Cancer in the school community

A school forms part of the fabric of its community, bringing together students, parents, other family members, principals, teachers and other staff. A cancer diagnosis can have a ripple effect, and school staff may need to provide support in a range of situations:

When a student has cancer

• The student, family and classmates may need support at the time of the initial diagnosis.
• Cancer treatment can mean long absences from school, so the student may need support to maintain both educational and social connections.
• On returning to school, the student may have practical, academic and social concerns and may need support and adjustments for many years.
• Classmates may need guidance so that they too can create a supportive environment for the student.

When a family member has cancer

• If a student’s parent, sibling or other family member has cancer, the student and their family may need support.
• In some cases, the student’s academic performance may be affected as they take on extra responsibilities and concerns.

When a staff member has cancer

• The principal and colleagues can create a supportive working environment during the staff member’s treatment and recovery.
• The principal can communicate to students, families and other staff how the workload will be managed.

When the school community is bereaved

• Cancer survival rates are increasing, but if someone’s prognosis is poor, staff may need to prepare the school community.
• After a bereavement in the school community, staff may need to offer comfort and guidance to students, families and colleagues.

As well as detailed information for each of these situations, we provide general tips on talking about cancer and links to further support. Our sample letters may help you communicate with families. The personal stories come from real people who have experienced cancer in the school environment and provide great insight into the challenges they faced and the support they received.

It is important to remember that each cancer journey is different, and every individual navigates it in their own way. Some people want to deal with cancer privately, others welcome all support. Some want to talk about it, others just want to blend in. How people feel about the involvement of the school community may change at different stages of the journey. A member of staff can be the family’s key liaison person and help to communicate the family’s wishes to the rest of the school community.

In Australia, about 1000 school-age children develop cancer every year, which means that at any time there are thousands of school students who have had cancer. Advances in diagnosis, treatment and follow-up care mean the overall survival rate for children and adolescents is now more than 80%. This can vary depending on the age of the patient and their diagnosis.

Cancers affecting children generally differ from those affecting adults. Childhood cancers usually occur in different parts of the body and are not usually linked to lifestyle or environmental factors. They tend to be more responsive to chemotherapy, and children often tolerate the treatments better.

The treatments can cause long-term side effects, however, and some learning impacts may not appear until years later. This is particularly the case for a child who was treated at a young age. Any student who has survived cancer should receive appropriate support throughout all the years of their schooling.

Childhood cancers

The most common types of childhood cancer are:

• leukaemia – a cancer that affects the blood cells; the two main types are acute lymphoblastic leukaemia and acute myeloid leukaemia
• brain tumours – the most common types in children are gliomas (starting in the brain’s glial cells) and medulloblastoma (starting in the cerebellum, the lower back part of the brain)
• neuroblastoma – a cancer of the nerve cells involved in the development of the nervous system
• lymphoma – a cancer that develops in the lymphatic system; the two main types are Hodgkin lymphoma and non-Hodgkin lymphoma
• sarcoma – a malignant tumour that develops in the bone, muscle or connective tissue.

You can find detailed information about these and other cancer types here.

People with cancer may have one type of treatment or a combination of treatments. The treatments can have physical, cognitive and emotional side effects – some occurring immediately, others appearing weeks or months later.

There are a number of ways for staff to help a student or colleague manage these impacts in the school setting.

How long will treatment take?

Some cancer treatments take a few months, and others take a number of years. An initial phase of intensive treatment may be followed by a longer period of maintenance treatment.

If cancer cells and symptoms reduce or disappear after treatment, the person is said to be in remission. If the cancer comes back after a period of improvement, it is called a recurrence or relapse.

Some people experience a recurrence of cancer after a period of remission. If this happens to someone in your school community, they may need extended support from school staff.

Chemotherapy

Chemotherapy is the use of drugs to kill or slow the growth of cancer cells. The drugs are most commonly given through a vein  (intravenously), but can also be given orally as tablets. They act throughout the body and particularly affect cells that divide rapidly, such as cancer cells or the cells in a person’s hair, skin or nails. Treatment may take several months and is usually given in courses (cycles) of 1–3 weeks with rest periods in between.

Side effects

• Side effects of chemotherapy depend on the drugs used and the stage of treatment.
• They may appear rapidly (within a few hours) or later (2–4 weeks).
• Short-term side effects may include nausea, vomiting, hair loss, mouth ulcers, sun sensitivity and lowered immunity.
• Long-term side effects may include tiredness and problems with concentration, memory and executive functioning – these can affect work or school performance for many years. Some chemotherapy drugs can cause infertility.

Radiotherapy

Radiotherapy uses high-energy beams directed onto a specific area to kill or damage cancer cells so they cannot multiply. It can be used to treat the original (primary) cancer or the symptoms of a cancer that has spread (metastasised). The radiation affects all cells exposed to it, but cancer cells are the most affected.

Side effects

• Side effects appear throughout a course of radiotherapy, but particularly near the end.
• Short-term side effects may include nausea, headaches, tiredness, hair loss and reddening of the skin near the area that has been treated.
• Tiredness can persist for many weeks, especially after radiation to the head area.
• Long-term side effects may include sun sensitivity, learning difficulties, growth failure, thyroid nodules, infertility, hair loss and (rarely) a second cancer later in life.

Surgery

Surgery involves the partial or total removal of a tumour. It sometimes requires removal of a part of the body (e.g. amputation).

Side effects

• The most common side effect is pain at the site of the operation.
• Other possible side effects include infections and reactions to the anaesthetic.
• Some kinds of surgery require prolonged rehabilitation such as physiotherapy.
• An amputation can change physical appearance and ability, and may require the use of mobility aids such as a wheelchair or prosthesis.

Steroid therapy

Steroid therapy uses corticosteroid drugs to reduce nausea or swelling. The drugs may be given orally or by injection.

Side effects

• Short-term side effects include mood swings, fluid retention, behavioural changes, sleep problems, increased facial hair, increased thirst and appetite, muscle weakness, weight gain, stretch marks and acne.

Stem cell and bone marrow transplants

A stem cell transplant is a long, demanding process that replaces stem cells destroyed by disease, chemotherapy or radiation (stem cells normally live in the bone marrow and give the body a constant source of blood cells). It may also be called a bone marrow transplant, a peripheral blood stem cell transplant or a cord blood transplant (depending on the source of the stem cells).

Side effects

• Lowered immunity makes the person highly susceptible to infections, particularly in the first six weeks.
• The treatment may involve many months off school or work and prolonged isolation.
• Families living outside a major city may need to relocate for the treatment.
• The donor cells sometimes attack normal cells, a reaction called graft-versus-host disease (GVHD). This can occur soon after the transplant or many months later and require more time away from school or work.

Hormone therapy

Certain hormones stimulate the growth of some cancers. Hormone therapy either blocks or removes hormones from the body to slow or stop the growth of cancer cells. It is mostly used for adults with breast, prostate, ovarian or thyroid cancer.

Side effects

• Side effects for men may include tiredness, weight gain, hot flushes, breast tenderness, depression and osteoporosis.
• Side effects for women may include blood clots, weight gain, generalised swelling, hot flushes and irregular menstrual periods.

Targeted therapies

Targeted therapies are new drugs that attack cancer cells while minimising harm to healthy cells. They may be used instead of or together with chemotherapy.

Side effects

• Side effects vary depending on the drug.
• They may include fevers, allergic reactions, rashes, diarrhoea and blood pressure changes.

Complementary therapies

Complementary therapies are used alongside conventional cancer treatments and may help with managing their side effects. The therapies focus on physical and emotional wellbeing. Examples include acupuncture, yoga, massage, meditation, music therapy and art therapy.

Side effects

• Side effects depend on what type of complementary therapy is used.

Alternative therapies

Alternative therapies are unproven therapies that are used in place of conventional treatment. They are often promoted as ‘cancer cures’ without scientific testing. Examples include shark cartilage, magnet therapy and drastic diets.

Side effects

• Some alternative therapies may cause serious side effects or interfere with conventional cancer treatment.