School Support

Children at school who have a friend or classmate diagnosed with cancer often want to show their support. As a teacher or administrator, there are things you can do to help both the patient and classmates stay involved with one another.

• Keep in contact with the patient.
  • Send a card in the mail signed by all of the classmates.
  • Does the patient have an email address? Send notes from you and the students in your class.
  • Make a video of what is going on in the classroom.
  • Make posters and draw pictures to decorate the patient's room.
• Have a health care professional, such as a nurse or child life specialist, visit the classroom to help the children understand more about cancer and what it means to the affected student and their classmates.

Talking with Your Classroom about Cancer

In order to facilitate adjustment and positive coping of young people with cancer, it is crucial to maintain normal life experiences as much as possible. Since school is the major “normal” activity of children and teens, we need to continue school experience as soon as cancer is diagnosed and throughout the illness and treatment experience.

At the beginning of treatment, it is very common for children to be unable to return to a regular classroom due to illness and treatment. It is essential to arrange a home teacher for the academic work, and social interactions with friends and peers, to the degree that is medically allowed.

It also becomes necessary to maintain the child’s connections to their school peers, even if they will not physically see each other for quite some time. This means providing basic information to the peers at school that is acceptable to the child and family. Remember that in the absence of factual information, children and adults tend to respond to rumors and innuendo that might be far worse than the actual facts. For this reason, a member of the child’s healthcare team might be helpful in sorting out what the children at school should or should not be told. A teacher at school who knows the child and is willing to become oriented to the issues of illness and treatment can help provide basic information to demystify what is happening.

When the patient is ready to return to school, it can be very helpful to prepare a classroom presentation that the child and perhaps a medical team member can present to the class. Having the child participate to the degree they are comfortable sends a positive message to their peers that it is OK to discuss the illness openly, rather than be fearful that the subject is too terrible to talk about. Classroom presentations should always be tailored to be developmentally appropriate and presented in language and concepts that the class is able to comprehend. Basic components of effective classroom presentation include the following:

• Introduction: What will be discussed, how all children share experiences with doctors and nurses, although few have been in a hospital overnight, and very few have chronic health problems that might be serious.
• Brief presentation about cancer and the specific cancer the student has. Make sure this information is developmentally appropriate for different ages. Focus on treatable nature of the illness and how this treatment will proceed.
• Review basics on relevant medical procedures their friend will undergo, like chemo or surgery, and what side effects are
• Dispel myths and misconceptions. Let the classmates ask questions and learn that cancer is NOT contagious, and was NOT caused by anything their friend did. Clarify what is known about cancer and curing it. Children may ask if their friend will die, and they need to hear that we have effective treatments and that everyone is doing everything they can so this does not happen.
• Encourage social support and let classmates know what they can do to help (eg., sharing notes if their friend is absent, helping kids in other classes understand what is happening and support the child with cancer if he or she is teased or called names because he/she looks differently).
• Resident Expert: Establish the patient as the “resident expert” in the class, and someone kids can address their questions to. If child is very shy or has difficulty with this, identify a teacher or counselor that can help peers with questions or comments.
• If a medical complication or relapse occurs, it is important to provide classmates with basic information about why the child is not at school and what is happening (John’s cancer was in remission for a long time, but he is now having some difficulties and will need more treatment to get well again ). If the child’s medical condition is deteriorating, let the classmates know that he or she is not doing well, but new treatments may be used. The goal is to balance factual information with what classmates can understand and need to know at a particular point in time so they are prepared. If death is imminent, a discussion emphasizing that everything has been done to try and cure their friend, but that the disease is no longer responding, and that the doctors will still continue to help their friend feel as comfortable as possible.