What is cancer?
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There are many different kinds of childhood cancer.
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The common theme is that cells in the body grow out of control.
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The outlook is good for many types of pediatric cancer, and on average up to 70% of cases of childhood cancer can be cured.
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The cure rate varies depending on the types of cancer, how far it has spread, the age of the child, and other factors. Because of this, many cancer survivors are attending child care and school.
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Children may come to school or child care as cancer survivors, or they may be diagnosed with cancer while enrolled.
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If children who have cancer are well enough during therapy or between rounds of therapy, they may attend child care or school.
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Being with groups of children can provide a routine and the chance to interact with friends, which can be a welcome break from a hospital setting.
How common is it?
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Every year, 14 out of 100,000 children in the United States are diagnosed with some form of cancer.
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The most common cancers are leukemia, lymphoma, and brain cancer.
What are some characteristics of children with cancer?
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Children who are undergoing chemotherapy or radiation to treat their cancer may have a suppressed immune system that can make them more vulnerable to infection.
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Some types of chemotherapy cause hair loss.
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Frequently, children who are receiving cancer therapy will have a central venous catheter in their arm, shoulder, or chest area that provides a way to withdraw blood or give medications without a needlestick. It should be kept dry and protected. The catheter will eventually be removed.
Who is the treatment team?
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Children with cancer are usually treated in special pediatric oncology centers.
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The doctors in those centers are hematologist-oncologists.
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They will manage the child along with the primary care provider in the medical home.
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Because children with cancer may need frequent hospitalizations, often child life specialists in the hospital help children adapt and keep up with any lessons they may miss.
What adaptations may be needed?
Medications
Some children may be on low-dose antibiotics to prevent infection, but they are usually given at home.
Dietary considerations
There usually is no special diet, but children who are recovering from weight loss from chemotherapy may be on high-calorie foods or shakes.
Physical environment
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Good hygiene such as hand washing and avoiding infectious diseases, especially chickenpox and herpes mouth sores.
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Follow any guidance in the Care Plan about physical activity, but usually children who are well enough to attend child care or school will be able to participate in most activities.
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Develop strategies for accommodating children with cancer. Suggestions include
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Schedule a meeting with parents/guardians to go over the specifics of the particular child’s condition because each case is unique.
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Have the child make a brief visit before the first full day returning to child care or school to meet with his teachers and classmates.
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The Care Plan will probably need to be updated frequently for a child who is still getting cancer treatments.
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Make sure Care Plans are updated after each hospitalization or change in therapy.
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Explain to the other children about the child’s condition, especially if the child’s appearance has changed.
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Children sometimes feel guilty that they somehow caused their condition and may need reassurance that this isn’t so.
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Immediately after chemotherapy or radiation, the child may be more tired or need to rest, but that will resolve over a few weeks.
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The child may have frequent absences for medical tests and treatments.
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What should be considered an emergency?
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Fever is a serious symptom when the child has low blood counts.
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The Care Plan should outline what measures to take if the child has a fever or other symptoms.
What types of training or policies are advised?
Ask the child’s oncologist for suggested training resources.
What are some resources?
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KidsHealth,www.kidshealth.org
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American Cancer Society,www.cancer.org, 800/ACS-2345 (227-2345)
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Starlight Children’s Foundation,www.starlight.org
Source: Managing Chronic Health Needs in Child Care and Schools: A Quick Reference Guide.
Products are mentioned for informational purposes only. Inclusion in this publication does not imply endorsement by the American Academy of Pediatrics.
Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.
The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.