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After treatment and remission

Back to school

Going back to school is one of the most important steps in a child’s return to everyday life. This topic explains how to prepare, how to work with the school, learning difficulties and relationships with classmates.

Last updated: ~3 min read
A backpack on a hook by a classroom door.
Figure 1.Going back to school.

01Short answer

School gives a child more than knowledge: friends, a daily routine and the feeling of being “like everyone else”. That is why doctors advise returning to school as soon as it is safe — often while still on maintenance therapy (topic “Remission in a child”). Preparation: hold a meeting with the parents, the teacher, the school nurse and, if possible, the hospital teacher or social worker; explain the child’s condition, infection risk, medicines, physical limits and when to call the parents. Make a personal plan: short days, breaks, a place to rest, free access to the toilet and water, adapted PE and help with missed work. Protection from infection: hand hygiene, immediate notice of chickenpox, measles and other infections in the class, and the vaccination schedule (topic “What is a late effect”). Learning: some children, especially after treatment directed at the central nervous system, can develop difficulties with attention, memory and maths, sometimes years later (topic “Memory and attention”). The COG recommends a neuropsychological assessment for these children; based on the results, special educational support can be arranged. Classmates: with the agreement of the child and family, the teacher can give the class an age-appropriate explanation — about hair loss, or that the illness is “not catching”. This reduces questions and teasing. Watch for changes in your child’s behaviour, mood and grades.

02Simple explanation

School means learning, friends and routine.

Return as soon as it is safe.

A school meeting and a personal plan.

Infections must be reported at once.

For learning difficulties, an assessment.

03Scientific explanation

Early return: the ACS notes that returning to school as early as possible benefits a child’s social and emotional development.

Working together: the ACS recommends advance planning between parents, school and the medical team.

Learning: according to the NCI PDQ, neurocognitive late effects can occur after treatment directed at the central nervous system.

Assessment: the COG recommends neuropsychological assessment and educational support for children at risk.

04What happens in the body?

When can my child go back?

When the doctor agrees — often while still on maintenance therapy. Starting with short days is possible.

Meeting the school

Discuss the condition, infection risk, medicines, limits and how to make urgent contact.

Family, hospital and school
Figure 3.Family, hospital and school.

A personal plan

Short days, breaks, a place to rest, adapted PE and help with missed work.

An empty classroom in morning light.
Figure 2.The school waiting for the child.

Learning difficulties

Problems with attention, memory or maths can appear even years later. Ask for an assessment and support.

Classmates

With agreement, an age-appropriate explanation: the illness is not catching and hair will grow back. This protects friendships.

When to call your doctor

Worrying signs — fever, bleeding, new pain, breathlessness — should be reported to your doctor between visits too. Getting in touch early is always better than waiting.

05Back to school

Steps.

Meeting — A meeting with school.1MeetingA meeting with school.
Plan — A personal plan.2PlanA personal plan.
Classmates — Classmates.3ClassmatesClassmates.
Follow — Follow progress.4FollowFollow progress.
LearningLearning continues.
FriendsFriendships recover.
SafetyRisks are managed.

06A reminder sheet for school (simplified)

TopicWhat to say
InfectionsTell us at once about chickenpox or measles
FeverCall the parents
Physical activityAdapted PE
TirednessBreaks and a place to rest
LearningExtra time, personal help

* Adapt the list to your child with the doctor.

07Key terms

Personal plan
School adjustments for the child.
Hospital teacher
A teacher who teaches in hospital.
Neuropsychological assessment
Tests of attention and memory.
Chickenpox
An infection that is dangerous for a child with weak immunity.
Maintenance therapy
Long treatment to keep remission.
Adjustment
A change to school conditions.

08Key points

  • Go back with the doctor’s agreement.
  • Meet the school in advance.
  • Make a personal plan.
  • Ask to be warned about infections.
  • Watch for changes in learning.
  • Explain things to classmates.

09Frequently asked questions

My child will fall behind.

Personal help and time often close the gap.

There is chickenpox in the class.

Call the doctor straight away.

My child doesn’t want to go to school.

Find out why; the teacher and a psychologist can help.

Can my child do PE?

Often yes, in an adapted form; ask the doctor.

Does this information replace medical advice?

No. This is general education; only your treating doctor can assess your situation.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. My child will fall behind.

  2. There is chickenpox in the class.

  3. My child doesn’t want to go to school.

  4. Can my child do PE?

  5. Does this information replace medical advice?

My questions

12Sources

  1. American Cancer Society. Children with Cancer
  2. American Cancer Society. After Treatment for Childhood Leukemia
  3. National Cancer Institute. Late Effects of Treatment for Childhood Cancer (PDQ®)
  4. Children's Oncology Group. Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers
  5. MedlinePlus (U.S. National Library of Medicine). Cancer in Children
  6. National Cancer Institute (NCI). Follow-Up Medical Care
  7. National Cancer Institute (NCI). Cancer Survivorship
  8. Cancer.Net (ASCO). Follow-Up Care After Cancer Treatment
  9. Leukemia & Lymphoma Society (LLS). Long-Term and Late Effects of Treatment
  10. National Cancer Institute. Facing Forward: Life After Cancer Treatment
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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