Does my nanny have breast cancer?

[Anonymous]

I love my nanny dearly, but she is very private and absolutely tough as nails and I didn't want to press her too much for details that she was clearly uncomfortable discussing. Last week, she was on vacation but texted to tell me that they returned early because it was raining, but that she still wouldn't come in on Friday because she was going to get a physical and update some vaccines. Today, she tells me that she's going for an MRI on Thursday (her day off). Then she also mentions that she'll be scheduling her appointments on her "off" days and weekends so it won't impact her work. When I pressed, she admitted that the doctor wants to start her on "preventative chemo" because everyone in her family has died of cancer. When I pressed a bit more, she hinted that there may be reason to suspect breast cancer, but that she refused a biopsy because "when you biopsy a tumor, it just causes it to spread." Then she waved me off, assuring me that she was healthy and energetic and felt absolutely fine. I've never heard of "preventative chemo," so I assume the doctors found a tumor. But how would they know its cancerous without a biopsy?

I told her that I understood that she doesn't like talking about these things so that I wouldn't ask again, but to please let me know how we can help and reminded her that I can alter my schedule if needed and she gives me some advance warning of doctor appointments and the like.

Is there anything I can do for her? What should we expect if she does go through chemo? And not to sound insensitive, but should I assume she won't have the energy to take care of my kids while she's going through treatment? Fortunately, I haven't lived through a cancer diagnosis with any close family member so I don't know what to expect.

[Anonymous]

Wow. You're way too fast jumping into the unknown. The doctors usually don't even know what they're doing.

[Anonymous]

I would press her and come up with a back up plan until she can return. I'd just reach out and offer as much support and flexibility as you can.

[Anonymous]

In many countries, working full time when you have cancer and are going through treatments is the norm.

My SIL's mother has had 4 re-occurrences of cancer (ovarian, breast and lung) and has undergone treatment with each and has continued to work full time time throughout. She doesn't have sick leave pay / benefits so this is just what people do in their country.

[Anonymous]

Anonymous wrote:Wow. You're way too fast jumping into the unknown. The doctors usually don't even know what they're doing.

Well, she told me tonight that the doctors want her to start chemo! So, I'm wondering if she has a more concrete diagnosis than she is telling me.

[Anonymous]

I have breast cancer and have never heard of preventative chemo. Even with a diagnosis it's definitely not automatic and I was advised not to have it.

[Anonymous]

Anonymous wrote:In many countries, working full time when you have cancer and are going through treatments is the norm.

Sadly, it is also the norm in this country among those of lower SES. My mother spent 4 days in the hospital for her mastectomy and then worked while she had chemo. She would go to the infusion center at night, have her chemo while she napped, come home for 3 hours, and then go back to work.

[Anonymous]

Could "preventative chemo" refer to Tamoxifen or similar drug? That would make sense if she's high risk.

My guess is there was some kind of radiology finding and she's refusing the recommended biopsy. Sounds to me like that's a really bad idea, but I could see doctors talking a resistant patient into at least taking Tamoxifen.

[Anonymous]

OP, why don't you just be as supportive as possible. There are lots of people working a variety of different jobs who are living with cancer quietly/secretly while undergoing chemo treatments. It all depends on how her body is handling the treatments. Sure there will be days when she's very tired and will get through it the best she can. Remaining active is beneficial. She's probably worried about losing her position with you and is avoiding full disclosure. Unfortunately, most employers as soon as you tell them you have a cancer diagnosis they assume you will be too sick to continue working or will die within a couple of years so they try to or do get rid of you.

Is the real question: should you find a backup nanny?

[Anonymous]

I have a question for you OP.

Is your nanny Hispanic/Latino? Reason being is that culturally, these groups tend to view illness in a different manner than us Americans. They tend to look down on illness...Even see it as a sign of weakness.

That may be why your nanny is being so casual about this, she may not want you to think she is weak + incapable because who really wants to be viewed in such a light?

If I were you, I would be direct w/her. This is a very important issue and not one you can sweep under the rug. If your nanny has cancer AND is going to go through treatment for it, then she needs to inform you. If she is going to go through chemotherapy and/or radiation, then she will be in no shape to care for your children, she will be hardly capable of caring for herself.

Stress this to her and let her know in no uncertain terms does any of this mean that you think any less of her. Having cancer does not make her incompetent or less valuable.

But if she is ill, she needs to take care of herself FIRST. Tell her you fully understand that + will support her as she undergoes treatment. Let her know if and when she returns, you will gladly give her back her position.

[Anonymous]

Anonymous wrote:Could "preventative chemo" refer to Tamoxifen or similar drug? That would make sense if she's high risk.

My guess is there was some kind of radiology finding and she's refusing the recommended biopsy. Sounds to me like that's a really bad idea, but I could see doctors talking a resistant patient into at least taking Tamoxifen.

+1.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Could "preventative chemo" refer to Tamoxifen or similar drug? That would make sense if she's high risk.

My guess is there was some kind of radiology finding and she's refusing the recommended biopsy. Sounds to me like that's a really bad idea, but I could see doctors talking a resistant patient into at least taking Tamoxifen.

+1.

+1 also. These were my thoughts exactly. She's wrong about the biopsy spreading cancer, by the way. Tamoxifen is not technically chemo but it is sometimes given to women who are at high risk. And if she's even talking biopsy there may have been something on the imaging, but that doesn't mean she has cancer.

I think at this point you have to back off.

[Anonymous]

Are *you* obligated to tell *your* employer everything? I think not. Seems like some healthy boundaries are in order here.

[Anonymous]

Anonymous wrote:I have a question for you OP.

Is your nanny Hispanic/Latino? Reason being is that culturally, these groups tend to view illness in a different manner than us Americans. They tend to look down on illness...Even see it as a sign of weakness.

That may be why your nanny is being so casual about this, she may not want you to think she is weak + incapable because who really wants to be viewed in such a light?

If I were you, I would be direct w/her. This is a very important issue and not one you can sweep under the rug. If your nanny has cancer AND is going to go through treatment for it, then she needs to inform you. If she is going to go through chemotherapy and/or radiation, then she will be in no shape to care for your children, she will be hardly capable of caring for herself.

Stress this to her and let her know in no uncertain terms does any of this mean that you think any less of her. Having cancer does not make her incompetent or less valuable.

But if she is ill, she needs to take care of herself FIRST. Tell her you fully understand that + will support her as she undergoes treatment. Let her know if and when she returns, you will gladly give her back her position.

OP here. I think this PP nailed it. Our nanny is hispanic and she absolutely sees illness as a sign of weakness. She is one of those women who is an amazing caregiver for others, but will never admit she needs care herself. I don't want her to worry about losing her job over this but I do feel like we need to discuss her health and any limitations that may come up as she goes through treatment. She is a wonderful wonderful nanny and I would do anything to keep her, but we need to realistically consider if we need to find a temporary or back up nanny in case she gets ill with treatment. I also want her to prioritize HER health for once and to make sure that she's getting appropriate treatment, but I suppose that's overstepping my bounds as an employer.

[Anonymous]

Does she have health insurance? Paid sick leave?