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Vicki Golding survived cancer. Here she explores how she felt on returning to work and how social work colleagues dealt with working with someone with a life-threatening disease.

Should you return to work while undergoing cancer treatment? Will you have the energy to work well and concentrate fully? How much do you tell colleagues about your condition?

I faced these dilemmas when I was diagnosed with breast cancer over eight years ago, and since that time I have watched other workers in the same situation. My experience was that many colleagues just listened and quietly gave support. Others felt unable to face me. They needed to see me as fit and pretend that nothing had happened. Some unexpected words from a colleague helped me. I rang to cancel a meeting and started by saying: "I have some bad news." Before ending the conversation the colleague told me that he was thrilled that I was going to be all right. "I expected to hear that you are terminally ill; instead you say you are going to be fine." It was a wonderful response when I had become used to receiving commiserations.

Jo Wright, a home care manager, was diagnosed with ovarian cancer three and a half years ago when she was 32 years old. She had a series of operations and was grateful for the tremendous support she received at work. Jo experienced waves of tiredness suddenly coming over her. "The people I worked with seemed to know when this was happening and sent me to my mum's to have a sleep. [I worked near my parents' house]. I used to sleep for a couple of hours and then go back to work."

Both Jo and I found it was important to discuss our needs with appropriate colleagues when returning to work while still undergoing treatment.

Jo and I found support in different ways. I knew six women working for social services who had been diagnosed with breast cancer, and I set up the first workplace cancer support group in the country. The aim of the group was to provide practical help, support and guidance through sharing experiences. It gave members space and time to talk as well as support at difficult times, and offered women an opportunity to discuss the experience of breast cancer and getting back to work. The group was an acknowledgement that when people come to work they are managing others parts of their lives. As it was closely linked to occupational health, guidance was also available from medical experts.

Jo felt that she would benefit from individual help and booked some sessions with the occupational health counsellor to explore the issues that were important to her. Most local authorities have occupational health departments and many employ counsellors. Jo found the idea of going back to work daunting and felt vulnerable when she did return.

She was able to explore her fears and concerns with the counsellor. "It was a relief to have the chance to honestly say how I was feeling because I tended to put on different faces for different people. The counsellor gave me the opportunity to stop my thoughts racing and not give myself such a hard time."

If you are self-employed, as I now am, a number of questions might worry you. How soon can you return to work? How long will your clients wait for you? Will you be able to give them a high quality service? There are no easy answers to these questions. But local support networks are very important. Other professionals are very likely to be able and willing to support you deal with these issues.

Whatever your employment status, what matters is to know your limits and to be clear about these with management and colleagues. This can be difficult but is important to remember that overdoing it can set you back, physically and mentally. Set simple targets. Check with a nurse or your GP to find out if these are reasonable.

Remember also that work colleagues may feel guilty about any pressure they may be putting you under. Jo's manager told her: "On hearing of your cancer one of my first thoughts was, had I put you under pressure? You worked very hard and were always ready, able and willing. Was the pressure too much for you?"

I felt really good about returning to work but a flashback made me realise that the fear of cancer was still with me. I was at a training day where participants were told to close their eyes and imagine health and social services in 20 years' time. I was in tears - I could not imagine being alive in 20 years. I felt I was letting myself and everyone else down in allowing these fears to intrude. I spoke about them openly and it never happened again.

Jo, too, had some low moments at work. She says: "However, one day when I was feeling particularly down a colleague told me out of the blue that I was an inspiration to him by the fact that I'd continued working. This really perked me up."

Jo and I both learned to live with the aftermath of cancer and grew from it. However, we always realised that we were fortunate with the support we received in our jobs. How others make the choice will depend on the culture in their particular organisation.

Vicki Golding is co-author with Jo Wright and Sheila Dainow of 441/2 Choices You Can Make if You Have Cancer, Gill and Macmillan, 2001.