Finishing cancer treatment and resuming a “normal” life should be a happy occasion, even a cause for celebration. After all, you've “made it!” You've overcome a life-altering challenge, and now you're headed back to a world filled with family, friends and familiar places instead of doctors, nurses and hospital beds. Bravo!
But what if the patient is a teenager, and “normal” means returning to school after weeks or months away? For some teens this can be a tremendous relief. For others it can be a time of great anxiety.
“They're worried about their image,” says City of Hope pediatric social worker Christina Cabanillas. She works with teens and hears their concerns every day. “How they look. Their mobility. Their energy. They worry about being stigmatized and about losing ground socially. They wonder if their friends forgot about them.”
Perhaps right now you're saying, “Nah, not my kid!”
You may think your happy, popular, well-adjusted teen will easily make a successful reentry without help. Don't count on it. Even the most resilient teen can run into unforeseen problems ranging from “chemo brain” and difficulty concentrating, to peers' inability to reconnect with their old friend who seems to have “changed.”
The good news is, with smart planning and thoughtful communication, just about any potential challenge can be anticipated and handled.
The key is to get started well before your teen goes back to school. Reach out to your doctors and find out what you need to know. Then reach out to the school staff and let them know what to expect. The hospital can help. Most have some form of “reentry team” for exactly this purpose. City of Hope, for example, can send a social worker to brief teachers, principals, counselors and nurses on the needs of the returning student: everything from medications he needs to activities he may have to avoid for awhile.
See if your teen would like to make a short visit to the school before actually resuming classes. It may help her and her friends ease back into their old routine. Your hospital can also arrange a special class presentation, where the other kids can ask questions, and get reassurance about many things, including the fact that cancer is not contagious (believe it or not, that myth is still out there!)
When your teen does head back for that first day, she may need a little extra support. Encourage her to pair up with a trusted friend, someone to lean on when fatigue sets in, a careless remark is made, or things just feel overwhelming. It can make a big difference.
Keep the communication going. Talk with your teen about any new problems that turn up. Be prepared to ask the school to make adjustments when necessary, such as cutting back on PE classes if your teen still isn't up to it. Or switching to alternative teaching methods if he's unable to concentrate in a conventional setting.
Depending on the situation, the school will work with you to develop either a “504” plan or Individual Education Plan (IEP) to address your teen's needs. Those plans can cover everything from specific learning goals to which additional services (speech therapy, occupational therapy, etc.) are available. You can change the plans as the student's needs change.
Whatever the challenges, it's important to help your teen get back to a regular school routine as soon as possible. That, more than anything else, will work wonders for her self-esteem, once she no longer feels “different,” or less capable of keeping up. Gently nudge her in that direction. Take a doctor's advice:
“It's normal to feel tired at first,” says City of Hope pediatric oncologist Nicole Karras, M.D. She encourages her teenaged patients to participate as much as possible. “Try to keep up. If you get tired, just tell somebody.”
Remember, the goal is to get back to “normal.” Because normal feels good, and social worker Cabanillas says returning to school is a big part of that.
“Doing things (like going to school) that help us feel better, matters!”