By Brad Gellert, Manager, Advocacy and Policy Unit, Cancer Council NSW Australia has made remarkable progress in improving cancer survival rates. More people than ever are now living with cancer. Yet, while our health system has evolved to help people survive, our workplace systems have not kept pace in supporting people to continue living and working through cancer.
A cancer diagnosis changes everything. Suddenly, life is filled with uncertainty, overwhelming choices, and an all-consuming focus on treatment and recovery. Yet for thousands of people across NSW each year, another fear arrives alongside the diagnosis – the worry of losing their job, and with it, their livelihood and so much of what makes life feel normal and secure.
Cancer Council NSW and the McKell Institute recently collaborated on a report examining the experiences of people with cancer in the workplace. The report highlights that staying in employment during cancer treatment often depends on factors outside a person’s control, such as the support of their manager, their employment arrangements and where they live, rather than consistent workplace policies or support systems.
For too long, we have viewed cancer and employment as separate issues. One belongs in the health system, the other in the workplace. The reality is that this divide is costing people, businesses and the economy far more than we realise.
Some key findings from the ‘State-based Policy Options to Support Workforce Inclusion for People Living with Cancer in NSW’ report include:
- Up to 3,000 NSW workers each year are pushed out of work due to financial pressure, limited flexibility and inconsistent employer support.
- Cancer is costing NSW more than $240 million in lost wages annually, on top of reduce income tax, and higher welfare reliance.
- People with cancer are three times more likely to leave full-time work than the general population.
- Almost half (46%) of cancer patients experience a major change in employment.
- More than half (56%) of rural cancer caregivers report a change in their employment after a loved one is diagnosed.
- Median cost of return trips from regional NSW to Sydney for treatment ranged between $379 and $739, with government reimbursement of $182 to $279.
- NSW has no dedicated policy to help people keep their jobs during cancer treatment.
At Cancer Council NSW, we witness these struggles every day through our support services. People tell us how so much of what matters most to them hangs in a delicate balance as they navigate treatment, from their health and family responsibilities to their livelihood and financial security. For many, holding onto work is a lifeline that helps avoid financial hardship and sustains their emotional wellbeing through the toughest days of treatment and recovery.
Yet whether someone can stay employed often comes down to luck.
The report found that employment outcomes are frequently determined by workplace culture, management support, contract type and geographic location rather than any structured system of assistance. Two people with the same diagnosis can experience entirely different workplace outcomes depending on circumstances largely beyond their control.
The challenge is particularly significant for people living in regional and rural communities, where greater travel distances, higher costs and limited workplace flexibility can make balancing treatment and employment more difficult. These barriers were also reflected in our Tamworth community forum, where local people highlighted the time, cost and logistical challenges of accessing healthcare while managing work and other responsibilities.
The impact extends far beyond the person diagnosed. Families and carers are often forced to cut back hours, take leave, or even leave their jobs entirely to support loved ones through treatment. This creates a ripple effect, placing additional pressure on households, employers, and entire communities across the state.
The report sets out a number of practical recommendations, including:
- Establishing a direct wage-subsidy scheme for employees undergoing cancer treatment, co-funded by the NSW and Commonwealth Governments, with payments made through the employer to help retain staff during treatment and recovery.
- Creating a portable “Cancer and Chronic Illness Leave Bank” allowing employees to access a shared pool of donated or government-funded leave when existing entitlements are exhausted.
- Expanding flexible work and carer leave provisions under the Fair Work Act to explicitly cover employees managing treatment for serious illness and their carers, with cancer-specific guidance from the Fair Work Ombudsman.
These recommendations are about building a safety net for people with cancer when their leave entitlements – if they have any at all – run out. They are not about creating special treatment, but ensuring people are not unnecessarily pushed out of work at a time when stability, financial security and connection to employment matter most.
A cancer diagnosis should never force someone to choose between their health and their connection to work. If we can build a system that enables people to maintain both, we will create not only a stronger economy, but a more compassionate and resilient society.
The time to make that investment is now.
