She worries about how her students at Basic High School will do on their Advanced Placement chemistry tests, just like she worries about why the backs of her hands once turned red and burned.

"I really like doing my job, and as a teacher it's like you're on all the time," said Milgaten, after straightening up from a lab lesson. "There are 40 kids in here, and it's packed. There's always so much going on, and I love doing that."

Working through cancer treatments is not physically possible for everybody, or at every job. But better anti-nausea medication and better telecommuting tools are making it more possible for patients to keep up a more-or-less normal routine.

"I'm not here to say that chemotherapy is a piece of cake," said Dr. Mary Ann Allison, an oncologist with Comprehensive Cancer Centers of Nevada, who is treating Milgaten for breast cancer. "But compared to where we were, it's much better. And many people are surprised at how less toxic it is."

That includes employers, whose sympathy eventually makes way for more practical questions.

Will that employee continue to work? How many vacation days will she need? How much support does she need from management and from colleagues?

Experts say these are all valid questions, and the answers can vary widely depending on how the treatment is going.

"I think employers have to look at what is the best way to handle the patient's needs," said Margo Otto, medical social worker for the Nevada Cancer Institute. "It goes along with the diagnosis: How intensive the treatment will be, how complex will it be. I believe the employer should be flexible, helpful and compassionate."

Allison was recently asked by managers from Vons grocery stores to talk about cancer and what is needed by employees undergoing treatment. She has three grocery checkers in her practice, two of whom are well enough to continue working.

"It's reasonable (for an employer) to ask: One, how much time are you going to be out; and two, are you really going to be able to do your job?" Allison said. "I get asked those a lot of patients, coming from the employer."

For some individuals, working through treatment is a necessity. At the Nevada Cancer Institute, a private suite is set up with phone lines, Internet access and a television — named after MGM Mirage executive Dinah Groce, who worked through many rounds of treatment in the '90s before dying in 2003.

Basic High School chemistry teacher Donna Milgaten continues to work while she under-goes chemotherapy. “I share everything that is happening (with the students) because I think it is good for them to see that things happen but life goes on,” she said. Photo by Tiffany Brown

"People literally come for the day and go to work," said Shelley Gitomer, the institute's director of development. "Nurses go in and out very quietly. The television can be on CNBC or MSNBC. People feel like they are being constructive, in touch, not losing time out of the office. It occupies their day in a substantial, gratifying and intellectual way."

For those types of people, a "no phones" sign in a hospital is an annoyance. Gitomer said she often hears patients surprised about the Dinah Groce room.

"We get requests," she said. "Someone's in there almost every day."

Milgaten says Basic High administrators made her life much easier.

She knew in the summer that she would spend most of the school year in chemotherapy and radiation, so the school scheduled her for an off period at the end of the day.

Every other Friday she goes straight from work to her doctor's clinic, near the St. Rose Dominican Hospitals' Siena Campus.

"I take a sick day on the Monday after chemo, so I have three days after to lay around," she said.

Allison, who only treats breast cancer patients, said she usually encourages individuals to take a full week off after the first chemo treatment.

"You never know what's going to happen the first time, but usually after the first time we have a handle on it," she said.

After chemo ends around November, Milgaten will begin radiation treatments every day for six weeks.

She gets weak at school, but not often. Once she was leading a game of "Element Bingo" and had to rush to the restroom to throw up. A couple of times she felt sick after staying longer her usual nine hours at work. Her students sometimes catch her saying one number, then writing another when doing a mathematical equation.

"This has been a crazy year, but it's been a good year," she said. "It's forced me to get more organized. If I let myself get behind I won't be able to get caught up."

Milgaten is someone who thrives on the support and attention of the school's community. Besides teachers checking in on her during the day, the entire school is rallying behind her and some other cancer patients in the community at homecoming this weekend.

A head-shaving fundraiser is collecting money for the American Cancer Society.

"There could be a lot of stress involved in dealing with an illness, and if somebody's not willing to be supportive of that, it would make it a lot more stressful," Milgaten said.

Some people may want the opposite, though.

"I had another teacher who did not want anybody to know anything," Allison said. "And she pulled it off, she wore a wig so you couldn't tell, she didn't want the kids to know."

Her best advice is just talk to the employee, and to know that the individual "may need time to absorb it all."

"This is the most devastating event, probably, in their lives, and they're trying to do the best they can," Allison said. "And they need support."