Purpose: The proportion of self-employed people in the workforce is growing. However, most research on work participation among cancer survivors has focused on salaried workers. We aimed to explore how self-employed people experience work during and after cancer treatment. Methods: We conducted semi-structured interviews with seven self-employed people who had been treated for cancer and seven key informants, namely counselors in the Norwegian Labour and Welfare Administration (NAV) who had long experience in supporting self-employed people and cancer patients around work participation. Interviews were audio-recorded, transcribed and content analysed. Results: Uncertainty was an overarching theme: uncertainty about the cancer, its treatment and future consequences, made it difficult to plan and caused uncertainties about the business. Five themes related to owning a business during and after cancer treatment emerged: Cancer treatment and late-effects; Entrepreneurship and engagement; Business-related worries; Support; and Shame. Survivors often worked during treatment. While working could provide a sense of normalcy, it was also essential to keep the business running. Survivors struggled with several work-related issues (e.g. high work demands vs low work ability), but financial issues related to running their business caused particular worry. Getting cancer and, consequently, struggling with financial problems elicited a sense of shame that was closely connected to their strong identity as (successful) self-employed business (wo)men. Conclusion: Self-employed cancer survivors experience uncertainty about personal and business matters. While work sometimes helped them to cope with having cancer, financial worries and responsibility for keeping the business running weighed heavily on them.

Few studies have investigated the support needed or received by self-employed cancer survivors to continue working. In Norway, the Labour and Welfare Administration (NAV) is responsible for supporting people both practically and financially to continue or return to work following ill health. Social welfare counsellors (NAV counsellors) are responsible for guiding workers in their effort to return to work. This study aimed to investigate NAV counsellors’ experiences of supporting self-employed cancer survivors. We also report how self-employed people experienced the support they received from NAV during and after cancer treatment. We conducted individual in-depth interviews among seven self-employed cancer survivors and seven NAV counsellors with experience in supporting self-employed cancer survivors. The survivors experienced NAV as largely absent and considered that the support offered was not very useful. The NAV counsellors stated that self-employed workers are in a difficult situation and that regulations and means of support were primarily designed to fit salaried workers. While they felt they were supposed to function as an “employer” for the self-employed, they found this difficult because of lack of time, expertise and means for supporting self-employed. These findings suggest that the social welfare system in Norway is not adapted to support sick self-employed people appropriately.