Children and adolescents with cancer face many challenges associated with having a life-threatening illness: undergoing intense and invasive procedures and treatments, experiencing changes in their appearance and abilities, and uncertainty about the future.  Despite these challenges, most kids are quite resilient.  When children with cancer remain engaged with peers, focus on typical activities and goals, and envision a future beyond cancer, they can maintain their quality of life during and after treatment.

To help children maintain a sense of normalcy and continue achieving important developmental milestones, we encourage them to remain in school and stay connected with friends.  Even the youngest children with cancer need to know that although some things change, many aspects of their lives will stay the same.  For school-age children and adolescents, who understand what cancer is and what they need to do to treat it, the need for normalcy and routine is even stronger.  Engagement in academics and connections with peers are essential.

Parents and educators play an important role in helping youth with cancer return to school, even as they deal with their own reservations about this process.  Parents may be reluctant to allow their children to attend school due to concerns about infection, fatigue or a lack of acceptance by other children. They may try to reduce stress for their children by minimizing responsibilities, including school attendance.  

Teachers are challenged to maintain academic continuity as the child moves in and out of the school setting and to set reasonable expectations.  Having a child with cancer in the class may be a teacher’s first experience educating a child with a chronic health condition, resulting in uncertainty.

With guidance from the child’s physician, children can take part in hospital school programs or homebound schooling, and attend school. Many hospitals offer programs, staffed by medical social workers and educational advocates, that help ease the transition for everyone  Some of the support services they offer include:
 
•    Help for parents in communicating with the school (teachers, nurses, students) about their child’s adjustment to cancer and current educational and medical needs.  
•    Educational materials for teachers to assist as they prepare themselves and their students for the child’s return.  
•    Visits by the Hospital staff to the child’s classroom to explain in developmentally appropriate ways what cancer is and what treatments the child receives. These professionals can emphasize that the child is the same (with or without hair) and dispel myths about cancer  (that cancer is contagious, that children with cancer do not have to do homework).  
•    Guidance for school nurses about how to care for the child with cancer at school.  
•    Support for families when schools are reluctant or inconsistent in providing accommodations, tutors and other resources that allow the child with cancer to access their education.  
•    Psychoeducational evaluation for children with cognitive issues caused by cancer or its treatment. This type of assessment can determine areas of strength and needs that should be addressed through an Individualized Education Plan (IEP).

Teachers, and students can also interact with the child who cannot attend school regularly by sending cards or emails, making bright, cheery posters for the hospital room, incorporating a lesson on cancer into a science class (for older children), including the child in class field trips or other special activities, or creating a memory book of the school year to share with the child.  These are just a few suggestions; often students have the best ideas for maintaining communication and easing the transition back to school.

It is important to remember that children with cancer, their parents and teachers may be anxious about the child’s return to school.  With proper planning and support, children can come back to the classrom, reengage with peers and enjoy active lives – all factors in helping them maintain hope and look to the future.