Guidelines for School/Education

 SIOP Working Committee on Psychosocial Issues in Paediatric Oncology


Integration into school is a critical and essential part of the normal psychological and social development of any child. Children affected by a chronic illness such as cancer are not only entitled to attend school, but they must be stimulated to obtain a full recovery attendance at school.

With this in mind, the SIOP Psychosocial Committee dedicated the meeting in San Francisco (October 1993) to the educational programs of different hospitals that form one of the topics reported in the official document of this group.

In San Francisco, lengthy discussion followed 20 oral presentations from different world centres. A general consensus was reached on how to approach schooling and education in the paediatric oncology community. It was considered mandatory to have a well-defined and planned hospital/school program. The program for children suffering from cancer, based on the need for an open communication at their own appropriate level of development (age), should include the following issues.

School in hospital

The management of children with cancer requires the participation of a multidisciplinary team (physicians, psychiatrist and/or psychologist, nurses, social worker, teachers, recreation specialists), and the intervention must have the purpose of educating the child. Also, depending on his or her clinical condition, the child should be kept alert and occupied with play therapy.

In-hospital teachers must be chosen with care from among individuals who are sensitive to the needs of ill children, who are able and willing to follow the educational programs of each individual child’s school of origin, and who are sufficiently flexible to be able to substitute a play program when the child is too ill to study. Teachers must be as well trained and as stable as possible.

School re-entry program

Once the child is ready to return to normal school, the program for which parental approval will be necessary must include several points discussed below.

Channels of communication must be opened between the hospital personnel and the teachers of the school of origin. Personnel must explain the child’s specific medical condition to the teachers and must be ready and willing to explain the illness to the child’s classmates (when possible, one of the doctors from the centre should be present)*. Furthermore, a manual for teachers including information about the disease and how to cope with the ill child should be prepared. Teachers should be assured that their role is to teach and the hospital’s role is to treat. This frees the teachers from unnecessary worries, anxieties, or depression over the child’s physical problems. Suggestions should be given to the teachers for ways of helping the child to adjust in school and to reduce his or her anxiety about the illness. An atmosphere should be created where the child feels free to express his or her concerns. The program should support teaching methods that would help the child with cancer to keep up with classmates even while ill at home (e.g. fax, two-way radio or telephone, video or audio lesson.

Personalised education program

Children with cancer respond differently to various treatment protocols. It is incumbent on the hospital/school team (1) to determine the specific competence and needs of each individual child through one of the many educational instruments available for the purpose, and (2), to set in motion a personalised education program if the child requires extra help, with all of the necessary resources.

Every paediatric cancer program should dedicate sufficient resources to guarantee an appropriate educational support for every child with cancer. Good schooling and play therapy are not expensive.

Final comment

The reintegration of the child with cancer into school is an essential part of the total treatment program. It starts during the period of diagnosis, continues during the period of treatment, and is extended after the completion of treatment. Only co-operation among the family, care team, and educators, in addition to a well-structured program, can help in achieving this goal and preventing serious negative outcomes.

* Sometimes parents or the child itself want to explain the illness to the classmates. Teachers should stimulate and support them in doing that (the editors).

If you need more information about childhood cancer, treatment please follow these links:

Links to other websites


Working Together to Feed a Sick Child

 Terezie Mosby

This article was presented at the SIOP-Africa-Meeting in Accra (Ghana) 2010.

Working together to feed a sick child (99kb)

Palliative care and pain management

WHO resolution on access to palliative care

 published in The Lancet Oncology, March 2014

The Lancet Oncology has published an articles about the WHO resolution on access to palliative care.

On Jan 23, WHO’s Executive Board introduced a resolution urging member states to integrate palliative care services into their health-care systems. They described provision of such care as an “ethical responsibility”, and added that, when needed, palliative care is “fundamental” to improve quality of life, wellbeing, comfort, and human dignity. In May, the resolution will be presented to the World Health Assembly, but ratification should be a formality.

More information about the article:

The Lancet Oncology, Volume 15, Issue 3, Page e109, March 2014
Published Online: 31 January 2014
Copyright © 2014 Elsevier Ltd All rights reserved.

To read this article in full you will need to login or make a payment (link to Lancet)

Grief and bereavement

Post-Traumatic Growth

An interview with Dr. Mark Chesler by Steven Ungerleider, Ph.D. (editor of the Prevention Researcher), 2004

Post-traumatic growth is an emerging and rapidly growing field of interest. Dr. Mark Chesler of the University of Michigan, along with his colleagues, Dr. Bradley Zebrack of the University of Southern California, and Dr. Carla Parry of the University of Colorado Health Sciences Center, have been examining the emergence of post-traumatic growth in long-term survivors of childhood cancer.

In an effort to understand the concept of post-traumatic growth better, Dr. Chesler has agreed to answer our questions about his exciting new concept.

The interview you find here.

Links to other childhood cancer resources

If you need more information about childhood cancer, treatment please follow these links:

Links to other websites

  • Innovative Therapies for Children with Cancer European Consortium (ITCC)
    ITCC aims to provide a combined biological and clinical drug evaluation programme to select and apply the most promising novel compounds for their use in childhood cancer.
  • IDA Foundation
    IDA Foundation is an independent not-for-profit organization, committed to contribute towards greater accessibility of healthcare supplies in developing countries. IDA’s core objective has remained to provide high quality essential drugs and medical supplies at the lowest possible price to the not-for-profit healthcare sector in developing countries.  IDA Foundation is the world’s largest not-for-profit provider of pharmaceuticals and medical supplies, offering a wide range of quality assured products from stock.
  • The Hospital Organisation of Pedagogues in Europe (H.O.P.E)
    H.O.P.E is a body which is concerned with the schooling for children in hospital.

Information on clinical trials

A Internet website created in the USA serves patients, parents and professionals to better understand and access information concerning paediatric medicines and clinical trials.  Created by the National Heart Lung and Blood Institute (NHLBI), in partnership with other National Institutes of Health (NIH) institutes, the site combines video and text to address some pertinent issues evolving from the new thinking on administering medicinal products for children that is resulting in clinical trials for paediatric populations of many diseases – including rare ones – both in the USA and in Europe. It is hoped that the new website will enable parents and paediatric patients to better understand the role of clinical trials and ultimately facilitate the consent process. The website addresses the major themes involved in paediatric clinical trials: why research is necessary in paediatric populations; benefits and disadvantages; what happens at the end of a study; rights of families; and much, much more.

The Charity Social Media Toolkit