????Still, not everyone is comfortable discussing illness at the office. Spence told of a client of hers who was a hard-working senior manager at an agricultural company. One day, she left packages for Spence and a few others before leaving for what her colleagues thought was a week's vacation. She checked into hospice and died three days later. "I was in shock when I found out. I had no idea she was sick," Spence said.

????Spence thinks employers fall into two main categories: those that follow sick leave or disability policy and laws rigidly and those that treat workers like individuals and work with them during their treatment. Many of the decisions are made one-by-one based on the employee's experience, value, and prognosis.

????"It's very personal. If an employer really likes the employee, that's when they tend to be more flexible or more sympathetic," said Kate Brown, director of support and advocacy at Lungevity, a lung cancer support nonprofit.

????Lungevity's Brown says that some workplaces organize "meal trains" where different people deliver a meal each week to a colleague with cancer. Another, she says, bought a special telephone with speakers so a worker whose voice was hoarse and dim could continue to field calls.

????Most corporate policies are based on federal laws and requirements, including accommodations mandated by the Americans with Disabilities Act. Cancer was added to the list of illnesses covered by the ADA on Jan. 1, 2009, and the EEOC issued guidelines for it a couple of years later.

????Businesses with more than 50 workers are required to give Family and Medical Leave to employees who have cancer. Under the FMLA, workers are entitled to 12 weeks of unpaid time off to care for a child, spouse, or themselves. The employer is expected to continue health insurance and hold a comparable job open for these employees.

????At Cancer and Careers, the staff is starting to hear more from employers looking to help workers through their cancer diagnosis and treatment. Sweeney urges firms to be flexible and to allow staff to work at home during chemotherapy or radiation. Some companies are creating "shared vacation pools" so that workers with extra days can donate them to colleagues battling cancer or other serious illnesses.

????Employers want to hang onto experienced staff, so the percentage of U.S. firms that offer cancer insurance policies has inched up to 34% (from 28% in 2008), according to the Society of Human Resource Management.

????"These employees are valuable," and employers often want to find ways to bring them back to work, said Tom Parry, president of the Integrated Benefits Institute, an independent research organization. Other workers are watching carefully how the employer treats them. "When employers do the right thing with someone with cancer, that is a very important message" that resonates with many workers, he said.