Most children with cancer will attend school at least some of the time during and after their treatment. Because school is a place for learning and fun, children benefit from returning as soon as medically possible.

Yet, returning to school after cancer treatment can be a tough adjustment for young survivors. Your child may have reservations about returning to school, including fears about:

• The reaction of friends and other children at school
• Missed schoolwork and social activities
• Changes in his or her abilities
• Changes in his or her appearance
• New routines

Discuss any fears your child may have about school before he or she begins. Help him or her develop coping strategies for situations he or she might face. For example, if your child has physical changes from cancer treatment, you should warn him or her about being teased by other children. Help your child learn ways to cope with teasing — and whom to talk to about it — to provide a sense of control over a situation.

You'll need to ensure that your child's education is started, maintained or changed as needed. Your child may have long- or short-term side effects that affect his or her education. Take these steps to ensure that your child gets the support he or she needs at school:

• Reach out to the treatment team. Many hospitals provide support for children as they return to school. An age-appropriate class presentation, either before or after your child returns to school, can let school friends and classmates know that it's okay to discuss the illness. The presentation can be prepared, and possibly given, by a medical team member, who can identify language and concepts the class can understand. If your child has undergone physical changes, such as hair loss, weight gain or scars, it can help to include this topic in the talk. Your child can participate in a way that makes him or her comfortable.
• Meet with school administrators, teachers and counsellors before your child returns to school. Make sure the staff is aware of your child's medical condition, and address any special needs or concerns with them.
• Let your child meet with his or her teacher(s) before returning to school to reduce anxiety.
• Ask school staff to promptly identify any issues that arise and provide you with relevant information.
• Ask your child's doctor to write a letter outlining your child's physical limitations or medical needs, such as the need for extra snacks, water or bathroom breaks.

Returning to School

School personnel may not be aware of the potential for long-term and late effects of treatment, therefore parents and medical professionals need to inform educators of the child's needs before he or she returns to school. Parents, educators and medical professionals can work together to develop a program tailored to the child's specific needs.

The program may include:

• Baseline testing. Children may benefit from baseline testing before treatment, if possible, and continued comparative testing during and after treatment to determine whether neurocognitive problems or associated learning disabilities have developed.
• Special accommodations. You and your child's teachers can take steps to ease your child's return to school, such as allowing him or her more time to complete class work or take exams. You may qualify for extended benefits through your employer. However, the programs that you might qualify for may be complex. For further help, reach out to your Patient Education & Support Manager of your local LLSC office, the social worker and other members of your cancer team.
• Long-term planning. Plans can be developed to help a child through certain situations such as transitioning from middle school to high school or going on from high school to secondary education and adult life.

LLSC offers several resources that can help ease your child back to school after an absence:

Informative publications, DVDs, videos and programs help explain to classmates and teachers how kids with cancer feel, why they may look different, what type of treatment they've undergone and special needs they may have on their return. All materials are available through local LLSC offices, including:

The Trish Greene Back to School Program*

The Trish Greene Back to School Program for Children with Cancer offers free information and materials to parents and educators from the local offices of The Leukemia & Lymphoma Society of Canada (LLSC). The program was developed to encourage communication among parents, young patients, healthcare professionals and school personnel to assure children a smooth transition from active treatment to back to school.

• Staying Connected: Facilitating the Learning Experience During and After Cancer Treatment

This educational program walks school personnel and parents through the emotional, physical, cognitive and late effects of cancer treatment that children may face, and introduces numerous resources that can help childhood cancer survivors flourish in the educational environment post-treatment. Contact your local LLSC office for schedule information.

• The Leukemia & Lymphoma Society’s Free Booklets and Videos

Click here to download or order any of the following:

• Coping with Childhood Leukemia and Lymphoma - This booklet offers practical suggestions for integrating a child back into normal family and school routines and gives parents, families and professionals insight into the child's diagnosis, treatment and survivorship (also available in Spanish).
• Learning & Living with Cancer - This booklet can help parents advocate for their child's educational needs. It examines the learning challenges your child may face both during and after cancer treatment, laws that protect the educational needs of children with cancer and specific ways that schools can help meet a child's educational needs (also available in Spanish).
• Pictures of My Journey Coloring Book- This colouring and activity book can help children ages 3 to 11 cope with the new people, situations and concerns that are part of the childhood cancer experience.
• The Stem Cell Transplant Coloring Book - This colouring and activity book is for children coping with having a stem cell transplant and for his or her siblings and classmates, as well as for children with a parent undergoing a transplant.
• Why Charlie Brown, Why? - This DVD tells the tale of a classmate who is diagnosed with leukemia. Using Charles Schulz's lovable Peanuts characters, the video helps children understand what leukemia is, how it's treated and how a child recovering from leukemia feels. When a classmate teases the girl because she has no hair, her friends rally around her and help the other children understand why his remarks were hurtful. Produced by Charles Schultz and United Media (also available in Spanish).

*For more information about The Trish Greene program, contact your local LLSC office.

Before her death from cancer in 1999, Trish Greene, Ph.D., was the senior vice president of Patient Services at The Leukemia & Lymphoma Society. She was devoted to patient services for cancer patients and created the Back-to-School program. Her devotion to patients and their families will never be forgotten.