Cancer and school

For children, school is about more than learning math, history or science. It’s a place where they develop communication and social skills. It’s also a place where others care for and about your child. Children who have cancer may not be able to attend school because they are staying in the hospital. Or they may stay home from school because their risk of infection is high or they just don’t feel well. But you can lessen the effects of cancer on your child’s education.

Inform your child’s teacher or principal about your child’s diagnosis as soon as possible. And then keep them informed. Your child’s doctor may be able to give you some idea of the school time that will be missed. Research has shown that open communication between the school, parents and child with cancer can lessen the effects of cancer on a child’s education. When you tell teachers and other students about what your child is going through, they can do a better job of supporting the child both during and after treatment. For older children, it’s a good idea to talk to your child first and ask if there is any information they don’t want others to know.

It is also important to let your other children’s teachers know about the diagnosis. This allows teachers and counsellors to support all your children.

It can also help if a member of the healthcare team visits the school to talk to the staff and students about cancer. Talk to your healthcare team about resources available to help the school, such as Helping Schools Cope With Childhood Cancer.

There will be times in your cancer experience when keeping up with missed schoolwork is not a priority. That’s OK. But if your child feels well enough, doing homework and getting extra help or tutoring for work that has been missed can help your child feel more comfortable when they do return to school.

To help your child keep up, find out from teachers what they are working on. You could ask for extra copies of textbooks to keep at home so they are always available. Ask for schoolwork to be sent home by email or with siblings or friends. Ask teachers if you can have copies of their notes or if they can record their class.

Be realistic. Talk to the teacher about a reduced workload that focuses on core subjects such as English and math during times when your child is feeling very tired or unwell. Don’t hesitate to ask the teacher about extra time for handing in assignments. Tests and projects can be postponed if necessary. It may also be possible to have exams in the hospital or at home.

Check with the healthcare team to see if there is a teacher available in the hospital who can help your child stay up to date with their school work. Your child’s healthcare team may be able to suggest other ways to keep up with school. There may also be help available through your school district.

School is where kids see their friends. When your child can’t be at school, help them understand that others are thinking of them. It may be helpful for classmates to send cards, letters, pictures or drawings that can be put up at the hospital or at home. Friends may also use texting, email or social media to keep in touch with your child, send messages of support and keep your child up to date with what is going on at school or other events. When your child feels well enough, have friends visit at home or in the hospital.

Arrange for your child to attend special events at school such as sports games, assemblies or plays, if possible and if your child feels up to it.

Some children may return to school on and off throughout treatment, but other children may not return to school until treatment ends.

Parents are often anxious about sending their child back to school after the diagnosis and treatment of cancer. You might worry about many things – that it’s too much for your child to handle or that your child will become overtired or sick by going to school. It’s also normal to be concerned about how children will be accepted back into school, especially if the child has an obvious sign that they have been ill, such as hair loss or amputation.

Children benefit from going back to school as soon as possible. School helps kids feel normal and gives them a sense of purpose. It also helps the child reconnect with friends. Parents also benefit when their child returns to school as their life can return to a more normal routine as well.

Most children will want to go back to school as soon as possible after being diagnosed and treated for cancer. However, some children, especially teenagers, may dread returning to school. They may look different and they may be afraid of the reactions of their schoolmates. Children may be afraid that they didn’t keep up with their school work and won’t be able to catch up to their classmates. Some children may have developed learning difficulties as a result of treatment, which can add to their anxiety about returning to school.

After cancer, many children will adjust to school with few problems. But it is still important to talk to your child about returning to school. Tell them that things may be different at first. But everyone will get used to them being back, and they will too. Try to prepare your child for questions they might be asked, such as why they don’t have any hair. Discuss ways your child can handle any teasing they might get about their changed appearance or abilities.

Your child may want to stop in and make a quick visit to the class before returning. It may help if you, your child or a member of the healthcare team talks to your child’s classmates about the cancer, the treatment, what it was like in the hospital and how and what they are feeling now.

Try to keep open communication with your child’s teacher and school staff. Your child may need to attend school part-time for the first while. They may need to miss school for doctor appointments. Your child may still be too tired or may not be feeling well enough to attend school on some days. You may want to ask your child’s teachers about a reduced workload or class schedule until your child adjusts to being back in school.

Ask your child’s healthcare team to prepare a letter for school staff. This may include information such as:

• your child’s general health and how it may affect attendance
• effects of the cancer and treatment on learning and thinking
• whether the healthcare team expects that the child will attend full or half days
• whether or not the child can participate fully in physical education classes, sports, recess or play
• a description of any changes the child’s appearance
• the child’s feelings about returning to school
• any changes in behaviour that may be expected from medications or treatment
• a reminder to never give any medications (for example, immunizations) at the school without discussing it with the parents first
• any special considerations, such as extra snacks, food issues, extra time to get from one class to the next or extra time to complete assignments or write exams
• instructions about exposure to communicable diseases, such as chicken pox, shingles or measles
• a list of signs and symptoms that need to be reported to the parents immediately – for example, fever, nausea, pain, swelling, bruising or nosebleeds

Speak with the parents of your child’s friends. Tell them it would be really helpful if their children could welcome your child back to school and just be there to support your child in adjusting to being back. Ask if their children could walk with your child to school or meet them outside the school and walk in with them so that they don’t have to walk in alone.

Listen to and discuss your child’s worries and fears. Try not to minimize them or brush them off. As with diagnosis and treatment, your child needs to know that they can share feelings with you and that you are there to listen.

Be prepared for good days and bad days. At first, your child may be excited to return to school. Once that excitement wears off, they may be tired or side effects may start to bother them again. Things will settle down over time.

Once your child is back in school, check with the child and teachers regularly to see how they are doing with school work and with adjusting to being with friends and classmates. Deal with issues as they arise so that they don’t grow into big problems. Your child will know that they can count on you to be there to help them.

Some treatments may cause a decrease in memory or other learning difficulties. Some of these difficulties will go away in time, but others can be long-term or even permanent problems. Don’t hesitate to ask for help. Some disabilities are physical and are seen more easily, but learning disabilities may not be so obvious.

Some children may develop learning problems as a late effect of treatments for cancer during childhood. Find out more about learning problems.

If your child is having problems with school, you or your child’s doctor can ask the principal to assess your child for learning problems as a result of cancer treatment.

Referral and assessment can vary by school but usually involves a teacher, psychologist, speech and language therapist and other resource specialists.

Your healthcare team can also help arrange to have neuropsychological testing done, in particular when treatment is finished. You can choose which parts of this report that you would like sent to the school to assist in your child’s learning.