Going to School During and After Cancer Treatment

Even with the challenges of cancer treatment, staying connected to school is important. School offers a place for learning, fun, and relationship building. It’s a place of routine for them that is critical for their growth and development. Here’s why it’s valuable:

• Normalcy and connection. Staying connected with friends and the school community provides a sense of a normalcy.
• Learning and growth. It lets them keep learning and growing, staying on track academically and socially.
• Eases the return. Staying connected during treatment can make returning to school after treatment smoother.

Keeping up with school during treatment

Your treatment center may have school coordinators, education specialists, or teachers to help with keeping up in school. They can help during long hospital stays or illnesses when you can’t go to school. Hospital education coordinators and teachers can also work with your school to arrange other types of instruction. If your hospital does not have a teacher on the team, talk with a social worker, nurse, or others on your care team about ways to work with the school.

The school options that may work best depend on many factors, including the type of cancer you have and the types of treatment needed. There are a few different ways to keep up with school during treatment, so it is best to talk with your team.

Options that might be available for children and teens in grade school include:

• Homebound instruction: Some public schools might arrange for a teacher to work with you at home.
• Hospital- or clinic-based school: Teachers from your school might come to teach in the hospital, if you’re expected to be there for a long time. Even one hour of school a day can help create routine and a sense of normal life.
• Attending school during treatment: Depending on the treatment schedule, it might be possible to continue attending school. Ask the cancer care team for advice. Some people enjoy seeing friends when they feel well and can go for small blocks of time during the school day or for special events.
• Individualized Education Programs (IEPs) and 504 plans: These services help outline modifications or extra support in the classroom when needed during and after treatment.

Educational support may also be available during other training programs, such as college or university. Find out about your school’s disability services. They should be able to help you understand what sort of help you may need and qualify for.

Planning to return to school

It’s a good idea to talk to your school and cancer team early. Talk to the cancer care team about what to expect during a transition back into school before you meet with the school. This can make going from treatment to school easier.

Talk to the cancer care team

• Ask the cancer care team when returning to school might be possible.
• Talk about how long the school day should be when going back. After cancer treatment, it might take a few weeks or a month to have the energy for a full day of classes.

Connect with the school

• Get in touch with the school principal, teacher, nurse, and school counselor. Tell them when you can come back and what to expect. They might have forms for you and the cancer care team to fill out.
• Ask to schedule a meeting with the school so everyone knows what to expect. For younger children, someone from the cancer care team might also join to help with the talk, depending on how the cancer center or hospital supports people returning to school. Teachers and others may have questions about things to watch out for.

Prepare for the transition

• Ask if the hospital has a re-entry program to help plan the return to school, especially for children and teens in grade school.
• Prepare for questions about the diagnosis or changes in appearance. Other people may have questions about cancer, why you might look different or where you have been. Having an adult or cancer care team member available to prepare children and teens to answer some of these questions can help ease anxiety about returning to school. Discussing these sorts of questions with the care team when preparing to return to a usual routine may be helpful for young adults as well.

What the school should know

Give the school a list that includes:

• The medicines needed and how to give them
• Medicines, treatments, or other things that are not allowed
• Any special things the school needs to do to keep you safe
• Who to call with questions and emergency contact information
• Any extra help needed in school because of learning problems or other needs
• Warning signs to watch for and when to call an emergency contact
• Anything else the school should know about your needs

As much as possible, children, teens and young adults returning to the classroom after cancer should be treated like their classmates.

Returning to school

With some planning, going back to school can be a smooth part of the cancer journey.

Navigating mixed emotions

Returning to school might bring mixed feelings. Some people might feel happy about going back to school, while others might feel worried or anxious. Any of these feelings is OK.

Transitioning back to school can be hard for parents too. Parents might worry about things like:

• Your child feeling overwhelmed
• Your child getting sick
• Your child being teased by others because they look different

These worries are normal. Many cancer centers offer support as you make this change. They might have school coordinators, education specialists, or other team members who can help.

Children and adolescents talking to peers about cancer

Children or adults might have questions about cancer. Some questions can be tough for people to know how to handle. Practicing the answers to some of these questions before going back to school might help reduce anxiety.

Some places that treat childhood, adolescent, and young adult cancer can send someone to school to answer questions. Ask them if someone can come to class. Here’s what you can do to help your child talk about cancer with other kids and teens:

• Let them know other people might not know a lot about cancer.
• Give them some examples of what kids might ask, like “What’s cancer?” “Are you going to die?” “Can I catch it?” “Why are you bald?” “Why are you wearing a mask?” and “Can you still play?”
• Role play answering these types of questions. Younger kids might need a nurse or teacher to tell their class that cancer isn’t something they can catch.
• Tell them they don’t have to answer questions they aren’t comfortable with or can answer questions without explaining everything. They can say things like:
  • “I don’t really want to talk about that at school.”
  • “I’m not sure.”
  • “Maybe you can ask the teacher or the nurse.”
  • Depending on the situation, they might use one of these answers and then talk about something else, like school, playing, or something that’s not about cancer.

Remember, every child handles things in their own way. Help them find what feels best for them before they go back to school. This will help them deal with questions from their friends in a way that feels good to them.

Struggling with wanting to go back to school

Making excuses to skip school could mean they’re having a hard time going back. If you or your child is sad before or after school, or you notice sadness or irritability on Sundays, going back to school may be causing stress. Older kids and teens might not want to go to school because they look different, people treat them differently, or because they missed a lot of school and feel distant from their friends.

Here are some things you can do:

• Ask what’s hard about school and brainstorm ideas of things that might help.
• Invite friends over before going back to school full-time. This might offer an opportunity to answer some questions they may have. It can be helpful to have someone to help navigate those first few days back at school.
• Talk to teachers and the school counselor about what to expect and how things are going as school starts back. They might have ideas to help.

Managing physical problems at school

Sometimes, cancer treatment can make it hard to move around and do well in school. Schools might need to make special accommodations to help people who had cancer treatment.

Here are some common problems and ways to handle them:

Individualized Education Programs (IEPs) and 504 plans

Individualized Education Programs (IEPs) and 504 plans help people with special needs get the help they need to learn. They are part of laws that apply to all public schools.

What is an IEP?

IEPs are for some children, adolescents and young adults who need special help with school. They’re for people ages 3 to 21, and they end when they graduate high school. They are part of the Individuals with Disabilities Education Act (IDEA).

To qualify for an IEP, a person must have a covered disability that affects their learning. Sometimes, cancer treatment can cause problems that count as a covered disability.

If eligible, an IEP team will work with you to create a special education plan and learning goals for the year. This plan will include any school accommodations needed.

What is a 504 plan?

504 plans protect people with disabilities and ensures they are treated fairly. They apply to schools, employers, and places that receive government funding.

A 504 plan in a school makes sure that people can learn without obstacles getting in the way. It’s different from an IEP and doesn’t have a specific plan or goals. Any person with a disability can get a 504 plan. Young people who don’t qualify for an IEP may still be able to get a 504 plan.

Like IEPs, 504 plans provide accommodations that are specific to the person or disability. For example, a quiet environment or extra time when taking tests might be a part of a 504 plan.

What accommodations might be made?

It can be tough to get back on track with school and career planning after a cancer diagnosis and treatment. Depending on the problem, an individualized plan for support may help.

Accommodations might be part of an IEP or a 504, depending on what is needed. They are meant to change how the schoolwork is done but they don’t change what will be learned. Accommodations might include:

• Technology, such as audiobooks and videos
• A certain class seat location or a quiet testing area
• Extra time for schoolwork
• Deadline extensions or lower penalties for late work
• Breaks
• Tools to help with sensory problems, such as hearing assistive technology
• Alarms for time management

How do I know if an IEP or a 504 plan is needed?

If schoolwork can be done with some help, a 504 plan might be right. The overall learning goals will be the same as others in the class.

If more support is needed, such as smaller group teaching or alternative learning goals and pace, an IEP might be better. Your teacher and other professionals, such as a school coordinator or psychologist, can guide you to the best plan. Goals are based on learning testing results and the education team’s decisions.

More information on IEPs and 504 plans

• The National Center for Learning Disabilities helps people with learning and attention issues through advocacy, research, scholarships, and community partnerships.
• Understood is a non-profit that provides information and resources about education for people who think or learn differently.
• Find your state’s department of education for more information.