Charles Hovis had won.
A year ago, the 27-year-old Mount Washington man defeated cancer. His Hodgkin's disease, a cancer of the lymph system, had been in total remission for four years, and Hovis was ready to enter the working world.
His reception was far from benign.
When Hovis applied for a job as a driver at a Glendale medical transport company, he was handed a four-page medical history to complete. Wary, but wanting the job, he filled the form out truthfully, answering "yes" to the question of whether he had ever had cancer.
Afterward, when a personnel officer interviewed him, she looked over the form, glanced up and asked, "Cancer--how did you catch that?"
The interviewer called Hovis at home a few days later to say the company had decided against hiring him because of his medical record. The firm's operations manager, she said, "wanted someone perfect" for the job.
"It's an attack on your self-image," said Hovis, still angry 12 months after the rebuff. "To work is something that's very important to a person. I feel I have a lot to offer. And I resent my health history being held against me."
Hovis ultimately got a job as a research assistant at County-USC Medical Center, where his medical record was better understood. But the barrier he confronted in Glendale is one faced by many cancer survivors--a growing cadre in the labor force as medical advances extend lives and often completely cure a wide range of cancers, especially those that attack in childhood.
Estimates of the extent of job discrimination against cancer survivors vary widely, but some studies say more than half--not counting workers who have minor scrapes with skin cancer--encounter bias in the workplace. Like Hovis, some are screened out of jobs by intrusive application processes. Others--victims of ignorance or the abiding stigma of a long-dreaded disease--are denied promotions, ostracized by co-workers uneasy about their own mortality or fired by employers who fear that they will be unproductive or will drive up health insurance premiums. Moreover, healthy, recovered cancer patients may face a subtler obstacle: Many find themselves locked into unsatisfying jobs that offer health insurance because they can't risk quitting and taking a better job where their health history may deny them coverage.
The hindrances are insidious. Cancer survivors can complain to government agencies, but resources for combatting job bias are limited and discrimination is not easy to prove. Physicians and counselors say some patients are sucked into a downward spiral; repeated rejections deepen a discouragement that can drive survivors out of the work force, diminish career expectations or rob patients of self-esteem.
"It's difficult enough being diagnosed as having the disease and going through treatment," said JoAnne Frankfurt, an attorney with the Employment Law Center in San Francisco who directs a statewide employment rights program sponsored by the American Cancer Society. "Then, when you see the light at the end of the tunnel, you face the social death of job discrimination."
The Cancer Society first drew attention to the problem a decade ago, backing research by USC social worker Frances Feldman that found that, among adult cancer survivors, 58% of blue-collar workers and 25% of white-collar workers experienced discrimination upon returning to the job market. About 20% of the survivors of cancers that strike in childhood--primarily Hodgkin's disease, non-Hodgkin's lymphoma, leukemia, testicular cancer and kidney, muscle and bone cancers--encountered bias when they sought jobs.
Subsequent research has turned up varying findings. In a Mayo Clinic study, only 3% of cancer survivors reported job bias, while researchers at Stanford University Hospital recently found 42% of the survivors they studied had experienced job-related problems.
Los Angeles oncologist Robert J. McKenna, a former Cancer Society president who helped focus attention on the survivors' plight, said growing awareness that many cancers can be treated and increased advocacy by survivors has made discrimination less common today than 10 years ago. The rise of AIDS, he adds, has deflected society's paranoia away from the cancer patient.
"AIDS clearly has some discrimination of its own, mostly through fear," McKenna said. "And therefore (employers) have shifted away from the cancer issue."
But the number of cancer patients and cured survivors is growing dramatically. Not counting those with mild forms of skin cancer, there are 5 million patients and former patients now, and 850,000 more each year, according to the Cancer Society, as 40% of cancer patients defeat a disease that not long ago was considered a death sentence. And the patients, as well as the doctors and counselors who advise them, say entering or returning to the work force remains among the biggest obstacles to living normal lives.