I distinctly remember "Will my child with cancer be able to go to school?" being one of the first questions we asked shortly after hearing the diagnosis from my child's doctor. Because she was a young child, I needed to remember, school was her job and her social network and it was the nucleus of her life.

Although some kids may say that they don't like school, if they are unable to attend for long periods of time, it has a huge impact on their lives as it removes them from their social network and gives them one more major reason to feel different than their peers.

The answer we heard was "No, at least not for a long time." Keep in mind that each child is different, and depending on the type of cancer, the stage of the disease and the recommended treatment protocol, your child might be capable of attending school with special considerations. This topic proved quite confusing for me. In retrospect the confusion was probably the result of years of recognizing how important school was and that kids should not miss school unless they were really sick. If they miss a day, sometimes it is hard to make up the work, especially as they get older and enter middle school and high school. However, under these circumstances, you need to forget those preconceived notions. The reality is that with one-on-one tutoring, and with the focus on what your child really needs help with, most children only need a short period of tutoring to keep them up to speed with the rest of their class.

Why School Might Be a Struggle

You are initially overwhelmed with tests, diagnoses and, usually, the immediate start of treatment. In some cases, hospitalization is required for port placement or biopsy surgeries shortly after diagnosis.

The child often feels ill from chemotherapy and the other medications he/she is prescribed. Some cancer diagnoses require lengthy inpatient stays as a result of the chemotherapy protocol. However, the trend is moving toward more children being treated as outpatients. This, combined with more effective medicines to treat chemotherapy side effects, increases the likelihood that children can continue their education.

Your child may miss school frequently and for long periods of time because of his immune system being suppressed, and he cannot be in places where there is a risk of catching something. And we all know school is a very high risk area when it comes to spreading germs.

Children can have high levels of fatigue or severe mobility issues.

Why School is the Right Thing to Do

It is important for the child undergoing cancer treatment to return to school as soon as he/she has been medically cleared. Returning to school offers the child and family a sense of normalcy and a sense of purpose and allows time to socialize with peers. Often schoolwork can be a distraction from treatment or painful procedures. Having to go to school is not only a sign that things are getting back into a routine, it's also a clear and reassuring message that there is a future.

When Returning to School Plan for your child's return to school with teachers and the school guidance counselor beforehand so everyone can be properly prepared. A 504 plan, specifically OHI (Other Health Impairment), is a form that can be completed with the help of your child's guidance counselor. This allows the school to give your child special accommodations that might be needed as a result of his/her physical condition. For example, Colleen was in a wheelchair and we needed to complete a 504 plan so that she could use the staff elevator and the staff restrooms. In addition, some schools have strict rules against the wearing of hats.

If your child is more comfortable wearing a hat after losing her hair, then the 504 plan might specifically give her permission to wear a hat while on the school campus. Some hospitals have a school re-entry program where a medical staff member goes to the school with your child and provides a classroom presentation to convey age-appropriate information to classmates to demystify cancer. For example, some children may think it is contagious and avoid your child when he returns to school. Others need to be given the opportunity to ask questions about your child's physical condition (i.e., his hair, a prosthesis, etc.). This presentation empowers your child through the support of the accompanying medical professional.

It also helps decrease the barrage of questions your child might receive that may increase stress during the first days back.

When Your Child is Out of School 

For a long time In some cases, your child may just be unable to go back to school for a long time, like in the case of Colleen. She had a very advanced case of osteosarcoma, which required aggressive inpatient treatment, and when she wasn't being treated, she was usually completely broken down and immune suppressed from the treatment. Fortunately, the school system and the hospitals have resources to help families in situations like this.

Outpatient

Talk to your child's school. There is a system called Homebound to assist children who will be out of school for four weeks or longer. A teacher will be provided for up to three hours per week to tutor your child. Ask neighbors and other family members to help with homework/tutoring. Your child's teacher will give you a realistic idea of how much time you should spend each week, but I guarantee it will not be anything close to what your child spends in school.

Inpatient

We are fortunate that both of the Triangle-area pediatric oncology hospitals have "hospital schools." Teachers are available to work with your child on the specific work that she is doing in class. The hospital teacher will contact your child's school, find out the appropriate curriculum and work with your child accordingly.

Also, be sure you communicate your needs to friends. In our case, the mother of one of Colleen's classmates volunteered to come in and tutor Colleen twice a week. She was an elementary school teacher who was taking time off to raise her children, and she is now a special person in our lives. You never know who is out there and willing to help you and your family.

The Bottom Line 

The emotional well-being of your child requires that his/her mind stay active and that he remains involved with his social circle as much as possible. Find ways to help stimulate your child's mind that will also be fun. There are lots of great homeschooling sites now that can help with ideas. Origami, reading, puzzles, writing in a journal-there's no end. Consider giving your child a project that involves social networking and interacting with people around the world. In the 21st century, there are lots of great ideas.

If you are thinking "Are you crazy? I don't even know anything about social networking myself!" I promise you, there are lots of people in the Triangle that would gladly spend some time with your child showing them the world through a laptop! If you don't know where to find them, I do! Send me a note through the Striving for More website.

Remember, children need relationships outside of their families, and they need to feel a sense of accomplishment. If they can't get to school, be creative and come up with ways to fill those needs for your child.