Cancer in the school community

It is important to remember that each cancer experience 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. 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.

– Read more of Ruby’s story

Learn more about:

• The role of the school
• Who gets cancer?
• Cancer in children and adolescents
• Treatment and side effects

Listen to podcasts on Explaining Cancer to Kids and Family Dynamics and Cancer

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.

An estimated one in two Australians will be diagnosed with cancer by the age of 85. In Australia, more than 127,000 people are diagnosed with cancer every year. People over the age of 50 are the most likely to be diagnosed with cancer, and children are the least likely. Unfortunately, however, some children and young people are diagnosed with cancer.

In adult men, the most common forms of cancer are prostate cancer, bowel cancer, melanoma, and lung cancer. Adult women are most often diagnosed with breast cancer, bowel cancer, melanoma, and lung cancer.

In Australia, about 1000 children aged 0–19 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 five-year survival rate for children and adolescents is now more than 80%. This can vary depending on the age of the patient and their cancer type.

Cancers affecting children generally differ from those affecting adults. Childhood cancers commonly 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.

Some side effects from treatment may not show up until many months or years later. These are called late effects. This is particularly the case for a child who was treated at a young age. Any student who has survived cancer will need appropriate support for the rest of their school years.

Childhood cancers

The most common types of childhood cancer in Australia 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)
• lymphoma – a cancer that develops in the lymphatic system; the two main types are Hodgkin lymphoma and non-Hodgkin lymphoma
• neuroblastoma – a cancer of the nerve cells involved in the development of the nervous system
• 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.

Cancer is increasingly seen as a genetic disease because it is caused by abnormal changes in a person’s genes. An individual’s cancer cells are unique. This means that different people may receive different treatments, even if their cancer type is the same. Doctors will recommend the best treatment for an individual based on the type and stage of cancer, the person’s age and their general health.

How long will treatment take?

Some cancer treatments take a few months, others take a number of years. An initial phase of intensive active 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. Remission may last for a long period of time. 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.

Side effects

Cancer and its treatment can have physical, cognitive and emotional impacts. There are a number of ways for staff to help a student or colleague manage these impacts in the school setting.

For some people treatment will cause significant side effects. However, not everyone will experience side effects. Some treatment side effects occur immediately; others appear weeks or months later. For more information, call Cancer Council 13 11 20.

People with cancer may have one type of treatment or a combination of treatments. Below is an overview of the most common cancer treatments and their side effects.

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 as tablets (orally), as a cream, or as injections into different parts of the body. Chemotherapy drugs circulate throughout the body. They particularly affect cells that divide rapidly, such as cancer cells or the healthy cells in a person’s mouth, stomach, skin or hair. Treatment may take several months. It is usually given in courses (cycles) over several weeks, with rest periods in‑between.

Side effects

• Side effects of chemotherapy depend on the drugs used and vary from person to person.
• They may appear rapidly (within a few hours) or later (2–4 weeks).
• Short-term side effects may include nausea, vomiting, tiredness, hair loss, mouth ulcers, sun sensitivity and lowered immunity.
• Long-term side effects may include problems with concentration, memory and thinking (cancer-related cognitive impairment). These can affect work or school performance for many years. Some chemotherapy drugs can cause infertility or heart problems.

Radiation therapy (also known as radiotherapy)

Radiation therapy uses a controlled dose of radiation 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 is specifically targeted at the treatment site to reduce the risk of damage to healthy cells. The radiation affects all cells in the area being treated, but cancer cells are the most affected. Treatment may be given daily for several weeks.

Side effects

• Side effects may appear throughout a course of radiation therapy, but particularly near the end or even several weeks after.
• Side effects will depend on the part of the body treated.
• Short-term side effects may include nausea, tiredness, hair loss and reddening of the skin near the area 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 problems, hair loss, infertility and (rarely) a second cancer later in life.

Surgery

Surgery involves the partial or total removal of a tumour. Surgery for cancer 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.
• Some surgeries cause bowel changes. Support and a private toilet may make this easier for the person to manage.

Immunotherapy

Immunotherapy uses drugs to help trigger the immune system to fight cancer.

Side effects

• Side effects vary depending on the drug. Some may become serious and treatment may need to be stopped.
• They may include fatigue, allergic reactions, painful joints, skin rash and diarrhoea. These can vary in severity and duration.
• Immunotherapy can also cause inflammation in any of the organs in the body.

Targeted therapy

Targeted therapy drugs attack specific particles within cells that let cancer grow. They may be used instead of or together with chemotherapy.

Side effects

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

Steroid therapy

Steroid therapy uses corticosteroid drugs to reduce nausea or swelling. Steroids are also used to help treat some cancers and to increase the effectiveness of some chemotherapy drugs. They may be given orally or by injection.

Side effects

• Side effects may include increased thirst and appetite, sleep problems, weight gain, behavioural changes, mood swings, stretch marks, acne, fluid retention, high blood glucose levels and muscle weakness.

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 more likely to catch infections.
• The treatment may involve many months off school or work and prolonged isolation.
• The donor cells sometimes attack a patient’s normal cells, a complication called graft-versus-host disease. This can occur soon after the transplant or many months later, requiring more time off 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.

Complementary therapies

Complementary therapies are used alongside conventional cancer treatments, and may help manage any side effects. They focus on physical and emotional wellbeing. Examples include acupuncture, yoga, massage, meditation and art therapy.

Side effects

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