Job Offer - Need Advice

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crazylife
Posts: 256
Joined: Wed Dec 30, 2015 11:29 am

Job Offer - Need Advice

Postby crazylife » Wed May 24, 2017 12:56 pm

So we find out on Monday DH has some lung mets after a year of being clear. On Tuesday he is offered a great job right near home.

Plan is to ablate the biggest lung met and watch the others. He has been told he is incurable and we should try and get into a trial. He has only been on folfox so far, so we do have other options although limited with the K-ras mutation.

He wants to work to get his mind off things. But I am thinking he should focus on the kids and being with them for whatever time he has left. We have no clue how long that may be.

Any thoughts on this or similar stories?
Wife to DH, 41 years old, diagnosed 11/15
Stage 4, Mod diff, 13/24 LN, 1 liver met
Colon/liver resection at MSK, 11/15
8mm lung met (not confirmed) and enlarged lymph nodes 1/16
12 rounds of folfox (9 with Oxi) 6/16
NED - July 2016
NED - October 2016
3 lung mets - March 2017
7 lung mets, May 2017
RFA to largest met, June 2017
Lung mets growing slowly, October 2017 (off treatment since June 2016)
Right lung surgery, November 2017
Left lung surgery, January 2018
NED - May 2018

ACPdiddy
Posts: 28
Joined: Wed Apr 12, 2017 4:01 pm
Facebook Username: Albert Pierce

Re: Job Offer - Need Advice

Postby ACPdiddy » Wed May 24, 2017 2:06 pm

This sort of thing is always a judgement call. And I don't have much knowledge of lung-only CRC.

That said, keep some things in mind. You have 3 FDA approved therapies still to try, any or all of which could buy you time. I assume you would at least try Folfiri before going to clinical trials? Given the good results you had with Folfox, I would think Folfiri might give you good results too. Then there are the immunotherapies coming through clinical trials right now. There are a couple regimens that look very promising already, and many, many more are being tested with results to come soon.

And I do know that work has been good for me. Couldn't he take the job and see how it goes? I would think that lung-only disease would not be particularly prone to rapid-onset crises. But I could be totally wrong about that. Worth asking the doctors about that.

MissMolly
Posts: 645
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: Job Offer - Need Advice

Postby MissMolly » Wed May 24, 2017 5:28 pm

Crazy life:
These are certainly "crazy" (meaning stressful) times for you and your family at the present as you navigate your DH's cancer pathway.

Not knowing your husband' current employment status or your family's financial security, I would trend gingerly and ever so carefully before your husband were to commit to a new offer of employment.

Cancer, as are all serious health conditions, protected by the ADA. That is, an employee cannot discharge or terminate an employee for having cancer/or any other serious health condition as long as they are able to meet the requirements of the position as defined in the position's job description.

But we all know that there are backhand ways that an employer can find means to terminate an employee who is a financial drain on a company's health insurance payroll. I worked for a large consulting firm (Accenture, formerly Arthur Anderson LLP) in the area of Human Resources and employment law. I saw many instances of employees who were terminated through means in which the employee was demoted or transferred to less desirable positions, as a means of pressuring the employee to self-exit.

If your husband has an established position with solid health care benefits, that alone may be more than worth its weight in gold.

Comprehensive health care benefits when facing a diagnosis such as stage IV cancer may trump all other considerations.

A new position may not have the same benefits or health care network providers that your currently have. In changing employers, your husband may put established care and known coverage at risk.

In addition, any new position usually has a 6 month grace period. An employer can terminate a new employee at will (without cause) during the first 6 months. What if the new employee were to learn of your husband's diagnosis and decides to terminate him as a potential liability to the company (the company concerned about his future ability to perform the job or the company concerned about having to cover any of his absences)?

Is your state an employment at will state? I would certainly study your state's relevant employment law. An employment at will state would leave your husband with limited protections is they chose to discharge him.

I have had the misfortune of enduring seriously compromised health now for several years. I was a former marathon distance runner, a bonafied work-a-holic . . until chronic ill health found me. No amount of positivity and "stay strong" could alter the course of serious illness and its effects on my hopes and aspirations.

The one thing that I have strived to maintain is solid health insurance. It is not an easy task when full time employment is not longer feasible. But I have been able to retain health insurance through a binding employment agreement in leaving my last position. I have been fortunate.

I never want to burden my family with astronomical health care bills. Never.

But I digress . .

You are a young family with two growing and maturing children. I would counsel you and your husband to give serious consideration of the incalculable value of health insurance coverage if he is in a current position with benefits.

I do not think that I would encourage you and your husband to put those known benefits at risk in pursuing another job.

Make sure that both you and your husband have a full discussion between you, evaluating the potential risks and benefits. Make sure that yours is a full due diligence.
- Karen -
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

tarheelmom
Posts: 168
Joined: Mon Mar 07, 2016 5:55 pm

Re: Job Offer - Need Advice

Postby tarheelmom » Wed May 24, 2017 6:55 pm

Keep in mind that you must be employed for at least 12 months at a company before you are eligible for FMLA. Also different companies have different policies on short term disability eligibility. FMLA protects your job and short term disability protects your pay. I have found both very important for serious health issues.
52 y at dx, mom to 4
DX: RC on 2/22/2016
Stage I, T2N0M0, 0/32 LN
23 mm x 7 mm moderately differentiated invasive adenocarcinoma
3 cm from anal verge
4/12/16: ULAR, TME, & temp ileostomy
6/14/16: ileo reversal

crazylife
Posts: 256
Joined: Wed Dec 30, 2015 11:29 am

Re: Job Offer - Need Advice

Postby crazylife » Wed May 24, 2017 7:57 pm

I neglected to mention he has been unemployed since diagnosis. He has been on SSDI. So he wouldn't be switching jobs but getting a new one.
Wife to DH, 41 years old, diagnosed 11/15
Stage 4, Mod diff, 13/24 LN, 1 liver met
Colon/liver resection at MSK, 11/15
8mm lung met (not confirmed) and enlarged lymph nodes 1/16
12 rounds of folfox (9 with Oxi) 6/16
NED - July 2016
NED - October 2016
3 lung mets - March 2017
7 lung mets, May 2017
RFA to largest met, June 2017
Lung mets growing slowly, October 2017 (off treatment since June 2016)
Right lung surgery, November 2017
Left lung surgery, January 2018
NED - May 2018

peanut_8
Posts: 2340
Joined: Sun May 25, 2014 1:31 pm

Re: Job Offer - Need Advice

Postby peanut_8 » Wed May 24, 2017 9:09 pm

crazylife

Just my opinion, butt I'd think it would be good for his mental outlook to have a job. Especially since he seems excited about it. Also good that it's close to your home to cut down on commuting.

How old are your kids, and who is caring for them now?

Best Wishes,
peanut
female, diagnosed Jan 14, RC stage 2a, age 56
MSS
April 14, 28 chemo/rad with Xeloda
June 14 adjuvant Xeloda 6 rounds
currently NED

crazylife
Posts: 256
Joined: Wed Dec 30, 2015 11:29 am

Re: Job Offer - Need Advice

Postby crazylife » Wed May 24, 2017 9:32 pm

[quote="peanut_8

Peanut8,

They are both in school full-time. I work full time from home.
Wife to DH, 41 years old, diagnosed 11/15
Stage 4, Mod diff, 13/24 LN, 1 liver met
Colon/liver resection at MSK, 11/15
8mm lung met (not confirmed) and enlarged lymph nodes 1/16
12 rounds of folfox (9 with Oxi) 6/16
NED - July 2016
NED - October 2016
3 lung mets - March 2017
7 lung mets, May 2017
RFA to largest met, June 2017
Lung mets growing slowly, October 2017 (off treatment since June 2016)
Right lung surgery, November 2017
Left lung surgery, January 2018
NED - May 2018

MissMolly
Posts: 645
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: Job Offer - Need Advice

Postby MissMolly » Thu May 25, 2017 8:53 am

CrazyLife:
From the employers' perspective, is this potential position one where the company wiuld be commiting significant capital and resources (training and seminars) to bring your husband on board?

How will he approach needed time off for treatments with the new employer? Is this a position that would place others having to cover for your husband to a great extent when he might need time off?

That is, is this a high pressure/corporate job or a less intensive and flexible job and work environment?

Has your husband considered volunteering for a company or entity that would interest him? Delivering Meals on Wheels? Serving as a youth reading mentor? Volunteering at a local community garden or outdoor natural habitat? (Portland has a city-owned rose garden and authentic Japanese garden that depend on volunteer support).
- K -
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

ACPdiddy
Posts: 28
Joined: Wed Apr 12, 2017 4:01 pm
Facebook Username: Albert Pierce

Re: Job Offer - Need Advice

Postby ACPdiddy » Thu May 25, 2017 10:24 am

Hi Crazylife,
This will certainly vary from place to place, but my employer has been incredibly supportive, flexible and accommodating about my diagnosis.
From my experience, I could definitely recommend that your husband at least seriously consider taking the job. But the particulars of his situation may be different.
-Al

User avatar
juliej
Posts: 3114
Joined: Thu Aug 05, 2010 12:59 pm

Re: Job Offer - Need Advice

Postby juliej » Thu May 25, 2017 2:43 pm

crazylife wrote:I neglected to mention he has been unemployed since diagnosis. He has been on SSDI. So he wouldn't be switching jobs but getting a new one.

There may be cuts to SSDI in the near future so that is something to consider.

I know for me working made a world of difference. During my hours at work I couldn't think about cancer, about my prognosis, about what might or might not happen to me. It gave my mind some "breathing room" and that in turn gave me strength to deal with whatever lay ahead. It also gave me a sense of "normalcy" at a time when I felt like the world was moving on without me. Not every cancer patient can work, but if he has the strength and is excited by the new job, I say go for it. The kids might enjoy the normalcy of a dad who goes to work too. Just my opinion though. Take some long walks with your DH and talk, talk, talk...
Stage IVb, liver/lung mets 8/4/2010
Xelox+Avastin 8/18/10 to 10/21/2011
LAR, liver resec, HAI pump 11/2011
Adjuvant Irinotecan + FUDR
Double lung surgery + ileo reversal 2/2012
Adjuvant FUDR + Xeloda
VATS rt. lung 12/2012 - benign granuloma!
VATS left lung 11/2013
NED 11/22/13 to 12/18/2019, CEA<1

DebZ
Posts: 83
Joined: Fri Nov 14, 2014 9:01 pm
Facebook Username: Bulc

Re: Job Offer - Need Advice

Postby DebZ » Thu May 25, 2017 5:37 pm

I am a chemo-for-lifer right now with multiple mets scattered in both lungs. I've been on Folfiri + Avastin for the past year. I've heard that with small lung mets chemo can keep them stable for years. I would make serious inquiries into the trial at NIH that Spleen was in before having that one lung met ablated. You need to have a big enough tumor for them to remove/bioposy (can't remember which), maybe bigger than an inch? So please don't jump into things without looking at alternatives! All my tumors are still too tiny and have gone unchanged for a year. We're beginning to look at trials to have ready when chemo may start to fail.

I can't say what to do about job opportunity. My motto is from the movie Shawshank ... get busy living or get busy dying. I choose to LIVE!! Unless I'm on couch knocked out from chemo, I am full throttle doing my thing and not thinking about cancer. I have two in college and a 10-year-old. We're busy!!
48 @ diagnosis Sept 2014
MSS; Kras mutant G12D
Oct 2014: right hemicolectomy
Dec 2014-May 2015: Folfox
June 2015: clean scans
Sept 2015: scans reveal ovarian mass and liver met; Folfiri
Jan 2016: liver wedge resection and hysterectomy
April 2016: multiple lung mets; Folfiri+Avastin
June 2017: lung mets growing; switch to Folfox+Avastin
Jan-April 2018: dropped oxali; CEA rising
May 2018: back on Folfox+Avastin, add pulse steroid treatment to get platelet count up (continuously in 50s)

crazylife
Posts: 256
Joined: Wed Dec 30, 2015 11:29 am

Re: Job Offer - Need Advice

Postby crazylife » Thu May 25, 2017 10:09 pm

DebZ - you read my mind! I contacted NIH to get into a trial and they have DH's info. The lung met is being ablated on Tuesday. Surgeon said it was getting close to a main artery so it was too risky to wait. Which I realize makes him ineligible for the trial, but it needs to be dealt with. It grew quite a bit in 2 months, so waiting wasn't an option.

Love your quote! Get busy living I say! He just needs to figure out how he wants to live. Working or maybe picking up some hobbies and spending time with the kids after school. Lord knows this old house could use some sprucing up. It's really up to him.
Wife to DH, 41 years old, diagnosed 11/15
Stage 4, Mod diff, 13/24 LN, 1 liver met
Colon/liver resection at MSK, 11/15
8mm lung met (not confirmed) and enlarged lymph nodes 1/16
12 rounds of folfox (9 with Oxi) 6/16
NED - July 2016
NED - October 2016
3 lung mets - March 2017
7 lung mets, May 2017
RFA to largest met, June 2017
Lung mets growing slowly, October 2017 (off treatment since June 2016)
Right lung surgery, November 2017
Left lung surgery, January 2018
NED - May 2018

WarriorSpouse
Posts: 220
Joined: Tue Aug 16, 2016 9:02 pm

Re: Job Offer - Need Advice

Postby WarriorSpouse » Thu May 25, 2017 10:22 pm

Also remember that SSDI has income limits. Go to the Social Security webpage to review the income rules so that you do not lose that income.

"...No Limits on Unearned Income. While a disabled (nonblind) person applying for or receiving SSDI cannot earn more than $1,170 per month by working, a person collecting SSDI can have any amount of income from investments, interest, or a spouse's income."

If he has been on SSDI for two years too, your husband should also have been signed up automatically for Medicare Part A and maybe B too. It is a secondary payer if he is on your work healthcare plan as a worker. Call your provider to see how this can affect his Medicare coverage.

Good Luck!
WS
D/H 47 years old, 10/2014, Stage IV M/CRC, nodes 12/15, para-aortic, 5 cm sigmoid resection, positive Virchow. KRAS mut, MSS, Highly Differentiated, Lynch Neg, 5FU/LV and Avastin 1 YR (Oxi for 5 months), Zeloda/Bev since 01/2016. 02/2019 recurrence para-nodes, back to 5FU/LV Oxy/Bev. It is working again. "...Perseverance is not a long race; it is many short races one after the other."-Walter Elliot


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