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How do people respond to childhood cancer?

Children
Children are impressionable and understand their world from the security of their home life, and look to their parents for protection from the unknown which can often be frightening. They need to be constantly reassured that they are not responsible for their illness. Children may experience separation anxiety, appearing clingy and insecure. Other reactions these children might exhibit include extremes in behaviour (aggression or withdrawal), school phobia, and social alienation.

Children may feel socially isolated, especially if they are unable to do things they used to do with their friends or to take part in everyday activities. Returning to school with its friends, familiar routines, and surroundings as soon as possible after treatment can help them rebuild their confidence and adjust to normal life.

Adolescents

Young people at this stage in their life are often focussed on personal and social relationships and can be preoccupied with the long term social implications of their illness such as peer rejection, changed physical appearance, the stigma of being 'different,' and privacy concerns.

These and other factors, such as inability to keep up with their courses and to take part in extracurricular activities, impact on adolescents' anxiety about returning to school. They may also struggle with what the future holds for them and with their own mortality as a result of their illness, and can become increasingly dependent on their parents and health care support team. In some cases, these students experience significant difficulty in their academic life and may drop out of school.

Family

Parents: Diagnosis of childhood cancer can be one of most distressing things that can happen to a family. In the beginning parents try to live day-by-day without thinking of the future. At first, the shock makes it difficult for them to come to terms with the diagnosis and subsequently with the implications and demands the illness places on them and their family.

Parents struggle with the uncertainty of the course of their child's disease, its treatment, and the long-term effects. There can be significant financial worries, e.g., if one or both parents have to take time off work. They also have concerns about the other children in the family coping with the sudden changes in family life, e.g., long periods away from home due to travel to treatment centres and arranging for their care by friends or relatives. Some parents attempt to keep up a 'normal' life and are keen to have their child return to school and hope they will be able to take part in all activities; others are concerned with what can go wrong, e.g., fear of infection.

Some parents bring expectations and behaviours rooted in their own culture. As examples, in some cultures, a sick child is expected to remain at home and not attend school; in others, one does not share family problems with outsiders. It is important to understand and respect these differences, and at the same time, to encourage the parents in continuing to provide for the educational, social, and developmental needs of their children.

Parents common concerns include how and what to tell teachers, how to protect their child from teasing, how to inform the school about the danger of communicable diseases, and how to deal with a child's initial reluctance to return to school.

Siblings: Cancer can cause siblings to experience intense feelings – fear for their ill brother or sister, pain for their mother and father, and hurt for themselves – all of which result in significant stress. At times their feelings conflict; they may resent and be jealous of all the attention being given to the sick child, worry about getting sick themselves, and feel guilty thinking they are somehow responsible for their sibling's illness or that they should have been the one to get sick.

Siblings may withdraw from their family's situation by exhibiting different behaviours such as constantly watching television, playing on the computer, staying in their room, falling behind or skipping school, or associating with peers who also feel alienated from their parents and are not a positive influence.

They may have emotional and physical reactions, such as depression and headaches or problems at school. It is important that all school staff be made aware that a brother or sister has cancer so that they can respond to emotional outbursts or behavioural difficulties firmly but with empathy.

Educators

Educators express a range of feelings when exposed to childhood cancer including fear, sadness, apprehension, anger, hope, helplessness, guilt, loss, uncertainty, ignorance, disappointment, frustration, lack of confidence in handling the situation, and relief with greater understanding. They may benefit from turning to others for support to discuss their own feelings and experiences with cancer so these feelings do not interfere with the student's schooling.

With accurate and up-to-date information educators can focus on their prime responsibilities:

Educators often follow these steps for special needs children. If you have a child with cancer in your school, you don't need to become an "expert" on cancer and its treatment. By being well informed about your student's illness and treatment, you can help him or her to continue with the school program to the best of their ability.

Classmates

In the absence of accurate information, classmates may believe rumours which are usually far worse and more frightening than the truth. It is essential that classmates be given straightforward, honest information. This lack of understanding can be manifested as teasing, name-calling, and other bullying behaviours. Students with cancer need to know how to react and respond to their classmates' inappropriate behaviour.

Teachers can promote a climate of openness with opportunities for questions and answers to help classmates respond appropriately.


Also see:  How do I address sibling needs?