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Recognising the full impact of childhood cancer

Just last month the Royal College of Midwives put the spotlight on Britain’s current baby boom. Certainly the proliferation of “Baby on board” badges on my train each morning would seem to bear testament to the veracity of these figures.

Apparently we are on track for more babies to be born this year than almost any year since 1970.  Clearly this is stressful news for a midwifery service in austerity times, though perhaps better times for some of our beleaguered retailers one can only assume, as sales of associated paraphernalia soar.

What we all hope is that this generation grows up happy and healthy, loved and cared for and raised to become considerate and productive members of our society.  Sometimes though, events conspire against those hopes and reality strikes – children do become ill, crises do happen and not all children are raised by people who put their welfare first.

Earlier this year we conducted research looking at self-harm amongst young people, which is steadily on the increase.  One of the issues we uncovered is that in most instances, none of the people closest to children feel they have the skills or knowledge to talk about the subject.  This included GPs, parents and teachers.  Young people need to be treated individually, and supported in the way best dictated by their circumstances.

Yesterday Clic Sargent published a report to coincide with Childhood Cancer Awareness Month which highlights the experiences of primary school children who have been diagnosed with cancer.  It goes without saying that childhood cancer is an extremely distressing experience for all involved, but aside from the physical and emotional impacts related to the diagnosis and treatment, this is a time when children should be at school – building the social and academic skills they need for life.  That point of stability in a child’s life, with its rapid cycle of friendships forged and lost, of new experiences and activities is disrupted in an often sudden and traumatic way.

It is, on one level, unsurprising to read that in the childhood world of constant change and evolution almost half (47%) of parents said that their child had grown apart from friends because of their cancer diagnosis and treatment.  This seems almost sadly inevitable when removed from the day to day contact.  Yet clearly this figure could be a lot better, and that level of isolation reduced as the same proportion of parents (47%) also said their child’s school did not help their child to stay in touch with their friends whilst absent from school.

When the child is well enough to return to or stay in school, this should be a positive step.  Yet, who can reasonably expect a primary school child to confidently return to the classroom and playground during or after treatment without support?  Whilst the answer may seem obvious, just over half of parents felt their child did not receive enough support.

And by the same token, do we realistically expect their friends to be able to comprehend what has happened, the reason for their friend’s absence, changed appearance and potentially reduced abilities to participate in the way they did previously?  They too are small children who may be scared by what they have seen or (over-)heard.  So that makes all the more shocking the facts that more than one-third of parents said their child had experienced bullying or teasing because of their cancer diagnosis and treatment and the same proportion saying they were not consulted about how their child’s condition should be communicated.

This is not about blame – of the children, the teachers, the parents or health and social services.  All are doing their best.  Childhood cancers are thankfully rare which means that few outside the medical profession will ever come across more than one case.  The message is in some respects the same as for self-harm:  all those involved with a child who has cancer needs to be given the information and resources to enable them to talk about the subject in the right way and tailor that message for the audience.  As responsible adults we need to be flexible and open, working within frameworks and policies which should be developed in the best interests of the child, but able to be adapted to each unique situation using publicly available tools.

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