Effects on Academic Functioning

The treatment for most childhood cancers takes weeks or months. Children often miss extended periods of time at school, partly because of clinic or hospital visits for treatment but also because children may need to stay away from school due to the immunosuppression resulting from the treatment. Many cancer treatments reduce immune function, making children vulnerable to serious illness in response to ordinarily minor infections. School requirements for vaccinations now lessen the exposure to serious contagious childhood illnesses such as chickenpox. However, many children are advised to avoid school when respiratory illnesses are endemic. Even when the children do attend school during cancer treatment, they may have difficulty learning. Fatigue, a common response to both chemotherapy and radiation, can interfere with concentration and sustained attention.

In addition to the medical obstacles to school attendance, children may feel uncomfortable at school. Changes in their appearance, such as hair loss, may make them self-conscious. They may feel unable to explain to their peers or teachers why they missed an activity or did not complete an assignment. Teachers may also feel ill prepared to explain the situation to their other students or may be fearful of having the child reenter the classroom while on active treatment. To address these issues, pedi-atric cancer programs have information they can send to schools, or they can have someone communicate directly with the teacher and/or school nurse. School reintegration can also be facilitated with a visit to the classroom by a trained person, allowing children to ask questions (Labay et al. 2004).

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