• Concerned about how you will manage financially

• Worried about how the situation might impact any employees

• Concerned about how you can continue to deliver for your customers

• Worried about the impact on your business's reputation

• Uncertain about how much to tell colleagues and/or clients and how they might react

• Guilty for not being able to give your business/work as much attention and energy as you would like

• Feel pressured to keep going as ‘normal’

However, being self-employed can also have advantages, such as being able to work in a more flexible way and set your own pace.

Talking about your feelings can be helpful. You may worry that asking for help will make you a burden, but most people are glad to be asked and happy to provide support. It can be difficult to know who to talk to and what to say. It may help to start by speaking to someone you feel comfortable with and can trust. You will be amazed at the generosity of family, friends and colleagues when you accept help in whatever form it takes. 

Continuing to run your business while going through treatment 

Being self-employed may provide you with additional flexibility as you go through treatment, since you can control your hours and deadlines to complete client work. Aim to keep your work schedule as flexible as possible. You may want to work from home if you are not already doing so – this may benefit you on days where you are not feeling well or may be low in energy. Colleagues and clients who are aware of your circumstances will usually be understanding, supportive and accommodating.

The decisions you make about working will depend on your unique circumstances. Your type of cancer, its treatment and potential side effects are all factors to consider. Taking time off, or not working permanently, could be a major concern if you rely on your income, or if your business has been a major focus of your life. Reading section 3.2 on ‘Coping with side effects’ may help you make a decision. If you are uncertain about what to do, discuss your options with family or friends. You could also seek professional financial advice. Talk with your healthcare team about what you can expect in terms of side effects, fatigue, etc., and how intense these are likely to be. Asking specific questions will give you a better understanding of the potential impact and whether you should expect any periods of disruption to your work schedule.

You have the best understanding of exactly what is required to keep your business running after a cancer diagnosis. Take some time to think through and note down your specific plan for working through all or part of your treatment. As you do this, be realistic about how much you can continue to do and keep in mind that the plan may need to be adapted as treatment progresses. When you first started working for yourself you may have had a business plan to help you stay organised and on track. It can be helpful to take a similar approach after receiving a cancer diagnosis to help you stay in control. Once you have a greater understanding of your treatment and its potential side effects, you can start to make some decisions. 

The following suggestions may help you manage work and treatment:

• Review your list of upcoming projects, meetings, other obligations and timelines

• Depending on the nature of your work, it may help to complete large projects prior to starting treatment and then manage the smaller daily tasks around how you are feeling as treatment progresses. Decide what needs to be done now and what can be postponed or delayed

• Think about how you do your job – can you travel less, work from home more, make greater use of technology?

• What do you think you will be able to handle personally and what might you need help with?

• If you are a sole proprietor, you may decide to get someone in to help you to keep things moving forward. This might be a trusted colleague or outside support from an agency. If you have a business partner, assistant or other staff who work for you, discuss with them if/how they might provide cover when you’re not able to be present

• Cancer treatment can take up a lot of your energy, so use the energy you have to do the things you enjoy the most or prioritise tasks that cannot be done by anyone else

• If you employ staff, keep them regularly informed about what is happening and communicate any changes you are making to keep the business running

• Ask for and accept offers of help

• Depending on the nature of your work, consider how safe it is for you and others to keep working during your treatment

• Can you pay someone else to run your business for a while and still break even/make a profit?

Financial support if you are self-employed

A big worry when you are going through cancer treatment is how you will manage financially if your income is reduced or stops completely. Being self-employed probably means you won’t receive sick pay, but you may be entitled to other benefits to help towards living and health costs if you cannot work, or if your income decreases. If you have insurance policies, it is worth checking them to see if you can make a claim. Talking to an independent financial advisor or your accountant, if you have one, may help.

Communicating with clients/customers and colleagues

Sharing your cancer diagnosis with clients is a personal choice. You do not have to tell them and your initial reaction might be to say nothing. If you are thinking about sharing the news, consider why you want to tell them and think about what their reaction might be. You may need different ‘scripts’ for different clients or groups of clients. For example, if you have clients who are likely to worry about the impact on them, you might think carefully how much, if anything, you want to tell them. Some clients may have been through similar experiences, either themselves or with loved ones, and may be more understanding and supportive. All clients will be looking for reassurance that your business will continue to meet ongoing commitments. You may choose to only tell established clients with whom you’ve built up a strong working relationship over the years.

If you do decide to talk to your clients, the following guidance may help:

• Consider how you want to tell them and how much information you want to share. Once it is shared it can’t be ‘unshared’ so you may want to focus on what you know now, rather than the unknowns. Because treatment plans can change, you may wish to emphasise that what you are sharing is based on what you know today but might change in the future, and that you will keep them updated. If you want them to keep some or all of your news confidential, be clear about this

• Explain how you will be working around your treatment. For example, how long you plan to take off work to recover from surgery, and how your schedule might be impacted by radiotherapy or chemotherapy. Let them know when they can contact you and whether you’d prefer to keep this to email or telephone. If someone is going to cover your work, introduce them and explain what they will be doing

• Provide regular updates and reassurance on the progress of projects. For example, “I may not be working my usual hours, but the project will be under control and completed on time”

• If you have physical side effects such as hair loss, or are struggling with fatigue, you may want to postpone face-to-face meetings and reduce travel. Use technology, such as email or conference calling, to stay in touch

• Be prepared – some clients may have misconceptions that will cause them to unfairly question your ability to get the work done. Some may take the news in their stride and be supportive and compassionate, whereas others may feel more awkward. They will be thinking about the impact on their business; some clients may even choose to stop working with you

• If you can’t meet a client’s needs, you may consider referring the work to another company, preferably one you know well and that will do a good job

If you employ people in your business, you do not have to tell them that you have cancer. You may want to consider the impact on morale if you don’t tell them and they find out anyway, particularly if it is a small company. If you decide to let your employees know, you will need to consider what to tell them. It is natural for your employees to be concerned about the impact of your diagnosis and treatment on their future. They may also be a source of support and provide some options you hadn’t considered for managing any business changes caused by your cancer diagnosis.

Making decisions about your business

You may reach a point on your cancer journey when continuing to remain self-employed is no longer an option because of the physical and mental demands of your work or your financial circumstances. In this case you will be faced with choices on what to do next. One option might be to look for more secure and predictable paid employment. See section 5.0 for guidance on changing your career.

Depending on how you are legally ‘set up’ as self-employed, if you run a business, another option is to consider selling it. However, this can be complex and takes time, and whether you profit from the sale will depend on the reason for the sale, the timing, the strength of the business operation and its structure. Whether you can do this or not will depend on whether you have a saleable business. Your accountant or professional advisor will be able to tell you if they think your business is viable as a going concern and suggest a potential asking price. You could consider potential buyers and how they could be approached. Bear in mind that selling a business consumes both energy and time and you will need to make sure that all your financial statements, returns and records are up to date.

You may decide to close your business. This can be upsetting and stressful, particularly if you’ve spent years building it up and have to let staff go. It’s also time-consuming as you’ll need to tidy up loose ends, meet your legal and tax obligations, and potentially handle employee redundancies. The steps that you need to take to close your business will vary according to its legal status and from country to country. Before you take any action, it’s helpful to prepare a plan to ensure you understand all you need to consider and that the business is properly wound up and any employees are treated fairly.
 

Caring for someone with cancer when you are self-employed

When a loved one is diagnosed with cancer, you may become a caregiver without warning, which can feel like having the rug pulled from under you with little time to plan or prepare. Many of the decisions you make about running your business while caring for a loved one with cancer will be similar to someone with cancer who is self-employed, so please also refer to the section above on managing cancer if you are self-employed.

As a carer, you will experience a rollercoaster of emotions. You may feel guilty and under pressure to keep everything going while worrying about not being a ‘good enough’ carer. 

You may feel under pressure to stay positive and upbeat as your loved one goes through treatment while also running a household and looking after other family members, especially if children are involved. Everything becomes a balancing act and it can be particularly challenging if you are a single parent caring for a child. There may be overnight hospital stays to work round, and not everyone has other family members close by that can help take some of the burden. 

Depending on the nature of your self-employment, you may only be paid on the days you work, which can mean working into the night or making calls from hospital, all of which can take a toll on your mental and physical wellbeing. If you decide to continue working alongside caring, think about how you can factor in time to look after yourself. Work can sometimes be a welcome distraction from your caring responsibilities and also give you a focus once your caring role comes to an end. It can also provide some welcome social and financial support.

Balancing your role as a carer with the demands of running a business is made more difficult because of the ever-changing nature of cancer, and its impact on the physical and mental needs of the person undergoing treatment. They may face a long period of treatment and the continuing, uncertain nature of the disease makes it very difficult to plan effectively. Flexibility is key, especially in the early days after diagnosis when the treatment plan may not be clear. You may need to consider very carefully how feasible it is to keep your business running, and if you even want to do so. There are a few suggestions as to what you can do in the ‘Continuing to run your business’ section above. You may, for example, need to review and update your work pattern frequently – even daily – depending on how your loved one reacts to treatment. 

Here are some top tips to help you manage your self-employment at this difficult time:

• Keep in regular touch with clients to explain what’s happening – they may even be able to offer you different work that you can do from a hospital bedside or quiet area 

• Improvements in technology have made working remotely much more accessible in recent years. Decide how much information you are going to share with clients, how often you will communicate with them and how you will reassure them that their work is being done. (Please note that clients may initially be sympathetic but their patience can quickly run out if you are unable to give definitive dates on when things may get back to ‘normal’, so be prepared for some disappointing reactions.)

• If you work with a team, make sure you keep them up to date and do not be afraid of asking them for support with your current workload or responsibilities

• It's essential to review your financial situation (personally and professionally) and possible sources of income while you are caring. It may be that you have to rely on savings to keep you going financially and top up any income you may lose when you can’t work. Because of this, it’s important to get as much support as possible. You may be able to get some grants, for example from charities, for specific costs such as travel or parking

• Depending on your nationality, you may be able to claim social security benefits or a carer’s allowance so it’s worth researching what financial support might be available or contacting organisations that can help

• Finally, do not neglect your physical and emotional health. Self-employment can be physically and emotionally draining – you cannot give the best care if you neglect your own needs