The importance of work in patients with cancer has received relatively little attention. This article reviews the existing literature and uses case examples to illustrate the themes that characterize work-related distress. Whereas loss of occupational identity can be a source of significant anxiety and depression, continuing or returning to the workplace allows many patients to maintain a sense of normalcy or control. The experience of discrimination can become a focus for strong feelings about fairness. Clinicians need to both address work-related distress directly and appreciate the larger significance these themes may have in their patients' coping. A closer look at the importance of work in oncology suggests several areas for future research.