School

Children and young people going through cancer treatment are encouraged to attend school as often as possible and should be at school whenever they feel well enough to attend.

This allows them to stay in touch with their friends and peer group as well as providing the normality of a structured day and education.

This being said, children and young people with cancer often have gaps in their education [1] and can be very reluctant to return to school. Children and young people will have access to education from hospital-based teachers whilst they are an inpatient. There is some regional variation in the delivery of hospital and home-based education; please click on the link below to see the regional set ups.

Children and young people who are not managing to attend school should be referred for part-time home tutoring. Again, there are regional variations in how this is actioned and in the availability of home education between education boards. Home education can take some time to set up, so this should be initiated as soon as it becomes clear that the child or young person is not going to return to school for some time.

The child or young person’s Paediatric Oncology Outreach Nurse Specialist (POONS) or CLIC Sargent Social Worker can visit the school before their return and discuss any concerns both the school and the family may have. At this meeting a plan is made for the child or young person’s return to school. The nurse visit may be more appropriate if the main needs are around the diagnosis or health needs in school. A Social Worker visit many be more appropriate if the main needs are around coping (child, parent, school staff, classmates), separation anxiety between parent and the sick child, bullying or practical issues regarding transport to school, adaptations in routines.)

The POONS will also explain and discuss with the school how best to keep the child or young person safe from the infections that are a threat to their health – for example chickenpox, measles and shingles. The school is advised they must develop a robust system (normally a standardised letter to all parents/carers) to ensure that parents/carers of other children in the school will let the school know right away if their child is ill with a childhood infectious disease.

It must then be ascertained without delay if the patient has been in contact with the infectious child or young person. If so, the following information must be immediately relayed to the parent/carer of the child or young person with cancer: 

  • What is wrong with the infectious child
  • When they were in contact
  • How close the contact was
  • How long the contact was for.

The patient’s care team need this information to decide on the best course of action.

Throughout the UK there is a Teenage Cancer Trust (TCT) school education programme [2] that offers schools a 50 minute education session to a peer, or year, group on teenage cancer. This may be with a view to educating and informing them on teenage cancer and health. CLIC Sargent has a comprehensive pack entitled “Cancer and school life” which has factsheets, teaching session plans and a DVD, with versions for primary and secondary school age children. There is also further information on the CLIC Sargent website to complement this pack for teachers, parents/carers and children.

Between the CLIC Sargent education pack, the TCT school education programme, the POONS and / or CLIC Sargent Social Worker school visit, it is hoped that understandably curious classmates are given an opportunity to ask questions in an appropriate and supportive environment, rather than potentially allowing misconceptions to flourish and inappropriate questioning of the ill child. 

Re-entry to school is a challenge for some children and young people with cancer. Some of the barriers are hair loss (Link), fatigue, pain, reduced attention span, the school environment, anxiety, altered body image (link),visual / perceptual / cognitive / hearing difficulties.

The occupational therapist (OT), CLIC Sargent Social Worker and the psychologist can all be helpful in assisting the child or young person to overcome these barriers. In some cases the occupational therapist may be required to carry out an environmental assessment of the school, to ensure the necessary adaptations are made to enable the child or young person to return to school safely and to participate in classroom activities. This is especially helpful for children with brain tumours and bone tumours where surgery may have left them with new disabilities.

When the child or young person is in hospital, schooling is usually provided via the hospital school if they are well enough.

Useful resources

CCLG

Welcome back! A guide for teachers helping children and young people return to school after a diagnosis of cancer.  

I have a friend who has cancer A pocket-sized leaflet for school friends, aged 10-16. 

CLIC Sargent

CLIC Sargent schools resources 

Includes storybooks for children, and the 'Cancer and school life' pack which contains

  • Guidance notes
  • A teaching session
  • Cancer and school life DVD
  • An overview of childhood cancer and treatment for teachers
  • A factsheet for pupils called 'Answering your questions about your friend's illness'
  • Information about the pack
  • Useful resources

The Royal Marsden Hospital 

The Royal Marsden Hospital schools resources 

Includes the following for teachers:

  • Pupils with cancer - A guide for teachers
  • Returning to school - A teacher's guide for pupils with brain tumours

References

[1] Children’s Cancer and Leukaemia Group (CCLG) (2014) Children and Young People with Cancer: A Parent’s Guide www.cclg.org.uk

[2] Teenage Cancer Trust School Education Programme https://www.teenagecancertrust.org/about-us/what-we-do/cancer-awareness/education-sessions