Helping Kids with Cancer get Back to School

By Marcia Stubstad, RN, CPHON Aug 23, 2016


Making the transitions smoother

When a child has cancer, there is so much to do…diagnostic tests, starting treatment, learning for the child and their family.  And then it’s time to go back to school.  With any luck, and some good planning, many kids can be back in school in just a few weeks.  It’s my favorite thing to do; to go and visit the school of a child newly diagnosed with cancer.

Sometimes it’s a small classroom of kindergarteners, or maybe a “pod” of middle school teens, and it might even be grades 1-12 in a smaller rural school.  Here we get to enter “their world” and see these kids through the eyes of their peers, parents, teachers and others who love them.  Why is it so important to be there right away?  By being present in the classroom, we get to help share their story, answer questions, calms their fears, and quiet the rumors.  No one wants to be forgotten.

A typical visit with a nurse and a child life specialist starts with the question – “can you tell me what has happened to your friend…?” And then “can you tell me what you think cancer is??”

No – cancer is not a germ, no you cannot catch it….and no one, not your friend or  his family did anything wrong to let cancer happen, it just did.  We call it bad luck;  and then, to share the brave story of their friend undergoing diagnostic tests, surgeries, and the plan for treatment.  “What is chemotherapy” we ask – and the answers are as many as there are kids brave enough to raise their hands. We share about central lines using a teaching doll for demonstration, and discuss activity limitations for low counts.  We talk about good hand washing to prevent the spread of germs, and in a way helping them all stay healthier.  We share how cancer has touched most of our families in one way or another.

And the harder questions – that are so important to raise, ”was anyone worried that your friend might be so sick he was going to die?” and many brave kids slowly reach a hand high. “ Well,” we say, “we cannot make promises – but most kids who have cancer survive.  We can tell you that we have a plan to make his cancer go away.”  This is the turning point — turning this from not only information, but an action plan, to keep this child’s education going, to make sure he is ready for the next grade next year; to give the child, his family, and his school family hope.  We want them to be planning for their future as survivors.  Most children with cancer do survive and it is our goal to not only have survivors, but healthy well educated, well-behaved and well-developed survivors.

After all, the business and “job” of childhood and adolescence is learning, growing, and developing and that is best done in the classroom.  Yes there are ways the school will be asked to change or modify curriculum: a child with cancer may miss 100 days or more of school in the first year of treatment.  Childhood cancer treatment can last from weeks to years and many lessons will be missed. But the learning can continue.

The child in school can continue to have connections to peers, to physical activity, to family and friends to help not only with their learning, but their self-esteem and keep their development on track.  Meeting at the school allows the healthcare team to connect with teachers, counselors and school nurses as well so that questions are answered and the transition back to school can be safe and comfortable for all of them.

It’s the best part of my job seeing a scared, sometimes bald, sometimes frail child, back in their world.  Amongst friends who will be their advocates, their supporters and most of all their friends for a very long time.  A glimpse into the lives of kids you don’t get to see in the clinic or hospital; a glimpse of who they really are and hope to be.