As school kicks off across the country, I write to teachers and administrators about students with cancer – or any serious medical diagnosis. Those who chose an education path are naturally caring by virtue of their selected occupation.  They undoubtedly juggle a great deal and come across unique student situations frequently.  This information is simply provided as an additional resource with helpful suggestions all in one place.  Probably the most important thing I want to impart is that these children desperately need you!

My son was diagnosed with cancer at age 5.  From preschool to 12th grade, he underwent hundreds of procedures, was frequently hospitalized, endured over 18 surgeries, and had continual testing. Through the years, he had some truly remarkable teachers who had a lasting positive influence on him. They were absolute gifts to him and our entire family.  Unfortunately, he had a few teachers who actually hurt him deeply.  Please remember that you are in a unique position to have a lasting impact on these sweet children who are facing the fight of their lives.

Here are some important reminders for teachers and administrators:

1. 1.  Know that both the cancer patient and parents are entirely overwhelmed.  They are scared, exhausted, and traumatized.  Going to school can provide a nice refuge and distraction for the child.  It can also present a lot of anxiety and fear.  The children are different.  They feel different.  They have had disrupted sleep and pain.  And that may be ongoing.  They sometimes look different, having outward signs of treatment or surgeries. They are coming to school feeling vulnerable and not quite themselves.  Even if they put on a brave face, it’s so important to keep in mind that their lives have been challenged in ways that you can’t possibly imagine.  In addition to the intense trauma of medical care, they have felt the stress of their diagnosis on the entire family … they have likely witnessed horrors in the hospital … they are often unclear or confused about their medical status … they are scared about overheard cancer stories … they have endured unbearable pain … they are unsure if they will survive … people are treating them differently … they have medication issues… and they have fears about future medical needs.  The list could go on and on.  In short, no matter how well adjusted a child may appear, please keep in mind that most still need some special attention. At a minimum, just keep an extra lookout to see if your intervention or support could be helpful.  You could be their lifeline.  You probably are their lifeline even if they don’t show it.
   2. This is somewhat obvious, but children with cancer are often physically and mentally drained. Please don’t underestimate this.  Their stamina is depleted as they have used so much fighting their disease.  They have been under attack in ways no child should be.  It can be hard for them to focus.  Participation can be difficult.  This can be exacerbated by the ongoing use of medication.  We all know that these drugs, although necessary, can wreak havoc on bodies in a multitude of ways.  The child may not have the awareness or confidence to relay these issues to you.  Please be mindful of the child’s limited endurance and abilities.
   3. Parents are often afraid to ask much of you as the teacher or administration.  They know that their child is presenting a unique set of circumstances and they don’t want to be a burden.  They desperately hope for a good school experience, but often don’t want to express too many concerns or outright ask for help.  They also have faced horror that most cannot imagine.  Fearing for your child’s life and watching their sweet little bodies endure brutal medical care is truly hell.  Parents may not have their wits about them either.  Of course, some parents may be full of requests or demands.  We all react differently.  Either way, please keep in mind that the parents are often as traumatized as their child.  Be patient with them.  And as an added act of kindness, you could even offer your help and empathy.  Taking that first step would be an incredible relief to any parent enduring their child’s difficult medical journey.
   4. Peer relationships are very, very complicated.  Children just want to fit in.  They want to have friends and participate in normal activities.  Cancer or any serious medical care can severely alter all of these things.  Just as adults don’t often know what to say or do around those who face intense medical care, children can be unsure also. Most children will be nice and supportive, but this often doesn’t last.  Some children ignore the sick child.  Some children are actually mean.  Mean behavior occurred in our situation and completely broke my heart.  My son was bullied on several occasions.  He was called a freak, told he should have just died, and more. Children with medical issues can be targets and unfortunately they are already quite vulnerable.  Exclusion and ignoring can be devastating to the child also.  They have already missed so much. They often don’t have the energy or confidence to push their way into the mix and could really use your help.  Please try to encourage kindness and inclusion.  Please keep an extra eye out for any mean behavior.  And please continue to do so throughout the year.  All of these issues can remain long after the medical care subsides.
   5. Remember that siblings are facing challenges as well.  Their household has been turned upside down.  They see their sibling in pain.  Their parents are frequently absent or distracted.  So much is running through their minds and they often don’t know how to handle or articulate it.  A little extra love to siblings of cancer patients can go a very long way.  Please also be sure to let parents know if you see any behavior they should know about.  Parents are out of their minds with worry about their sick child, but they worry about their other children as well.
   6. Be aware that even after medical care has seemingly ended, pediatric cancer patients still face challenges.  Over 90% of childhood cancer survivors have lifelong and debilitating side effects.  Some are mental and some are physical and most are very daunting.  Children often take medications for the rest of their lives that can cause ongoing problems.  Sleep, alertness, learning issues, and overall well-being can be impacted.  Most children also undergo constant scans to check that their cancer has not returned.  The fear and worry attached to a possible recurrence can take a huge emotional toll. Children often face depression, sadness or forms of actual PTSD after treatment.  This can creep into all areas of life and can last a very long time.  Please remember that childhood cancer survivors likely have some ongoing medical and emotional issues that can impact their daily lives.  Just because they seem to be in remission and cured, there are likely underlying issues related to their past medical care that aren’t readily visible.
   7. Know that parents appreciate your help so much!  The appreciation really cannot be over emphasized.  They may not show it, but they definitely feel it.  In the midst of a child’s cancer care, parents are often lost in a fog.  I am sure most express thanks, but the depths of that thanks go deeper than you can imagine.  I look back even years and years later and wish I had thanked, hugged, and hugged again certain teachers over and over.  Their acts of kindness and support meant the world to me.  There is no more helpless feeling than watching your child fight for their life and health.  It’s hard enough to watch your child struggle through the normal trials of life.  A cancer battle is excruciating to witness.  Those teachers who go above and beyond to help these precious children are angels and we parents hold them deep within our hearts forever.

Thank you for reading and considering these suggestions.  I hope you understand what a unique position you are in to truly impact the life of a child facing cancer or any intense medical care.  I realize that most teachers are intuitively aware of these things, but gentle reminders can never hurt.  Thank you for caring for our children.