Todd Friedman, president of a Miami marketing firm, was taken aback when a senior director handling several major projects told him she needed time off. The woman explained she would be undergoing cancer treatment.

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Todd Friedman, president of a Miami marketing firm, was taken aback when a senior director handling several major projects told him she needed time off. The woman explained she would be undergoing cancer treatment.

Friedman knew the road ahead would be tricky: “When you are a business owner, you have a responsibility to your people to help them succeed,” he says. “But as their employer, they need you to succeed as well.”

At a time when many companies are scrambling for profits, employers face an added source of pressure: the increase in cancer. More than 1.4 million Americans will be diagnosed with some form of cancer in 2008, adding to the 12 million already afflicted, according to the National Cancer Institute.

The increase of cancer requires more employers to balance supporting the employee during treatment with keeping a business on track.

Friedman says the first move he made was assuring Lee Goddard, director of strategic research and planning with the 35-employee Propeller Corp., that her job was safe. His second was hiring a freelancer to pitch in on the days Goddard wasn’t up to working. “In today’s market, there are a lot more freelancers than there used to be,” he said.

For Goddard, a single mother, keeping her job was a concern: “I support my family. If I’m not working, we’re in big trouble.”

Friedman gave Goddard a laptop and a wireless card, which allowed her to work in waiting rooms or from home. She was able to do research during times when she had the most energy: “I wasn’t at the office attending meetings, but didn’t feel like a lot fell through cracks.”

In Goddard’s opinion, Friedman’s creative solutions to a difficult situation made her feel appreciated and loyal. “It saved my life.”

When a high-level executive gets cancer, some companies change their way of thinking about work/life balance issues. Of course, some situations may only need a temporary patch — letting other employees fill in. Some may require a longer-term solution — hiring an interim manager, consultant, or professional.

The goal is to allow the employee to continue to contribute to the organization, to set and manage the expectations of co-workers and to balance the employee’s time off with the team workload.

Team members should be clued in about the illness, says Gabriela Cora, author of Leading Under Pressure. However, she suggests urging them to support their co-worker through behavior rather than emotions. “Just communicate what needs to be done at the office level.” And, if critical tasks are not getting done, or mistakes are being made, Cora says, point it out “in a nonchallenging way.” After all, in a small business, the livelihoods of all could be at stake.

Both worker and company need ongoing communication: “As soon as you learn of the illness, make a plan to hold regular conference calls to keep everyone up to date. It’s partly courtesy, partly business,” say Bill Werther, professor of management with University of Miami.

He also says management should develop people who can step up when needed. But if they lack that person, they should turn to their network of outside contacts — lawyers, accountants, ad agencies — to recommend someone who can fill in. “If the person is a key player, that job must get done.” It can get difficult when a top executive refuses to acknowledge he or she can’t perform as usual.

Not long ago, I spoke with the CEO of a real-estate company who told me that her business lost significant value when its former chief executive underwent cancer treatment without appointing an interim executive. Although other executives tried to pick up some tasks, when the executive eventually died, offers for the business were a fraction of what they should have been.

In May, Patricia San Pedro, owner of a Miami public-relations/marketing firm, discovered she had breast cancer and needed to undergo surgery and chemotherapy.

“Cancer can happen to anyone, a CEO or a person in the mail room,” San Pedro said. San Pedro said she planned for the worst-case scenario and asked freelancers already onboard to take on more work.

“My clients have been very flexible with me,” she said.

Handling illness respectfully, she said, “is not just humane. It’s good business.”