The author is chief executive of Barclays and is writing in a personal capacity for World Cancer Day

I was diagnosed with non-Hodgkin lymphoma, a blood cancer, in November 2022, around the time of my first anniversary as the chief executive of Barclays, the global bank. My first reaction was to understand the diagnosis, prognosis and treatment, worry about the new burdens on my family and arrange my medical care. Then, as a chief executive, I had to consider public disclosure and managing my job through treatment.

Disclosure was the easy part — with my physician’s advice, I was able to convey the diagnosis and prospects. The response from LinkedIn was overwhelming.

The doctors said I could work through most of the treatment. This raised two uncomfortably clarifying questions: how should I spend my time and where would I add the greatest value?

In thinking about it this way, though, I made my first mistake. In this article I wanted to share what I learnt from my experience in working with cancer, both professionally and personally.

Be prepared to explain your choices

To my great surprise, a significant minority among many messages of support questioned my choice to work at all during treatment.  They wondered whether this was a form of privilege, with my role affording me a flexibility denied to many others. Some even asked if it was CEO swagger or, worse, “negative virtue signalling”, implying that it was wrong for others to take complete medical leave to heal themselves. Others felt that my apparent unwillingness to “let go” was a problem.

Cancer is of course a broad disease, and treatments vary. Mine placed relatively manageable demands on my time and energy. With other treatments, my decision might well have been different. I wanted to work because I enjoy it. I quickly clarified that the decision to work was mine alone, and neither Barclays nor I would ever expect others to do the same if they were unwilling, or unable. My choices were neither a model nor requirement for others, and though they were the right ones for me,  I wish I had been more sensitive at the outset to this perception.

Draw the lines quickly

Barclays is a large organisation, employing about 90,000 people worldwide, processing millions of customer transactions daily, large and small. The reality is that all of this happens anyway without my direct engagement and I could leave well enough alone. On the other hand, I must attend to important operational and business decisions, including the investments which keep these transactions processed smoothly. There are many things in between, though, and I found it useful quickly to lay down some principles on what mattered for the time being.

Use absence to make the management team grow stronger

You have to let go and have total trust in your colleagues to handle the responsibilities you are relinquishing temporarily. Senior executive teams comprise high-achieving, opinionated leaders — that is what got them there. Shelves of management books advise on building cohesive teams who work perfectly together, with a shared vision. In reality, teamwork is always a work in progress. If it were so easy to do in practice, these books would not exist.

However, human situations and our unexpected difficulties — gratifyingly — do tend to accelerate the cohesion. I was confident, having worked with my colleagues for a number of years, that they would step into any gaps and that I would feel rewarded by their increased ownership of business strategy and execution.

Preserve the personal touch

During my few months of treatment, I needed to remain out of the office, unable to drop by our branches, visit regional locations, wander on to trading floors, chat to colleagues in cafeterias, lobbies and lifts, or to join client meetings. I always knew I would miss the constant contact and sought to remain accessible and responsive on email, and I never stopped calling colleagues and clients. All this may not have been necessary but I enjoyed it: it is important not just to do what you need but also what you like.

Less ‘doing time’ is not a cost

This is the area where I have struggled the most. It has been a habit of a working lifetime to take the frequent pulse of markets, of our business activity and of progress across many projects. In doing so, I took in a vast amount of information and expected to sift the signal from the noise. Now, with fewer occasions to probe colleagues, I had to decide which questions mattered — and when I should engage with them. It is a habit I should have cultivated more carefully earlier.  

More ‘thinking time’ is a benefit

An advantage of a slightly lighter schedule and relative confinement is that I have been able to be more contemplative about my role. I think my comparative advantage to the firm is to be a more strategic and deliberative leader, engaging less frequently but more thoughtfully, and relying more on my colleagues.

Seek mental wellbeing and normality

As anyone who has had a cancer diagnosis will know, there are many deeply intense personal and emotional aspects to one’s illness which of course outweigh the professional issues. Fundamentally, going through treatment for cancer is a struggle between short-term suffering and the expectation of long-term health. Our emotional happiness, physical wellbeing and friendships are affected by the disease, the treatments and the social restrictions resulting from weakened health and immunity. These human qualities are, however, precisely what we need to help us endure the treatment.

Encouraging mental wellbeing is an acknowledged part of modern cancer treatment. Even when in perfect health, our equanimity is taxed by endless stresses. Chemotherapy regimens, which create euphoric highs followed by melancholic lows, do not help. Luckily, these lows are shortlived and relatively predictable. Both the swings and the deeper malaise, I found, are best countered by continuing those activities which naturally bring me happiness and relaxation, such as sleep, yoga and TV.

Even if the body does not feel fine, physical activity is essential to create a sense of normality. A temporary lift of energy reminds us of what was, and what will be. A tip which many others gave me, and I followed, is to talk to nursing and clinical staff about how to manage the treatment — minimising its side effects on the body brings great joy!

Our sources of support and human connection come mostly from those closest to us: family, friends and colleagues. There is nothing more helpful and indeed, as Shakespeare tells us, “it blesseth him that gives and him that takes”.

I was also blessed with encouragement from some unexpected sources: two chief executives with family and personal experience of lymphoma; the sister of a colleague who, while bravely enduring her own struggles, has formed a refreshingly original and positive view of life; most inspirationally, a note from a colleague’s young son, who had recently overcome medulloblastoma following a brutal treatment at five years old.

Individuals who receive a cancer diagnosis should decide for themselves whether they are able and willing to work during treatment — and should be able to change their minds. Whatever they choose, they may find that cancer also gives one opportunities: to build resilience, gain empathy, strengthen old friendships and make new ones, and above all, increase self-awareness.  

For this hope and choice, we should all be enormously grateful to the scientific and medical community.

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