Cancer in the · A tumour can be benign (not cancer) or malignant (cancer). A benign tumour does...

Cancer in theSchool Community

A guide for staff members

Cancer in the School CommunityA guide for staff members

First published March 2008 © The Cancer Council New South Wales 2008 ISBN 978-1-921041-65-8

Writer and Editor: Laura Wuellner Designer: Suzanne Pye, Starfish Design Cartoonist: Greg Smith Cover art: Katherine Chadwick, Designland Contributor: Carol Fallows Series editor: Alyssa White Director, Cancer Information and Support Services: Gillian Batt Manager, Supportive Care Development Unit: Dr Kendra Sundquist

Images on pages 8 and 9 courtesy of The Cancer Council Victoria. Table on pages 18 to 21 and “Gemma” case study on page 43 adapted from When a Parent Has Cancer: how to talk to your kids (The Cancer Council NSW, August 2007, pages 16 to 17 and 21).

AcknowledgementsWe are grateful to many school staff members, parents and young people, whose real-life stories have added to the richness and relevance of this book.

We thank the expert reviewers: Warwick Chipman, Professional Officer, NSW Secondary Principals Council; Leigh Kurth, Senior Project and Services Officer, Redkite; Kate Lovelace, Student Health Coordinator, NSW Department of Education and Training; Jeremy Medlock, consumer; Katrina Sheraton-Yu, Education Program Coordinator, Back on Track; Dr Michael Stevens am fracp, Senior Staff Specialist, Oncology Unit, The Children’s Hospital at Westmead; Tim Rogers, General Manager, National Services, Redkite; Jane Turner, Senior Lecturer, Department of Psychiatry, The University of Queensland; Maria Twigg, Grant and Projects Manager, Redkite; and Daphne Walshe, Oncology Community Clinical Nurse Consultant.

We also thank staff members of private and public schools across NSW, and employees of The Cancer Council NSW. Your feedback has been instrumental in the development of this book.

The Cancer Council New South WalesThe Cancer Council is the leading cancer charity in NSW. It plays a unique and important role in the fight against cancer through undertaking high-quality research, advocating on cancer issues, providing information and services to the public and people with cancer, and raising funds for cancer programs.

This booklet is funded through the generosity of the people of NSW. To make a donation to help defeat cancer, visit the Cancer Council’s website at www.cancercouncil.com.au or phone 1300 780 113.

Before commencing any health treatment, always consult your doctor. This booklet is intended as a general introduction to the topic and should not be seen as a substitute for your own doctor’s or health professional’s advice. All care is taken to ensure that the information contained here is accurate at the time of publication.

The Cancer Council New South Wales 153 Dowling Street Woolloomooloo NSW 2011

Cancer Council Helpline: 13 11 20 Telephone: (02) 9334 1900 Facsimile: (02) 9334 1741 Email: [email protected] Website: www.cancercouncil.com.au

About this book

Cancer in the School Community is a resource for public and private school staff members who would like to better support students, parents and colleagues with cancer. We hope it will provide you with the information and tools you need to understand and respond to issues that arise when someone you know is affected by cancer.

Although this book was written for an audience of public and private school staff members, the content is also relevant to a

wide range of people. This book will also be useful for parents, students and family members.

Cancer affects not only an individual and their immediate family, but also has a ripple effect throughout the school community. It can help to acknowledge your feelings and work through them with the help of others and by using resources from organisations including the Cancer Council NSW.

Cancer in the School Community evolved from interviews with experts in oncology – such as oncologists, nurses, social workers, pyschologists and counsellors – school staff members, family members, CanTeen, Camp Quality, the NSW Department of Education and Training, hospital school staff and students.

The quotations and stories in this book are authentic, however some names have been changed to protect people’s privacy.

Who this book is for

How this book was developed

To avoid gender-specific references, we have used third person plural pronouns (“they”, “their”) in place of third person singular pronouns (“his or her”, “him or her”) throughout this publication.

This publication is a resource and starting point for those seeking information and advice about supporting someone with cancer. There are practical strategies for supporting colleagues, parents or students with cancer, and there is information about cancer, grief and support resources.

While you may choose to read the book in one sitting, we encourage you to read each chapter as it becomes relevant to your school. Each section explores a particular issue your school community might address – for example, if a staff member has cancer.

Please keep in mind that Chapter 7: Cancer, death and the school community may be confronting for some readers, and may not be applicable to your school community.

How to use this book

The double-page spread Cancer in the school community: 10 ways your school can help can be photocopied and distributed to start discussions about cancer (see pages 4 to 5). You can also contact the Cancer Council Helpline on 13 11 20 for one-on-one advice.

ContentsCancer in the school community: 10 ways your school can help

Chapter One: Information about cancer

Chapter Two: Talking about cancer

Chapter Three: When a student has cancer

Chapter Four: When a parent has cancer

Chapter Five: When a staff member has cancer

Chapter Six: A principal’s guide for supporting staff

Chapter Seven: Cancer, death and the school community

Chapter Eight: Events and fundraising

Chapter Nine: Support services, resources and information

Chapter Ten: Glossary and chapter index

4

7

13

23

39

45

51

57

67

71

79

A snapshot of the best strategies for supporting a person with cancer. You may distribute copies of this section within your school community to start discussions.

An introduction to cancer. This section includes information about common types of cancer treatments and their side effects.

Information to help you talk to different audiences about cancer. It includes strategies for respecting a family’s privacy and appointing a liaison person.

Ways for you to support a student through all stages of their cancer and help classmates understand what is happening.

Information about how a family member’s cancer can affect students, and tips about how your school can support the family.

Facts about how cancer may impact a staff member’s life and how your school can help support someone at any stage of their illness.

Tailored advice for principals on how to support colleagues with cancer, including ways to reduce someone’s cancer-related stress and how to address HR concerns.

Guidance about students’ understanding of death, ways to prepare for death, and how to help the bereaved. It also advises on how to plan a memorial service.

Details about ways to raise cancer awareness in your community. This includes information about fundraising and organising a cancer awareness presentation.

Contact details for the Cancer Council and other support organisations. This section also contains websites for further information and sample letters.

Information about how to define common cancer-related words for people of all ages, and an index to help you navigate this book.

Appoint a liaison pe

rson

Help a family affe

cted by

cancer by appointin

g a single

point of contact w

ithin your

school. This liaison

person can

keep up with a fam

ily’s ongoing

needs and ensure i

nformation

isn’t duplicated or

overlooked.

Be flexibleSchool or work may be the last thing a person thinks about when they are diagnosed with cancer. Remember, a person’s schedule and expectations may change, and

your school should try to accommodate these changes.

Respect a family’s wishesEveryone has a different preference about what information they’d like to share with others, who they want informed and when they want to share news. Be sure to respect someone’s wishes and ask for their input, particularly if they want to keep their diagnosis private.

Be ready to helpWhen you make yourself available to a person with cancer, they may feel more confident asking for assistance. Your school’s welfare or learning support officer can also provide support.

4 The Cancer Council NSW

Cancer in the school community: 10 ways your school can help

Keep in touch

Stay in touch with

the person

who is absent, if th

ey would like

to maintain contact.

Peer support

and friendships can

provide a

welcome relief from

thinking

about cancer. Keepin

g in touch also

gives the person wit

h cancer an

opportunity to discus

s any concerns

that may arise.

Set up strategiesYour school’s student welfare team or learning support team has experience working with students, families and staff members. Tap into their knowledge about the best ways to support a person with cancer.

Raise cancer awaren

ess

Establishing links to

cancer

in core curriculum o

r exploring

other ways to prese

nt

information about can

cer can

help raise awareness

in your

school community.

Utilise school networks

Involve key members of your school

network, such as student welfare

staff, P&C representatives and ancillary

staff when you are developing

strategies for supporting people with

cancer in your school community.

Empower the person with cancerAcknowledge that the person with cancer is the expert when it comes to their il lness. You can also help by maintaining normality as much as possible and communicating openly.

Be sensitive to diff

erent

cultural groups

People from different

cultural

backgrounds have th

eir own

attitudes and under

standing of

cancer, and it is im

portant to be

aware that these m

ay not be

the same as your ow

n. Always ask

someone for their p

erspective.

5Cancer in the school community: 10 ways your school can help

Cancer in the school community: 10 ways your school can help


“The school was fantastic. The reverend, head of senior school and counsellor came to

the hospital to discuss my situation with my family. They said my health was the first

priority, and they laid out the options: I could either give up on Year 11 and try next year,

or I could try to keep up with the minimum curriculum requirements.

My parents encouraged me to give up Year 11 and do it next year, but I didn’t want to

be left behind by my friends. I decided to try to do the minimum requirements.

My parents encouraged me to stick to my decision. We established this system, where

I’d try to do at least a little bit of work every day, focusing on the key concepts my

teachers identified. As we went on, though, there were days when I just wasn’t up to

doing any schoolwork. We called those days Chemo Days. I didn’t do any schoolwork

on Chemo Days.”

Jeremy, secondary school student with cancer

“I absolutely couldn’t have

managed if I hadn’t been able

to work part-time. That was

so helpful.”

Susan, primary school teacher with cancer

“I wanted to keep things as normal as possible

at work. That helped me keep things normal at

home, because I have four children, and two are

young. Routine helps them cope well.”

Janet, primary school canteen manager with cancer

“He does worry that his hair

will fall out; he has told us

that. He would let us know

if anyone picked on him.

And we look out for him.”

Kristin, primary school teacher of a student with cancer

“The principal was picking my son up and taking

him to school at one stage. We lived quite a while

away, but the principal lived near us. It was helpful

because I couldn’t drive, and that way my son

didn’t have to spend an hour on the train or bus.”

Carmen, parent who has cancer

When someone in your school community is diagnosed

with cancer, it is helpful to know something about the

disease, its treatments and side effects. This chapter will

help you understand some basic information about cancer.

Informationabout cancer

7

Chapter One


What is cancer?

Cancer is a disease of the body’s cells, which are the body’s basic building blocks. Our bodies constantly make new cells: to help us to grow, to replace worn-out cells, or to heal damaged cells after an injury.

Normally, cells grow and multiply in an orderly way, but sometimes something goes wrong with this process and cells grow in an uncontrolled way. This uncontrolled growth may result in abnormal blood or lymphocyte cells, or a lump called a tumour.

A tumour can be benign (not cancer) or malignant (cancer). A benign tumour does not spread outside its normal boundary to other parts of the body. However, if a benign tumour continues to grow at the original site, it may cause a problem by pressing on nearby organs.

A malignant tumour is made up of cancer cells. When it first develops, this tumour may not have invaded nearby tissue. This is known as a cancer in-situ, or carcinoma in-situ.

The

Can

cer

Cou

ncil

Vic

toria

©

The beginnings of cancer

Boundary

Lymph vessel

Blood vessel

Some benign tumours are precancerous and may progress to cancer if left untreated. Other benign tumours do not develop into cancer.

Normal cells Abnormal cells Abnormal cells multiply

Malignant or invasive cancer

9Information about cancer

As the tumour grows, it invades surrounding tissue, becoming invasive cancer. An invasive cancer that has not spread to other parts of the body is called primary cancer.

Sometimes cells move away from the primary cancer and invade other organs and bones. When these cells reach a new site, they may continue to grow and form another tumour. This is called a secondary cancer or metastasis.

Cancer is not:

• contagious

• an inevitable death sentence

• caused by something someone has said, or a punishment for bad behaviour.

How cancer spreadsPrimary cancer

Local invasion

Angiogenesis – tumours grow their own blood vessels

Lymph vessel

Boundary

Metastasis – cells move away from the primary tumour and invade other parts of the body via blood vessels and lymph vessels

Blood vesselThe

Can

cer

Cou

ncil

Vic

toria

©


Cancer treatment / description Side effects

Chemotherapy

• Chemotherapy is the use of drugs that kill or slow the growth of cancer cells.

• Chemotherapy can be administered orally in tablet form, but it is most commonly given by injection or infusion at intervals of one to three weeks over a designated period of time.

Surgery

• This involves the partial or total removal of the tumour. Sometimes this requires the removal of part of the body affected by cancer (such as an amputation).

Radiotherapy

• Radiotherapy uses radiation to kill or damage cancer cells so they cannot multiply. It can be used to treat the original (primary) cancer and to treat the symptoms of a cancer that has spread (metastasised).

• Radiation affects all cells in the area exposed to it. However, normal cells are better able to resist or recover from its effects.

• Side effects vary greatly from patient to patient. Some side effects start within a few hours of treatment. Others may not occur for two to four weeks. Nausea and vomiting may persist for days after chemotherapy is dispensed. In some cases, symptoms may begin before the drug is administered.

• Most effects, such as hair loss and mouth ulcers, disappear within a few weeks of stopping chemotherapy.

• Some drugs may cause cognitive impairment, which can affect work or school performance. For more information, see pages 33 and 50.

• The effects of surgery depend on what part of the body is affected. Pain at the site of the operation is the most common side effect. Infections and reactions to the anaesthetic are also possible.

• The side effects of radiotherapy are localised and depend on which parts of the body are receiving treatment.

• Short-term side effects appear towards the end of a course of treatment, and commonly include nausea, headaches, lethargy, drowsiness, hair loss and a reddening of the skin near the treatment area.

• Delayed effects of radiotherapy may include growth failure, thyroid nodules, infertility and a second malignancy later in life.

Cancer treatments and their side effects

There are many types of cancer treatments. The following table provides an overview of some treatments and side effects. For more detailed information, call the Cancer Council Helpline. Facts about accommodating side effects in the school setting are included in the following chapters.

11Information about cancer

Cancer treatment / description Side effects

Steroid therapy

• Steroid therapy uses corticosteroid drugs to improve appetite and reduce nausea or swelling to the brain. It may be administered orally or by injection.

Stem cell and bone marrow transplantation

• Stem cells are found in bone marrow. They give the body a constant source of blood cells. Stem cell transplants are given to resupply the bone marrow when it has been destroyed by disease, chemotherapy or radiation.

• Depending on the source of the stem cells, the procedure is called a bone marrow transplant, a peripheral blood stem cell transplant or a cord blood transplant.

Hormone therapy

• Hormones are chemicals produced in one part of the body for transmission to another part of the body, where they exert their effects.

• The growth of some cancers is dependent on, or stimulated by, the presence of certain hormones. Hormone therapies work by either removing or reducing the production of a stimulating hormone, or by preventing the hormone from stimulating cancer cells.

Complementary and alternative therapies

• Complementary therapies, such as massage, acupuncture, yoga and art therapy, are used in conjunction with conventional therapy. These therapies focus on the physical and emotional well-being of a patient.

• Alternative therapies are unproven therapies used in place of traditional hospital-based therapy. For example, some patients elect to make drastic changes to their diet.

• Temporary side effects include mood swings, sleeping problems, fluid retention, increased facial hair, increased thirst and appetite, muscle weakness, chubby cheeks, weight gain, abdominal fat and fat at the back of the neck.

• After this type of treatment, a person’s immunity levels will be very low, and they will be particularly susceptible to bacterial infections in the first six weeks.

• A reaction called Graft Versus Host Disease (GVHD) can occur when donor cells attack certain organs (such as the skin) of the patient. The person will often have to leave school or work to receive further treatment if GVHD develops.

• The impact of hormone therapy will depend on the age of the person receiving treatment.

• Males may suffer from tiredness, weight gain, hot flushes, depression, osteoporosis, erection problems, reduced sex drive and breast tenderness.

• Females may experience blood clots, weight gain, generalised swelling, hot flushes, vaginal dryness and/or discharge, irregular menstrual periods and a decrease in libido.

• The side effects depend on the therapies the patient is undergoing. Some alternative therapies may cause serious side effects.

• Complementary therapies, however, often can decrease the side effects of conventional treatments.


Who gets cancer?

Common young people’s cancers

The likelihood that a person will get cancer increases with age. An estimated one in three Australians will be diagnosed with cancer in their lifetime. It is predominantly a disease that affects the elderly – children in late childhood have the lowest incidence. Unfortunately, however, some young people are diagnosed with cancer.

In adult men, the most common forms of cancer are prostate, bowel, melanoma and lung cancer. Adult women are most often diagnosed with breast, bowel, melanoma and lung cancer. For more information about cancer incidence rates, call the Cancer Council Helpline on 13 11 20.

There are several types of cancer more typically diagnosed in young people. The most common are:

• acute leukaemia, which is a cancer that affects the blood cells – there are two types: acute lymphoblastic leukaemia and acute myeloid leukaemia

• sarcoma, which is a tumour that develops in the bone, muscle or connective tissue

• brain tumours, the most common of which is a medulloblastoma or a primitive neuroectodermal tumour

• lymphoma, a cancer that develops in the lymphatic system – there are two main

categories of lymphoma, commonly referred to as Hodgkin’s disease and non-Hodgkin’s disease

• neuroblastoma, which is a cancer of the nervous system.

Thanks to advancements in treatments and follow-up care, the survival rate for children and young adults is about 70%.

To find out more about the different types of cancer go to www.cancercouncil.com.au or call the Cancer Council Helpline on 13 11 20.

After my first chemo session I was okay to begin with. But within a few days I felt queasy, lethargic and fatigued. Chemo made me nauseous and gave me diarrhoea and anxiety problems.


Talking about cancer is never easy, and it can be especially

difficult to talk to others in your school community.

Deciding who should be told and remaining respectful of a

person’s privacy can be challenging.

However, your school already has an existing student

welfare policy and avenues of communication which can be

used to provide support for individuals affected by cancer.

In this chapter, we will outline how to use your existing skills

and resources to communicate with others.

Talking about cancer

13

Chapter Two


Talking to someone with cancer

It can be very difficult for someone to talk about a cancer diagnosis. Some people wish to keep their diagnosis private, while others may want to share this information. It’s important to respect a person’s wishes, no matter what they decide.

When you’re having a conversation, avoid giving unsolicited advice or telling the person you know exactly how they feel, even if you have been in a similar situation. It is best to use phrases like, “That sounds really difficult” or “Hearing what you’ve gone through upsets me. Is there anything I can do to help?”

Most importantly, just be yourself and try not to worry about doing ‘the right thing’.

I waited until I could call the deputy principal without

weeping. I talked to him on Saturday because I was

diagnosed on a Friday and had a surgeon’s appointment on Monday, so I wouldn’t be in.

I told him I had breast cancer and I was happy to talk

about it, but I asked if he would tell the staff at the Monday

morning meeting.

Shirley, secondary school teacher with cancer

Students sometimes find it especially difficult to talk to a peer with cancer. See Helping students talk to a friend with cancer on page 35 for information about how you can guide them.

15Talking about cancer

Helpful conversation tips

If you talk to a person with cancer, it may be helpful to:

• Listen and let them lead the conversation. If the conversation stops, it’s not always necessary to fill in the gaps. Silence can be just as important as talking.

• Offer them support. For example, a parent undergoing treatment may benefit from a carpool service.

• Enjoy a laugh. People living with cancer want to talk about other things too. Not every conversation has to revolve around illness. Students, especially, may come to school to regain a sense of normality and routine.

• Acknowledge their feelings. It is acceptable for someone to feel sad or angry about their cancer diagnosis – you shouldn’t try to change their feelings.

• Tell the person if talking about cancer makes you emotional.

• Invite them places. If you used to eat lunch in the staff common room, share coffee breaks or sit together on playground duty, continue to ask the person along. If you think they are too ill, suggest another activity or join them where they are comfortable.

• Ask questions if you’re confused about something.

Importance of respecting privacy

Some people wish to keep their cancer diagnosis private. There are several reasons someone may be concerned with their privacy.

Students may see school as a return to normality and their pre-cancer life. They also may fear the reactions of their peers.

Parents or family members may want to avoid gossip or probing questions. Sometimes parents need more time to talk to relatives or decide on a treatment plan.

If you have a colleague with cancer, they may want to continue working and focus on their day-to-day activities. Some teachers worry that their students are too young to understand cancer. They may wish to keep their prognosis private if they don’t know how long it will be possible to continue working.

These are legitimate concerns, and people’s rights should be respected unless there are overriding health and safety issues.


Appointing a school liaison person

Your school’s student welfare team can support a person with cancer by appointing a willing staff member (such as a member of a student’s learning support team) to liaise with them. In cases where students or family members are affected, a liaison person can provide a channel for keeping the family and the school up to date.

Though it can require a significant time commitment, families usually find it quite

helpful and convenient to have a single point of contact within the school. This ensures that one person is aware of the family’s ongoing and changing needs.

Remember, the school community plays a central role in some families, but for others – often those with strong family networks – it is not as important. A family may not ask the school for support or assistance.

I don’t mind being a liaison person. I’ve gotten quite close to Mark’s mum. It’s easy to do and quite important.

Kristin, primary school teacher of a student who has cancer

Understanding cultural differences

If your school community has a mixture of diverse cultural groups, people will probably have different attitudes regarding health care and how to communicate about it.

The word cancer can have different meanings for people from certain cultural backgrounds, and some people may not want to talk about it openly. Some cultures believe that cancer is contagious, caused by bad luck or always fatal.

It is important to be open and honest to avoid confusion. When you talk about cancer, try to be as direct as possible without

making anyone uncomfortable. For example, you can ask what kind of support a colleague, family or student would like, rather than assuming you know the best way to help. If the person is uncomfortable discussing cancer or has privacy concerns due to cultural reasons, they will be able to let you know.

For more information about how different cultures regard cancer, or to obtain information about cancer in a different language, call the Cancer Council Helpline on 13 11 20.


Balancing everyone’s needs

Schools must always consider and balance the needs of students and staff members in the community. For example, if a student has cancer, the school must respect their privacy while continuing to focus on its primary purpose and obligation, which is to educate students.

However, a teacher might need to know certain details about the student’s illness to

accommodate their needs in the classroom and playground. If the teacher is aware of the situation, they can anticipate questions from pupils, colleagues or family members and distribute information.

It is essential that in all cases, the person with cancer or their parent has given their consent regarding who they feel comfortable knowing about their cancer diagnosis.

Communicating with people of all ages

A person’s understanding of cancer depends on their age, maturity level and experience with the disease.

The following tables on pages 18 to 21 provide some basic information about how some people without cancer may understand the illness, their possible reactions, and how you can talk to them about it.

Remember that each person is unique and these are broad guidelines.

You can also read the Glossary section on page 80 for a list of cancer-related words. This glossary provides two definitions for each term – one that is appropriate for adults, teenagers and older children, and another which is more suitable for younger children.

Often people are most disturbed by what they don’t know, so I took a very up-front approach. If people are brave enough to ask questions, I don’t think there should be fog and mirrors. No mystery.



Preschool / Kindergarten-age students (3-5 years)

Understanding of illness Possible reactions Suggested approaches

• They have a beginning level of understanding about illness.

• Children may believe that they caused the cancer (e.g. by being angry with their parent or thinking bad thoughts about a classmate or teacher). This is an example of magical thinking.

• Preschoolers are egocentric – they consider themselves the centre of the universe. This means they cannot yet empathise with other people.

• Children may think cancer is contagious.

• Illness may be regarded as a punishment for naughty behaviour.

• thumb-sucking

• fear of the dark, monsters, animals, strangers and the unknown

• nightmares

• sleepwalking

• sleeptalking

• bed-wetting

• stuttering

• baby talk

• hyperactivity

• apathy

• fear of separation from others (especially at bedtime and going to preschool)

• aggression (hitting or biting, for example)

• repeated questions about the same topic, even if it has been discussed several times

• Listen and be alert to their feelings, which they may express through speech or play.

• Talk about the illness with pictures, dolls or stuffed animals. Read a picture book about cancer.

• Read a story about aggression or other reactions.

• Explain what they can expect; describe changes to their school schedule.

• Reassure them that they will be taken care of and will not be forgotten.

• Provide brief and simple explanations. Repeat your explanations if necessary.

• Encourage them to have fun at school or participate in activities. This can help them to have fun or achieve goals.

• Assure them that they have not caused the illness by their behaviour or thoughts.

• Continue usual discipline and limit-setting – provide outlets for aggression that are positive, such as running in the playground. Be sure they get physical activity to use up excess energy and anxiety.

• Assure them they cannot catch cancer, like a cold or flu.

Adapted from When a Parent Has Cancer: how to talk to your kids, The Cancer Council NSW, August 2007.


Primary school-age children (6-12 years)

• They are able to understand more complex explanations of cancer, and they can understand basic information about cancer cells.

• They still may feel responsible for causing cancer because of bad behaviour.

• In many cases, children in the middle of this period understand that parents, teachers or classmates can die. However, if a child has been exposed to illness or death at a young age, they may have a more mature/advanced understanding of death and dying.

• irritability

• sadness, crying

• anxiety, guilt, envy

• physical complaints such as headaches and stomach-aches

• separation anxiety when going to school

• hostile reactions, like fighting or yelling

• poor concentration at school, daydreaming, lack of attention

• poor marks

• withdrawal from friends and family

• difficulty adapting to changes (such as a replacement teacher or new schedule after school)

• fear of performance, punishment or new situations

• super-sensitivity to shame and embarrassment

• Listen and be alert to their feelings, which they may express through speech or play.

• Use books to explain illness, treatment and potential outcomes.

• Assure them their behaviour or thoughts did not cause the cancer.

• Reassure them about their care and schedule.

• Assure them that though it is possible, the chances of someone else getting cancer are slim. A counsellor or social worker may help initiate this conversation.

• Let them know how they can help a teacher, classmate or parent with cancer.

• Take time to listen and let them know you care about their feelings.

• Social workers or psychologists may help to gently broach the topic of a parent, teacher or classmate dying.

• See also the ideas on how to approach preschoolers.




Secondary school-age children/teenagers (13-18 years)

• They are capable of abstract thinking: they can think about things they have not experienced themselves and feel sympathetic to others.

• They are able to begin thinking more like adults.

• They are able to understand that people are fragile.

• They are able to understand complex relationships between events.

• They are able to recognise prevention measures and symptoms.

• They are more likely to deny fear or worry in order to avoid a discussion.

• worry about being different and not fitting in

• desire to be more independent and to be treated like adults

• angry and rebellious

• critical of how parents, teachers or classmates handle the situation

• depression

• anxiety

• poor judgment and risky behaviour such as smoking, binge drinking or unsafe sex

• withdrawal

• apathy

• physical symptoms: stomach-aches, headaches, rashes

• more likely to turn feelings inward (so parents, teachers and friends are less likely to see reactions)

• regression: tendency to lapse into previous habits or behaviours, such as watching children’s TV shows or being especially dependent on parents

• Encourage them to talk about their feelings, but realise it may be hard for them to confide in you. They may find it easier to confide in their parents or closest friends.

• Listen to them, don’t just talk to them.

• Express your feelings (for example, mention that you miss a teacher who is on sick leave).

• Provide privacy as needed.

• Encourage them to maintain activities and friendships at school, if possible.

• If they have severe reactions, provide opportunities for counselling.

• Don’t rely on the student to take on too many extra responsibilities.

• Take advantage of in-school opportunities for them to learn more about cancer and receive support.

• See also the ideas on how to approach primary school-age children.




Adults (such as parents and staff members)

• They are capable of abstract thinking: they may have close friends or family members with cancer, so they can imagine what it may be like. This can sometimes bring up feelings of sadness about their own experiences with cancer.

• They feel sympathetic to others.

• They are able to understand the impact of diagnosis and treatment on all aspects of life (for instance, school and personal relationships).

• They understand complex relationships between events.

• They are able to recognise symptoms and understand prevention measures.

• depression

• anxiety

• withdrawal

• physical symptoms such as headaches

• for some, the need to talk about how they are feeling with others

• putting extra energy into work or distracting activities

• When it comes to talking about cancer, different people will feel comfortable with different approaches. For ways a school can talk to parents about a staff member’s cancer, see the Choosing to tell parents section on page 49.

• Adults should be provided with simple and factual information if a student has cancer. This will alert them to the student’s potential needs and encourage them to seek further information as necessary. You should discuss and agree on the information that may be shared with the students and their families.

My 15-year-old daughter is in class with a student who has cancer, and I have cancer, too. My daughter is very empathetic and now knows how to talk about cancer.

My younger children have reacted differently. My three-year-old understands what is going on – he says, ‘Mummy’s boob is sick.’ But he does act very naughty the weeks I receive chemo.





Where to get information or assistance

Talking about cancer in your school community can be very difficult, and there are many reasons you might seek the support of experts. The Cancer Council offers a free and confidential telephone information service (called the Cancer Council Helpline) where you can discuss questions you may have. Calling the Helpline costs the same as making a local call.

The Helpline is staffed by experienced cancer health professionals, including oncology nurses and counsellors. They are available Monday to Friday, from 9am to 5pm, and can provide detailed information

about the best ways to communicate about cancer and deal with a diagnosis. They can also send you written information, direct you to resources in your area or provide you with reliable Internet links.

You can reach the Cancer Council Helpline on 13 11 20. If you are calling outside business hours, leave a message on the answering machine and your call will be returned the next business day.

You can also visit the Cancer Council’s website, www.cancercouncil.com.au.

It is heartbreaking when a student is diagnosed with cancer.

Though the experience is undeniably difficult for a

family or school to address, in most cases, young people

with cancer are very resilient, demonstrating maturity and

wisdom beyond their age.

Your school can help a student with cancer in several ways.

This chapter will teach you how to support a student through

all stages of their cancer, make in-school adjustments and

help classmates understand what is going on.

When a student has cancer

23

Chapter Three


When a student is diagnosed

When a student is diagnosed with cancer, it may come as a shock to many people in your school community.

It is difficult for families to receive this upsetting news, and they often describe the days and weeks after diagnosis as a whirlwind. Family members not only have to come to grips with the diagnosis, but they also have to make decisions about their child’s treatment protocol and inform their extended family network. This can be especially difficult for single-parent families, large families or parents with demanding work schedules. At this early stage, families may not inform the school of a student’s illness.

Teachers or peers may notice a student’s absences and speculate about the student’s behaviour. You should endeavour to minimise rumours, even if you suspect (or have confirmed, in confidence), that the student has cancer. A liaison person or member of the student welfare team may contact the family to offer support.

Helpful tips

If or when a family informs your school that their child has cancer, you (or one of your colleagues) should:

• Offer support to the family. Families may not be aware of the support that your school network can give, or they may feel uncomfortable requesting help unless approached. Your school may link the family to school counselling services.

• Inform them about the school’s usual plan of action. Your school may involve the student welfare team, appoint a liaison person, or notify the principal or teacher/s. Telling the family what to expect will make the process smoother.

• Respect their wishes. A person with cancer may wish to keep their diagnosis private. The school community should respect the family’s wishes and give family members time to decide what they would like to do.

The day in hospital when all my friends went back to school and I didn’t – well, I found that very depressing. I kept thinking of

my mates back at school, and it made me feel left out. I worried I was going to miss out socially.


25When a student has cancer

Setting up a communication channel

Talking and communicating openly about cancer helps people understand what is happening and adjust to the news. Different schools have preferred ways of disseminating information into the community. This may depend on how urgent the message is, the content of the message or how many people need to be informed. The most important thing for your school is to inform those immediately involved and be as candid and direct as possible.

The family, school staff members and liaison person should meet to discuss the preferred way that the school should communicate about the issue. For example, some families may want you, or one of your colleagues, to discuss cancer with their child’s classmates. Others may want your school to send a general letter to parents about cancer.

Communicating openly can help students to demystify health problems and let people know that it is okay to talk about cancer and ask questions. Just be sure to respect the family’s privacy and ask for consent before sharing any information.

His parents are so distressed, and his mum is the one who distributes the information to me. I don’t want to force her to relay news to us several times, so she just talks to me and I talk to the principal. She just hates to talk about it. She hates to even say that he has cancer.

Kristin, primary school teacher of a student who has cancer

Ways to communicate

Schools can use a number of methods to communicate about cancer, such as:

• small group meetings

• parent and teacher conferences

• school/community newsletters, newspapers or magazines, either online or in print form

• teaching and learning programs or information sessions

• letters (for some sample letters, see pages 75 to 78)

• emails

• classroom discussions or guest speakers (such as a visit to the school by a member of the patient’s treatment team with parental consent)

• direct phone calls.


Supporting a student during treatment

Keeping in touch

Whether a young person is healthy or sick, school is an enormous part of their life. It is upsetting when a student must disrupt their routine because of cancer. Attending school is about more than just education – it establishes a familiar routine and provides a stable environment and an opportunity for socialisation.

If the student is absent for a long period of time, it may be beneficial to maintain contact with classmates. Young people with cancer find it easier to return to school if relationships with their friends have been maintained throughout their absence. Communication can make the patient feel special, as young people often look forward to hearing from friends.

Remember, not all families want to maintain close contact with the school, and the young person may not be able to reciprocate, depending on their age and prognosis.

How to maintain contact

Members of the school community could choose to:

• post letters, drawings and paintings

• record a tape/DVD of a school event, or record personal messages

• send photos or small gifts

• email notes, photos or videos

• create a website about what is happening at school

• use a computer social networking or messaging system (such as Facebook, AOL Instant Messenger or MSN Messenger) when not at school.


Helping with school work

Long-term patients in some bigger public hospitals may be linked to a hospital school that caters to students of all ages, from kindergarten to Year 12. The aim of a hospital school is to provide continuity of education to make the return to school as easy as possible and to boost a young person’s spirits and self-esteem.

When a young person is in hospital for several days, the hospital school may collaborate with your school to organise its curriculum. It is natural to feel anxious about how the student is going to manage the work.

All my teachers and friends were in contact via email. I was never out of touch with the group because of email.

They also sent me lots of cards and letters. Being given 25 letters at once was very overwhelming and made me feel very happy. People in my year also organised large cards, which they got over 300 people to write on. They kept me entertained for hours!


Talk to the student’s parents about their expectations about keeping up with school work. A patient may not be able to manage a full workload due to their treatment regime.

Ways to support a student who is absent

You (and/or the school liaison person) can help by:

• providing the hospital school with outlines of the curriculum

• providing the hospital school with a list of necessary textbooks

• sending copies of worksheets and projects to the hospital school

• making sure the student receives school emails and any handouts

• letting the hospital know if the student needs extension activities or a remediation program

• facilitating online access to assignments or applicable websites with information about school activities, if possible

• organising visits to the hospital by classmates, if approved by the student’s parents.


The Back on Track program

The Back on Track program, funded by the Fight Cancer Foundation, aims to support students whose educational progress has been compromised by school absences and periods of hospitalisation. This program helps patients by keeping them educationally and socially connected.

Back on Track provides a variety of services, including tutoring and access to technology, to link the student with their NSW school. When a student is enrolled in the program, an Education Program Coordinator (who is a trained school teacher) liaises with the student’s school, family and hospital staff to create and implement an individualised plan. This plan may facilitate a smooth transition for students returning to school or entering a tertiary institution on completion of their treatment.

At the time of print, Back on Track is only available for young people receiving treatment at The Children’s Hospital at Westmead, however there are plans to expand the program throughout NSW. For more information, call (02) 9845 0423.

Redkite

Redkite is a charity that supports children, young people and their families through cancer by providing financial assistance, educational services and emotional support. It provides professional tutoring grants for students trying to catch up with school work and scholarships for students with a particular goal in mind.

While Redkite’s educational assistance is usually coordinated by hospital social workers, you can play an important role by making parents aware of Redkite’s support services or directly referring a student. Patients or family members as old as 21 years old can receive educational assistance from Redkite.

Redkite also provides telephone and email support for young people diagnosed with cancer, their families and support networks. For more details call 1800 334 771 or visit www.redkite.org.au.

The Children’s Hospital at Westmead has a hospital school. They have a Years 9 to 12 group that meets around 9am to noon some days, but

I was immunosuppressed and couldn’t be around other kids. The teachers came around to our bedsides to tutor us in the afternoons.



Supporting the student’s classmates

School fosters close relationships between students, so you can expect a range of reactions when you talk to students about their classmate’s cancer. It’s important to remember that everyone reacts differently to a stressful situation. You might notice that students are visibly upset. Others may be angry, confused or annoyed. Some may have no outward reaction to the news.

No matter how close a student is to their classmate with cancer, they will have feelings about it. The best thing you can do is communicate as openly and honestly as possible with the students and their parents (considering any confidentiality requirements).

Give the students opportunities to voice their feelings or ask questions. They might ask some difficult or sensitive questions, like if

they can ‘catch’ cancer or if their classmate will die. You should approach the class in a sensitive manner. In some cases, a member of the patient’s treatment team (such as the community nurse) may be present to help you to answer the students’ questions.

Refer to the Communicating with people of all ages section (page 17 to 21) for some strategies on how to talk to children of all ages. If you are particularly concerned with fielding

questions about death, see What young people understand about death on page 61.

It is wise to establish beforehand if some

students will be particularly susceptible to being upset because

of a close association with a person with cancer. If a student becomes very distressed they may need time out with a counsellor or teacher with whom they feel comfortable.

The hardest thing is speaking to her classmates. We can’t ignore the physical side effects. The class is very aware that something is going on, and they’re worried about her.

John, primary school teacher of a student with cancer


Supporting a student after treatment

Returning to school

Getting back into a school routine is very important to children and young adults – it maintains continuity in their education and their social relationships, and it is also reassuring because it reinforces the idea that life will go on and they have a future.

It is normal for parents to have a wide range of responses to their child returning to school. Some may be overprotective or stressed about the transition, while others may be relieved or pleased.

“When a child is just off treatment, the school really needs to know about keeping them away from chickenpox and measles – for the first six months if they’ve had chemotherapy, 12 months if they’ve had a bone marrow transplant.”

Kylie, clinical nurse consultant to young people with cancer

If you have difficulty dealing with a parent’s reaction, talk to the student welfare coordinator, a school counsellor or a clinical nurse consultant about how best to handle the situation. Sometimes parents need reassurance that the school will adequately monitor their child.

I worried about leaving my parents and returning to school – but I didn’t tell anyone. They’d been there for me throughout my entire treatment and I was scared to leave them behind and to be doing

something without their help – even though I was 17.



A student who has been absent will also have concerns when they return to school. They might worry about:

• Being left out or rejected. You can assure the student that their classmates missed their company, and though peers may be shy initially, they will eventually be more welcoming. You should prime classmates for the student’s return before they arrive.

• Keeping up with work. You can enlist the help of your school’s student welfare team or liaison person, or you can arrange tutoring or special assistance to help the student catch up. Assure the student that they won’t be expected to be immediately up to date.

• Being bullied or teased. Your school will have policies to counter bullying, discrimination and harassment. Closely monitor the reactions of other students and be aware of your school’s strategies to identify, report and address bullying behaviour (see page 34). Resentment on the part of other students can play a part in this type of behaviour. You should equip the student with cancer with strategies to respond to any bullying behaviour.

• Fitting in with other classmates. A student who looks different (due to weight gain or loss, hair loss, a physical disability or a swollen face, for example) might worry about their peers’ reactions. Again, talking with classmates honestly may alleviate the stress.

• Relapsing or returning to hospital. Some students have a compromised immune system due to treatment (immunosuppression). This means they are highly susceptible to contracting infectious diseases. Implementing standard infection control measures and encouraging general hygiene such as hand washing can help prevent a student’s exposure to common germs. A school counsellor or parent can also assure the student about their health. See page 75 for a suggested letter to parents about infection control.

The school liaison person may also be able to assist by obtaining relevant information about the young person’s medical condition, adjusting grading procedures or adapting sporting events and physical education. This will ease the worries of parents and the student with cancer.


Helping the student settle back in

A student returning to school may have to manage side effects and delayed effects of treatment, which can appear months or even years after treatment has ended. They might have difficulties with spelling and writing, reading comprehension or mathematics. A student might also have difficulties taking notes or copying information, remembering things, organising and planning, or completing tasks on time.

Your school may need to make accommodations for students with cancer. This may include providing catch-up work in different key learning areas, organising an in-class buddy (who can help with note taking or recording assignment due dates) or adjusting homework assignments and deadlines. You (and your school’s learning support team) should work with the student’s family to arrange a suitable routine.

In addition to concerns about academic performance, a young person might worry about how to communicate their feelings to staff or peers.

One way to alleviate these concerns in a primary school classroom is to use an emotions thermometer, a simple device that allows the student to show how they’re feeling each day.

A student can decide on the feelings that should be included on the thermometer and make a pointer that can move between the feelings. Some examples of statements might be, “I need some space to myself today”, or “I would appreciate some help taking notes today”. The young person’s teacher or a classroom aide will need to help the student manage the thermometer.

The principal introduced Sean to all the staff and they put a picture of him on the teachers’ noticeboard so any relief teachers

would know who he was.

Jim, father of primary school student with cancer


Making practical modifications for students

Accessibility

In some cases, students with cancer can become physically disabled as a result of treatment. For example, a student may have had an amputation, or they may need access to a wheelchair. School buildings may already be modified to meet the needs of students with physical disabilities. However, additional adjustments, such as access to a lift or timetable changes, may be necessary to ensure the young person has physical access around the school.

Sensitivity to sunlight

Some students who receive treatment must stay out of the sunlight. Your school may have to ensure there are shaded areas or indoor activities available.

Cognitive impairment

One possible side effect of cancer or its treatments may be cognitive impairment. Some young people with cancer may need more time to process information, or they may have to deal with short-term memory loss. Some students have particular trouble solving maths problems or remembering lists of facts.

You should make accommodations for students who struggle to keep up, such as providing extra tutoring, allowing more time for homework or assigning an in-class buddy to take notes or record assignment information.

Central venous access devices

Some students will have a central venous access device (line), which is a tube inserted into a vein in the neck, groin or chest. This line allows doctors to easily administer intravenous drugs or draw blood.

If knocked or jarred, a central venous line may bleed. Ask the student’s parents whether they can participate in contact sports, and don’t allow peers to use rough physical contact. Also, some types of central lines should not be submerged in water. Relevant school staff should be aware if the student is not allowed to swim.

The central line should not require regular maintenance from school staff unless it bleeds. In this case, the area between the line and the bleeding site should be pinched or compressed while medical assistance is sought. If a cap has fallen off, it may have become dirty, so it should not be inserted back into the end of the line without medical assistance.


Dealing with teasing and bullying

Supporting the student’s parents

Unfortunately, young people can be cruel to each other. Most teasing and bullying occurs when a young person wants attention, feels resentful or hurt, or doesn’t understand something.

If you work at a public school, you will be familiar with the NSW Department of Education and Training’s Student Discipline in Government Schools Policy, and you should implement strategies to prevent bullying in your school community. Private schools also have relevant anti-harassment policies.

The best way to prevent bullying is to be as open as possible about a student’s cancer. Cancer is frightening to young people – the more students know about cancer, the more likely they are to be supportive.

You should also realise that some students may feel resentful when a student with cancer returns to class. They may believe their peer is receiving undue special treatment. You can explain why the student requires extra attention, then endeavour to maintain a normal classroom atmosphere.

When a family has a child with cancer, communication with the school can provide significant support. If your school has a liaison person, a buddy system, a welcoming network or parent contact lists, you are already set up to provide support. A support network can help in many ways, such as taking children to

after-school activities, providing meals or helping with household chores.

Remember, the school community plays a central role in some families, but for others it does not. Be sure to consider the privacy concerns of the family before taking action.

We’re working with his parents to help him make the transition to secondary school. We help all the kids, but we need to take special care with Jason. Because he’s ill, he must really balance education

with the happiness and contentment he feels being around friends.

Kristin, primary school teacher to student with cancer


Helping young people understand cancer

It can be extremely difficult to talk to children and young adults about cancer. If you talk to students, you should consider how old they are – and anticipate difficult questions they might ask – before starting

the discussion. You might practise what you will say, or ask the family how they would like you to approach the class. See page 17 for specific ways you can talk about cancer with young people.

Helping students talk to a friend with cancer

It is not uncommon for the classmates of a student with cancer to feel helpless and unsure about what to do or say around them. Sometimes students will look to teachers or their parents for guidance on how to act, but at other times you might notice that the students are uncomfortable.

You can help by:

• Listening to students’ concerns.

• Encouraging discussion and talking openly about what cancer is, its treatments and possible side effects. This will help prepare students for physical and emotional changes in their classmate. See Chapter 1 for more facts about cancer.

• Answering questions, or finding out the answers if you don’t know. When you discuss the facts openly and honestly, anxieties and uncertainties will diminish.

• Advising the students on how to act around a classmate with cancer. For some examples on how to guide students, refer to the following section, Advising students on how to act.

• Encouraging emotional expression. Painting, writing, composing music or participating in other activities may help the student with cancer feel at ease.

• Inviting a member of the student’s medical team to speak to the class, with the written consent of all students’ parents, including the student with cancer. This will help mature students gain a better understanding of what their classmate is experiencing.


Advising students on how to actYou might want to help students talk to a friend with cancer. You can advise them to:

• Acknowledge the situation. You might recommend that they say, “I don’t know what to say, but I want you to know I care”, “We missed you”, “How are you going?” or “Is there anything I can do to help in class?”.

• Take cues from their friend with cancer. By observing how their friend acts, students might learn how to respond.

• Try to talk normally about day-to-day things. You should remind students that their classmate is probably tired of talking about cancer all the time.

• Understand that the student might act a little differently. You can point out to students that aside from health-related modifications to their routine, their classmate will follow the same school rules as everyone else.

Planning a lesson about cancer

In some cases, a lesson or class discussion about cancer can help students understand what is going on with their classmate. The NSW Board of Studies, which serves government and non-government schools,

may provide some guidance on how to incorporate information about cancer into the core curriculum. For more information call (02) 9367 8111 or visit www.curriculumsupport.education.nsw.gov.au.

I explained what would happen when he went to hospital. I didn’t get too detailed, but I was open to questions. The students just wanted

to know basic information – they’re very interested and bright. I think my approach worked. They were pleased to be told the truth.

John, primary school teacher of a student with cancer


Special provisions for the HSC

Although all students are required to meet course requirements, the NSW Board of Studies (BoS) can adapt HSC assessments to accommodate special needs of secondary school students with cancer. Illness/misadventure provisions may also be available for students who have family members with cancer.

The permitted HSC modifications depend on each student’s circumstances. For example, some students may be allowed time to rest between examinations. Other students may need to have physical disabilities accommodated. The NSW BoS may also consider marking the student

based on their scores throughout the school term/s, rather than the usual combination of in-school assessments and external exams.

If possible, the NSW BoS prefers that students sit their exams, then appeal for a different marking procedure. However, if you know a student might be eligible for special provisions for an upcoming exam, you should talk to the student about their options. You can contact the NSW BoS Special Provisions Section on (02) 9367 8111 or www.boardofstudies.nsw.edu.au and help the student apply. Applications may take two weeks to two months to process.

The school’s special ed department organised someone to help me apply for special help for the HSC. I was a slow writer and had problems writing essays within the time limits. They arranged for extra time for me, and a laptop, because I type faster than I write. I sat all the exams at the same time as the other students, but I was in an area with other kids with the same considerations. All those accommodations were fantastic.



Gaining access to tertiary study

The Universities Admission Centre (UAC) has a variety of Educational Access Schemes (EAS) that may help a student gain access to tertiary study if they have experienced educational disadvantage due to circumstances such as a cancer diagnosis or treatment.

If a student’s Universities Admission Index score (UAI) has not already been adjusted considering their medical circumstances, an

EAS may help the student gain admission. A student would apply to both the selected university and the UAC. Each university applies its own EAS to calculate the student’s score and determine if they will be admitted into their elected program of study.

For more information about how you can help a student apply for an EAS, see www.uac.edu.au/equity/eas.html.

I applied for the Broadway Scheme, which allowed the University of Sydney to give me extra marks because of my special circumstances.

If my UAI was 95 and I received two extra points from admissions, I could enrol in a course that requires a 97 minimum.

It’s easy to apply for, and it’s fair. In the end, I didn’t use the Scheme because I got good enough marks. But it helps if you’re

disadvantaged. It makes you feel like your uni plans won’t be ruined just because you had cancer.


When a parent has cancer, it has a profound impact on their

children. Each parent addresses cancer in their own way,

depending on their circumstances.

If your school is aware that a student’s parent has cancer,

you might need to make a few special considerations for the

student. You may note changes in a student’s attendance,

school performance, social relationships and behaviour.

Though it specifically addresses when a parent has cancer,

the information in this chapter is relevant if another

significant person in a student’s life (such as a grandparent or

guardian) has cancer. This chapter also specifically addresses

the impact of a sibling’s cancer on a student’s life.

When a parent has cancer

39

Chapter Four


How cancer affects family members

Each year in NSW, about 35,000 people are diagnosed with cancer. About one-quarter of these people have a child under 18.

When a parent is told they have cancer, their first worries are often for their family. How will the children react? What should they be

told? How will it affect their lives? The parent may make many difficult personal decisions, experience financial strain, feel overwhelmed or become more protective of their children. These are all normal reactions.

Our routines had to change. I couldn’t drive or do the shopping after surgery. My husband did as much as he could, and my kids picked up

extra responsibilities. My son got interested in cooking – he would plan out the menus.

But it was overwhelming in many ways. We were looking after my mother with dementia, too. It affects your family.

Carmen, parent who has cancer

41When a parent has cancer

How young people react

Children and young adults can have many different reactions to the news that their parent has cancer. A person’s response depends on their age, the relationship with their parent and their understanding of cancer.

When a parent has cancer, their child may misbehave in the classroom, mirror their parent’s symptoms or side effects, and be distracted, sad, angry or withdrawn. A young person may also be unable to keep up with their school work due to changes at home (for example, they may have to go straight to the hospital after school). Some young people

ask their parent not to tell the school about the cancer. They might not want their peers or teachers to perceive them differently.

These are understandable responses from young people. Because members of your school community notice changes in a student’s behaviour, parents usually choose to tell select people about their diagnosis. This allows school staff to create a positive school environment for students.

For more information on how people react to cancer, see the Communicating with people of all ages section on pages 17 to 21.

When my husband was sick, my son would be quite rambunctious at school. I talked to his teacher to warn her about this type of reaction.

Patricia, parent with spouse who has cancer

Changes in school performance

When a parent has cancer, their child will probably be very preoccupied with what is going on at home. Outside of the classroom, a young person may be acting as a carer, spending time as a hospital visitor or looking after their siblings. Studying and completing homework may not always be their main priority.

You, or a school liaison person, should anticipate changes in the student’s academic performance. You should also talk to the student’s family about changes in their expectations. While many families may hope their child can keep up with peers, others may acknowledge a need for flexible deadlines or extra tutoring, if appropriate.


How your school can help

There are many ways your school can assist a parent with cancer or their child. With the family’s consent, you might:

• Mobilise a group of community members to help a parent keep track of excursions, homework or school activities. They may also give the student lifts to and from school.

• Appoint a welfare coordinator to monitor the student’s behaviour and help keep track of assignments and school events.

• Put the parent in touch with another parent who has experienced cancer.

• Get in touch with CanTeen, an organisation for young people living with cancer, including siblings and offspring.

The NSW Board of Studies (BoS) can adapt HSC assessments for students who have a family member with cancer. If you know a student who might be eligible for special provisions, you should talk to them and contact the NSW BoS. Visit www.boardofstudies.nsw.edu.au or call (02) 9367 8111.

I went to the school counsellor, just to talk about what was going on. He didn’t know about my mum’s cancer. It might have been helpful if

he’d known, but it was nice to vent to him anyway.

Katie, secondary student with a parent who had cancer

Talking about a parent’s cancer

A young person may see school as a sanctuary – a place where they don’t have to constantly think about their parent’s cancer. Thus, a student may not want to talk much about cancer in the school setting. You should never force a student to discuss their parent’s cancer.

If a student would like to talk about their situation, you should involve members of your school’s student welfare team. It may

be necessary and appropriate in some situations to offer counselling support to a student who has a parent with cancer.

For general information about how a parent might talk to their children about cancer, see the booklet When a Parent Has Cancer: how to talk to your kids. This may give you more strategies about how to discuss cancer in a school setting. Ring 13 11 20 for a free copy.

43When a parent has cancer

Helping classmates understand

A parent with cancer may be especially concerned about the responses of their child’s classmates to the situation. Young people of all ages can be particularly image-conscious and sensitive to others’ reactions.

Your school may integrate information about cancer into the core curriculum or plan cancer awareness activities to teach students more about cancer.

Talking about the situation can reduce the classmates’ curiosity and gossip, and may make life easier for the affected student. Remember that other students may not intend to be unkind – they often lack the maturity to understand appropriate ways to react.

Gemma, aged 8, asked her mother, Gayle, not to pick her up from school because Gayle was wearing a wig. Children at school had teased Gemma about the way her mother looked. Gayle confronted the issue directly.

After asking permission from Gemma, the school and her classmates’ parents, Gayle visited the class and spoke about her cancer and treatment side effects, and why she wore the wig. Once the children understood, the teasing immediately stopped, and the children started to support Gemma.


When a sibling has cancer

Young people with a brother or sister who has cancer sometimes feel overlooked because of the time and energy their parents give to their sibling. They may feel angry or jealous that things have changed at home, lonely, guilty about their sibling’s cancer, afraid that their sibling will die, or worried that they themselves will get cancer and die. These feelings can cause the healthy sibling to misbehave, withdraw from others, act demanding or clingy, feel sick, get angry, demonstrate ‘extra good’ behaviour, or have difficulty at school.

Your school community can provide a strong support system for a sibling of a cancer patient. If you are aware that a student’s sibling is ill, try to keep things consistent at school. Just like a young person with cancer, a sibling may view school as a safe, comfortable place. They might enjoy feeling normal, or even take pleasure in receiving attention from teachers or classmates.

You and other school staff should work to adapt to the student’s schedule, monitor their progress and encourage them to do fun things or help out at school. The student might even confide their feelings about having a brother or sister with cancer to a respected teacher or counsellor. You should make their parents aware if you notice any alarming or out-of-character behaviour.

CanTeen is an excellent organisation that offers support for siblings of cancer patients. See page 74 for more information on how to contact CanTeen.

My way of coping was keeping very busy during the day.

That way I didn’t have time to think about it.

Jamie, secondary school-age sibling of someone with cancer

Respecting a family’s privacy

Though some families choose to share information about their health with school staff, others may wish to keep the information private. Your school should respect a parent’s decision. Remember that the parent does not have an obligation to share information with you unless it somehow jeopardises the education of their child.

If a staff member in your school has been diagnosed with

cancer, you know it will affect every aspect of their life –

including their employment. Work is an important part of life

for most people – besides income, working at school may

provide satisfaction, enjoyable challenges and a chance to

mix with people from different age groups and backgrounds.

Someone with cancer may have to take an extended leave

of absence from work, and it will probably be difficult for

them to decide how to approach colleagues about their

diagnosis. This chapter offers practical tips about the issues

that might arise during and after treatment.

When a staff member

has cancer

45

Chapter Five


How cancer affects school staff

When one of your colleagues is diagnosed with cancer, it has a broad impact. They will have to confront several issues. A person with cancer may have to decide:

• Who to tell (and how to say it). Some people may decide they want to keep their diagnosis private. Their wishes should be respected. Others may talk to the principal, a staff support officer or their colleagues. In some cases, a person with cancer will make a personal announcement, but they might also consider other methods of communicating information about their illness and any absences from work.

For more information about communicating with students and parents, see the Choosing to tell students and Choosing to tell parents sections, on pages 48 and 49, respectively.

• Their plan of action. While some people may continue working, others may take a leave of absence or retire. For more information about how staff members can modify their work schedule, see Ways to reduce cancer-related stress on page 55.

The hardest part is going for tests. I had constant tests – three-month tests, scans, doctor appointments. It takes it out of you. I would

try to do it all in one day, so I didn’t have to take too much time off school, but it was exhausting…I made the decision to take

six months off. The administration was supportive of my decision.


47When a staff member has cancer

How people may react

When people in your school community learn about a colleague’s cancer, there will be a variety of reactions. Some people will ask questions or be extremely helpful; others will pretend they don’t know or will go out of their way to avoid the person with cancer. Uncommonly, there may be parents who will make it clear they don’t want their child in the

class of a teacher with cancer because they feel their child’s schooling will be disrupted.

The principal and school counsellor should make themselves available to anyone in the school community who needs more information about cancer or would like to access counselling services.

I never actually told the students. As far as my colleagues were concerned, some were comfortable enough to be openly supportive. But some were so uncomfortable that they didn’t ever talk about it. I don’t think that those people had a lack of concern, I just think they had no idea what to say.


When the staff member is a parent

Many employees are parents themselves, and this adds to their stress when they have cancer. They will likely be preoccupied with managing changes at home. Your school may make special accommodations or offer extra help if a staff member needs it.

You should also be prepared to answer students’ questions about the staff member’s child, particularly if the child attends the same school. For more information about how to answer students’ questions, see page 29.


Choosing to tell students

A staff member is not obligated to tell students about their cancer, but some people choose to share some information with students and parents. If they choose to talk about their cancer, the person should take a sensitive approach. Remember, students come from all different backgrounds, so some of them may not know much about cancer and others may have personal experience with it.

Young people’s ages and maturity also affect their level of understanding.

It is recommended that a person outlines what to say in advance (using words the students will understand) and prepares to answer questions from the students.

Sometimes it is beneficial to send home a letter to parents on the same day, to prepare them if their children have questions about cancer. Any letter home should also contain access details for appropriate support services and resources. An example letter is provided on page 77.

Students only have a right to know information about a staff member’s health if it directly impacts upon the students’ well-being.

I don’t know that the students noticed my diminished schedule, but they didn’t ask me questions. Maybe they’d been told not to.

But I honestly didn’t mind.


49When a staff member has cancer

Choosing to tell parents

If a staff member has elected to talk to parents in the school community about their cancer, they should decide on the best way to address the issue. Their approach should be discussed in consultation with the school principal, counsellor, student welfare team and/or staff welfare officers, as appropriate.

Most families will appreciate a staff member’s straightforward approach, so if possible, the person with cancer should make an effort to talk to parents directly. At this time, the teacher can clearly articulate that the school will continue to look after the students.

While young people sometimes aren’t mature enough to realise their questions may be too probing, parents will typically be much more tactful and considerate.

Unfortunately, this is not always the case. If any member of your school community reacts in a severe or harsh manner, the person with cancer should speak to your principal or staff welfare officer.

Ways to share information

Some ways that a teacher might inform parents are:• sending a letter – for a suggested

format, see page 77• telling the P&C or a similar

committee• phoning the parents• holding a meeting with parents.

Some parents are concerned their child’s education will be disrupted, but if you tell them what the school is doing, they are more understanding.

Bill, primary school teacher with cancer


Dealing with side effects

How parents in the community can help

People diagnosed with cancer or undergoing treatment often experience a range of side effects, such as nausea, vomiting, lethargy and depression. They can also experience cognitive impairment, such as short-term memory loss or difficulty concentrating.

A person may elect to decrease their workload for several months or years after their

treatment. Sometimes getting extra sleep, making to-do lists and avoiding situations where quick thinking might be required can help people cope with cognitive difficulties.

Employees should talk to their employer to ensure they can manage their workload. You can ask a colleague with cancer how you can help lighten their workload.

If parents are aware of your colleague’s cancer, they might offer to help in and out of the classroom. The teacher – or a colleague serving as a contact person – can decide whether or not to accept these requests.

Depending on school policy, a parent’s assistance as a classroom aide may be extremely helpful at this time.

The teacher with cancer may receive offers for assistance outside the classroom. Parents might offer to prepare food, mind their

children or help around the home. Many teachers have their own personal support network outside the school community, so they may not feel comfortable combining their professional and personal lives. However, others gratefully accept offers of help.

If a teacher with cancer is uncomfortable with direct attention, your school might consider hosting a general fundraising or cancer education day. See page 68 for more information.

After chemo, I definitely had some problems concentrating and remembering things, both at work and at home. I did a lot of knitting

because you can pick it up and put it down.


Although you might feel uncertain about managing staff

members with cancer, as a principal, you should be prepared

to address several issues, including the impact of cancer

on an employee, other staff and students; ways to reduce

an employee’s cancer-related stress; and other HR issues

(such as sick leave entitlements and work scheduling).

A principal’s guide for

supporting staff

51

Chapter Six


Cancer in the workplace

Studies estimate that between 10% and 38% of employees do not return to work following cancer treatment – this varies depending on a person’s age, position and prognosis. As more people are diagnosed in early stages – and as survival rates and treatments improve – it is increasingly likely that an employee will return to work in some capacity.

School staff members with cancer are often very anxious about returning to work after treatment because they will have to address cancer-related fatigue, employer expectations, and changes in their workload, productivity and relationships with colleagues and students.

Talking to a colleague with cancer

First and foremost, you should be sensitive and sympathetic when a staff member informs you that they have cancer. Remember that in addition to addressing work concerns, the person may be making several difficult personal decisions.

If the person has been recently diagnosed, they may feel like they are being bombarded with information. When the employee first approaches you, you might not want to add to this ‘information overload’. Instead, you can set up a meeting at a later time and come prepared with relevant information (such as more detailed information about working arrangements and sick leave entitlements).

If there is another school staff member with cancer, you may consider putting the employees in contact with one another (with their permission). Talking to someone in a similar situation may be helpful.

If a colleague is returning to work after an absence, set up an initial return-to-work meeting and arrange for regular consultations. This will help the person to manage their workload and give them an opportunity to bring up any ongoing concerns.

The first time around, the principal was very involved. I took off for some tests and he rang me that night. When I told him the results, he was just as devastated as I was.


53A principal’s guide for supporting staff

When a colleague has a serious illness

As a principal, you can play an important role in providing advice and guidance regarding changes to a colleague’s work schedule. The staff member with cancer may consider being released from duties, changing their workload or arranging a flexible work schedule.

You can help a colleague with cancer to make these decisions in accordance with leave and relief staffing procedures. You should consider the most appropriate way to minimise any impact on student learning programs and normal school procedures.

For example, it may be beneficial to organise a single relief teacher, where necessary and possible. This can maintain continuity for students during extended absences.

You should always respect a colleague’s preferences about how much they would like to disclose about their cancer, and who they would like to tell.

Because I knew the relief teacher, I gave her full access to everything I owned. I left my plans and diary on the desk and she

would write in it as if it were hers. When I came back, I could look at what she’d done. We also left ourselves Post-its and called

each other, so that was absolutely the ideal situation.



How cancer affects someone’s colleagues

When an employee has cancer, you must also attend to their colleagues’ concerns. If you’ve talked to the staff member with cancer, they may ask you to liaise with colleagues on their behalf. Support should be offered to employees who are upset. If your school offers an Employee Assistance Program (EAP), you may refer staff to this service.

If an employee has to take a leave of absence, you may also have to work with colleagues to organise substitutes for the absent employee. Most colleagues are likely to be flexible and accommodating, but if there is a great deal of work, you may need to hire a temporary substitute or permanent replacement.

How cancer affects students and families

Providing support to a colleague if they decide to talk to students and parents about their cancer is important. You may help the person to share information with colleagues, parents or students, if that is their wish (for example, a teacher may be uncomfortable standing up in front of the class or calling parents, so they may ask you for support – see the Choosing to tell parents section on page 49 for more information). You can reduce the burden on a colleague by helping to liaise with concerned parents.

If you talk to students, assure them that you are supporting their teacher and, if you are aware, tell them if their teacher will be taking time off. You should also tell students that school staff are available to support them.

For more information about how a teacher might talk to students, see the Choosing to tell students section on page 48.

I took an extended leave because if I had been intermittently there and gone, there would have been a huge reaction from parents and

students. My decision was just borne from experience.


55A principal’s guide for supporting staff

A colleague volunteered to do my playground duty, and I was grateful. While I was managing to stand in front of classes, I didn’t think I could walk the yard and keep kids from doing all the awful things they could do in a schoolyard.


Ways to reduce cancer-related stress

There are several ways you can reduce an employee’s anxiety and help them during their transition back to work. You should:

• meet regularly to talk through their concerns (such as job security)

• adjust their work schedule and workload

• take a proactive role in liaising with parents and students, if appropriate

• make necessary physical accommodations

• liaise with other staff (act as a contact person or coordinate offers of help)

• offer counselling/EAP support for the person and their family

• support the employee’s decisions and boost their morale.


Addressing HR concerns

The following resources may be helpful if you have any additional queries:

• Cancer Council publications, such as Working with Cancer: a workplace resource for leaders, managers, trainers and employees. There are also several publications relating to specific types of cancer and treatment. These may be relevant if you would like to learn more about an employee’s cancer. For more information call the Helpline on 13 11 20 or visit www.cancercouncil.com.au.

• The Australian Government workplace and employee relations website, www.workplace.gov.au. This site has information about industrial relations laws and workplace issues.

• The NSW Department of Commerce Office of Industrial Relations website, www.industrialrelations.nsw.gov.au. This site has information about workplace laws and employer practices.

• A NSW Department of Education and Training staff welfare officer in your region.

• A representative from the Association of Independent Schools of NSW or the Catholic Education Commission NSW.

The main issue was that the school didn’t want me to return. But I wanted to, and I had to for financial reasons. I felt like the school

saw me as a liability. If I hadn’t had a letter from the surgeon and demanded it, I don’t think they would have done much. I think

schools need to take a more humanitarian approach.

Anne, primary school teacher with cancer

In the event of a death, public school principals should implement the procedures outlined in the NSW Department of Education and Training’s Guidelines for Schools and TAFE NSW Colleges and Campuses: Management of Serious Incidents. Private school principals should adhere to their school’s relevant guidelines. See Chapter 7 to learn more about death, or see page 78 for a sample letter about a death in the school community.

This chapter is an introduction to a very difficult issue – one

that hopefully never affects your school community. Though

cancer survival rates are increasing due to better treatments

and early detection, some people with cancer do die.

The information in this section will explain ways to prepare

for death, how to help the bereaved, and how to break the

news and organise a memorial.

Cancer, death and the

school community

57

Chapter Seven


How to prepare for a cancer death

When a cancer patient’s prognosis is poor and it is known that they are going to die, your school community should plan ahead to prepare people for what might happen. This might include:

• visiting the person, if desired by their family

• continuing to communicate with the person in other ways (via letters and emails, for example)

• keeping community members up to date about the prognosis

• having age-appropriate discussions about death

• informing key community members of the situation.

After the person dies, you can consider helping students, parents and colleagues to organise a memorial scholarship, host a special service, attend bereavement counselling or fundraise.

Remember, different plans will be useful in different situations. For example, if a classmate or prominent teacher has advanced cancer, students will probably feel very emotional. You might prepare students for death by discussing it and sending correspondence to the person with cancer.

People who are not heavily involved in the school network may not feel directly affected, so they might prepare for the situation privately.

We were told to say our goodbyes, but I wasn’t ready to say it. Friends and family always said that at least I had the opportunity to

say goodbye because his death didn’t happen suddenly in an accident. The truth is, it is just as bad either way, and you are not prepared for

it even if you are expecting it. From the day my father was diagnosed to the last day was the hardest eight months I will ever face.

Daniel, student with parent who had cancer

59Cancer, death and the school community

Action to take when someone dies

When someone in your school community dies – particularly a student or colleague – a school must decide how to inform people. It is usually better to tell students in their normal class groups or in small groups, rather than holding an all-school assembly.

Staff members who will talk to the groups of students should be briefed with the following information:

• an outline of key points which clearly explains the circumstances of the death

• some positive words of reminiscence

• details of how the school will honour the person who has died, if appropriate

• details of the funeral service and arrangements for attendance, if known and appropriate

• information about support and counselling services available.

Remember, the purpose of telling students is to draw the school community together and facilitate the grieving process. Not everyone in the school community will be informed by class meetings, so it may be important for you and your colleagues to spread the information through other means. For example, you can send a letter to parents, update the school’s daily or weekly bulletin and meet separately with your colleagues.

When death is sudden

Though members of your school community will usually be aware if someone is near death, in some cases, a person’s death will be sudden or unexpected. It can be hard for some people to grieve – and react to a crisis – if they feel they were unprepared.

Students might feel shocked that they weren’t informed of the person’s prognosis in advance. Others might feel hurt or angry that they did not have the chance to say goodbye. For ways to help the bereaved, see the following section.

You and your colleagues will have to be particularly sensitive if the death was sudden. You should be prepared for more emotional reactions, and be able to offer support (such as counselling) to those who need it. Additionally, you should inform others (for example, by sending a letter to parents).

See page 78 for an example of a letter informing people in your school community about a death.


How to help the bereaved

If someone in your school community dies, each person’s reaction and grieving process will be unique. Grief does not operate on a timetable – it is an individual experience. Bereavement depends on someone’s personality, the nature of the relationship and degree of attachment to the person who has died, and their access to support services. Bear in mind that it is normal for someone to feel out of control, overwhelmed or even disbelief.

If you want to help someone in your school community mourn the loss of someone special, you can:

• Encourage the bereaved person to talk about the deceased. If you have a conversation, be attentive and non-judgmental.

• Allow the person to silently reflect on their loss. Don’t try to talk about other

things if they aren’t interested. Correspondingly, let the person cry, act angry or talk about something else.

• If you can, offer support to the family or closest friends of the person who has died. Sending a note of sympathy is a simple but effective way to show support.

• Accept that it may take some time for the intensely painful feelings of grief to abate. Eventually the bereaved will have better control over their emotions, though life has forever changed. As time goes by, it can become easier to recognise birthdays, anniversaries and other significant occasions.

Bereavement support services may help you or someone you know who is going through a difficult time. See page 65 for contact details.

When (my husband) Colin died, it was after his cancer metastasised and he had a sudden stroke on our son’s seventh birthday. That was so hard. When my son returned to school, though, the teacher and all the

kids had made a book about Joey’s dad. It was so thoughtful, and it means a lot to have a tangible keepsake like that. The kids really don’t

have many things like that.

Patricia, parent with spouse who had cancer


What young people understand about death

Children and young adults understand loss in different ways, depending on their age and maturity level. It is important not to consider the following guidelines too rigidly. If you have any questions about how young people understand loss, consult a member of your school’s student welfare team or a social worker.

Early primary school students are only just beginning to understand that death is permanent. They might realise that death means someone isn’t around any more, but they may not understand the cause of death. Children sometimes believe death was the result of their own behaviour.

Younger students have many different concerns when they think about death. If a parent or teacher dies, they might wonder who will look after them or teach them. If a peer dies, they will wonder if cancer is contagious, or if they will die, too. Children in early primary school will be very open with their questions, which may sometimes be very confronting.

Later primary school students will understand death is permanent, and they will know some reasons why death happens

(e.g. illness or old age). They’re less likely to blame themselves for the loss, but they still might blame someone else.

They will still want to know the facts about death – including what happens after death. Children in this age group will be better able to articulate their feelings and act sympathetically towards others.

Secondary school students or teenagers usually understand the facts of death, but they might respond in a self-centred way. Teenagers often feel and act as if they are invincible, and the death of someone in the school community can force them to come to terms with their own mortality.

Students will express their feelings in different ways. They may abuse drugs or alcohol, act recklessly or skip classes. Some young people will express their feelings in more positive ways, by listening to music, playing sports or writing in a journal. Teenagers usually want to spend more time with their friends after a loss, but they find it helpful to know other support and counselling is available. They might also find it especially helpful to participate in a private or public memorial service.


When a student dies

The cure rates of cancer for children and young adults have improved substantially over the last 20 years. Today, more than 70% overall of young people with cancer will be cured, and this rate is expected to increase due to improvements in treatments. However, some children and young adults do die from cancer.

The death of a young person is an enormous tragedy, and it can be difficult to accept. It is important that your school community responds in a compassionate manner.

You or the student welfare coordinator should ask the family of the deceased student what the school can do to help, how the parents would like to inform staff and students (if they don’t already know) and if a memorial can be organised.

If you or one of your colleagues worked closely with the student, you will feel

understandably saddened when they die. You will need to take time to deal with your own feelings before talking to students. It may be helpful to attend a funeral service.

The student’s classmates will react in different ways, depending on how old they are. (For more information about how young people understand death, see the previous section.) Their reactions will depend on their relationship with the student and their own coping mechanisms. Classmates should be able to turn to school staff for guidance and support.

In some cases, schools acknowledge the death of a former student, respecting the relationship between past and present school members. Though the person was no longer a student, their death may be confronting to some people.

I was devastated when Lisa died. I didn’t think it would happen. She was my best friend and school just wasn’t the same without her.

Melissa, classmate of a student who had cancer


When a parent dies

When a parent in the school community dies, the reactions of community members can be quite varied. If a parent has a child attending the school or was a well-known community member, people may outwardly grieve the loss. If the parent was not particularly well known in the community, many people may be unaware of their death.

Students who know a classmate’s parent has died will probably worry about their own family. They may express sympathetic sentiments and wonder how to support their friend. Some students may attend the funeral service to support their classmate.

Other parents who are aware of the loss may reach out to help the family. Parents can help make meals, keep track of the child’s homework or provide transportation to school and after-school activities.

You and other school staff members will probably be aware of the death, and you should explain the situation to students, if necessary. You will need to grieve the death in your own way and provide in-class support (such as more flexible homework deadlines) to a student who has lost a parent.

The principal of the kids’ school attended my husband’s funeral. I truly appreciated that. It was above and beyond.


When a student’s sibling dies

The loss of a student’s sibling is extremely traumatic. No matter how close the young person was to their sibling, they will need time to mourn their loss. The student may have to take time away from school, and their parents will likely be occupied with making funeral and other arrangements. You should be supportive when the student

is away from school, and try to help them manage their schoolwork on their return. It is understandable that a student will be more focused on their family than on schoolwork for a certain period of time. Sometimes it is helpful to refer a grieving child or young adult to counselling services, in consultation with their family.


When a staff member dies

When a prominent member of the community, such as a teacher, dies, there is a far-reaching impact. You and your colleagues will be confronted by your own feelings, and in the midst of your own grief, you must continue working and counsel students who may also be grieving.

If you are grieving, you should be made aware of all available employee support services and take time to deal with your own feelings.

If you worked closely with the person, you will probably wish to attend a funeral or memorial service. This can help you honour your colleague. A service may also allow parents and students to pay their respects.

Students can also take the death of a teacher particularly hard. They will mourn in individual ways. The principal or a counsellor can talk to students about ways to honour their teacher and how to deal with grief.

In some schools, or for some individuals, faith or religious tradition plays a central role in dealing with loss. If you work at a school that employs a chaplain or spiritual adviser, they may be able to provide pastoral care, religious and personal advice and support to the bereaved.

Planning a memorial

Your school might hold a memorial service to honour the life of a student, parent or colleague. Community members can collaborate with family members to organise the event. When planning a service, you should think about:

• How to share favourite memories or thoughts. Will there be a program?

• The setting. Will the service be held at the school? How formal will it be? Is there any special music that could be played?

• Who will attend. You can make a public or school-wide announcement to let people know about the service.

• Who will lead the service. There may be colleagues, friends, students or family who would like to be involved.

• Whether there will be flowers or an opportunity to make charitable donations.


Seeking professional support

Some people need professional support to deal with the death of a classmate, parent or staff member. Your school counsellors can help people who need it.

A person should be referred to professional help if they:

• say they want to die too

• are extremely preoccupied with dying

• suffer academically or at work for an extended period after the death

• act sad and withdrawn, or demonstrate severe behaviour like self-mutilation

• have trouble socialising

• simply need someone to talk to.

Talk to your school about ways to support members of your school community, or contact one of the organisations listed in Chapter 9 of this book.

Bereavement support services

There are several community services that offer support to people who are bereaved. These services include:• The Bereavement Care Centre –

trained counsellors provide support to adults and children who are bereaved. Call (02) 9804 6909 or visit www.bereavementcare.com.au.

• Relationships Australia – specialist grief counselling helps people address their feelings and discuss their loss. See www.relationships.com.au or call 1300 364 277.

• The Cancer Council Helpline – consultants can refer callers to local services or recommend a telephone support group. Call 13 11 20 or visit www.cancercouncil.com.au.


We are living with the impact of cancer every day. The fact is, my husband died of metastatic bowel cancer six years ago.

My kids don’t have a father, and they transferred schools to be near their cousins. The school knows that.

But the school should also know that I’m not a single parent – I’m not someone who’s separated from their partner. I’m a

sole parent, and my children have experienced a different kind of loss. This affects how they act around men their father’s age,

such as teachers. I think the school should still reach out and offer support, even after time has passed.


When a school community is confronted by cancer, people

usually ask: “How can we help?” Often, a school will ask

a person with cancer or their family if it is okay to arrange a

fundraising program or cancer education day. These

events can empower school community members, help

educate others and spread a message of support and hope.

This chapter details some fundraising options for your

school and information about how you can organise a cancer

education day, if you choose to do so.

Events and fundraising

67

Chapter Eight

The week Sean started, the Camp Quality cancer

puppets did a performance. After that there was a

noticeable change in how the other kids treated him.

Jim, father of primary school student with cancer


Hosting a school cancer education day

While it is preferable to integrate information about cancer into the core curriculum, your school may also consider hosting a cancer awareness and education day. Though many awareness days involve some kind of fundraising, such as buying ribbons, your school does not have to collect funds.

The cancer education day could involve brief in-class discussions or lessons from teachers. Young students could draw pictures, write stories or watch a puppet show. Older students may want to hang posters, make presentations about cancer, or set up a stall to distribute information.

Planning tips

When you are organising an awareness day, you should:

• Ask the person with cancer (or their family) if they are comfortable with the idea. Though the information can be presented in a very general way, families may want to ensure certain details are kept private.

• Send a letter to parents informing them of the upcoming event (and providing some details). For an example, see page 76.

• Do not force students to attend. Plan alternative activities for those who are not attending.

• If you are hoping to invite guest speakers, book well in advance. Up to two months notice is usually required.

Camp Quality puppet shows

Camp Quality is a not-for-profit organisation that presents free puppet shows to primary school students. The puppet shows address bullying and teach tolerance to children who are learning about cancer. To date, over 2.5 million children in Australia have enjoyed these shows. See page 74 for more details about how to book a Camp Quality puppet show for your school.

Focused on raising awareness and funding for research into breast cancer, this event is held in October. The proceeds from sales of pink ribbons, bracelets and other merchandise go

towards women’s cancer research. For more information, call 13 11 20 or visit www.pinkribbonday.com.au.

69Events and fundraising

Fundraising options

Some families face financial hardship as a result of a cancer diagnosis. Though the primary role of schools is to educate students, some schools allow students and staff to organise fundraising programs. The funds raised may be directly donated to the person with cancer, or they can support cancer-related charities. Some fundraising events that support people with cancer are:

Every May, more than a million Australians come together at school, work, home and in their community to donate money for cups of tea and coffee. The Cancer Council uses this money to perform cancer research and support those affected by cancer. Visit www.biggestmorningtea.com.au or call 13 11 20 for more facts about this fundraiser.

Organised by CanTeen, the Australian organisation for young people living with cancer, this event sells bandannas, which are a symbol of cancer’s impact on young people. It is held each year in October. To find out more, visit www.canteen.org.au or contact CanTeen on 1800 226 833

The daffodil is a sign of hope, and Daffodil Day is a day to remember people touched by cancer, celebrate survivorship, hope for a brighter future and raise money to fight cancer. Daffodil Day is held by the Cancer Council in August. To learn more, visit www.daffodilday.com.au or call 13 11 20.

Relay for Life is a fun, outdoor community event where teams of 10 to 15 people take turns walking or running around a local oval to raise funds. In many cases, the event is held on a school campus. To find out more about upcoming Relay events, call 13 11 20 or see www.relay.cancercouncil.com.au.


A male colleague and two students offered to shave for a cure. In three weeks, the students raised almost $2,500 during roll call.

A Year 8 student ended up cutting my hair.


Make-A-Wish Australia’s national day of celebration aims to raise awareness and funds to help grant children with a life-threatening illness a cherished wish. To find out more about Wish Day, call 1800 032 260 or visit www.makeawish.org.au.

Each May, Starlight holds a fundraiser for children and families who live with serious illness and hospitalisation. For further information, visit www.starlightday.org.au or phone 1300 727 827.

Sponsored by the Leukaemia Foundation, this annual event raises funds for leukaemia patients. There is also a related school-based event called Crazy Chin Day, where students decorate their chins to raise money. Visit www.worldsgreatestshave.com or call 1800 500 088 for more information.

This annual family-focused picnic event is hosted by The Children’s Hospital at Westmead to support treatments for their young patients. Tickets are sold individually or in packages. Visit www.chw.edu.au/tbp or call (02) 9845 3364 for more information.

A great deal of cancer research is being done in Australia and

overseas, and there is continually new information available.

This chapter includes a list of some reliable Internet

sites, books, library resources and organisations where you

can learn more about school- or cancer-related issues.

This section includes some sample letters, which you may

send to families in the school community. The letters

include information about cancer awareness, students and

staff with cancer, and a death in the school community.

Support services, resources

and information

71

Chapter Nine


Finding information

The Internet can be a useful source of information, although not all websites are reliable. The websites listed below are good sources of information.

Australian

Association of Independent Schools of NSW .............................................................................................. www.aisnsw.edu.au

Australian Government Workplace Relations ...................................................................................... www.workplace.gov.au

Cancer Institute NSW ....................................................................................................................................... www.cancerinstitute.org.au

Catholic Education Commission NSW ......................................................................................... www.cecnsw.catholic.edu.au

NSW Board of Studies ....................................................................................................................... www.boardofstudies.nsw.edu.au

NSW Department of Commerce Office of Industrial Relations ........ www.industrialrelations.nsw.gov.au

NSW Department of Education and Training .............................................................................................. www.det.nsw.edu.au

NSW Health .......................................................................................................................................................................... www.health.nsw.gov.au

The Cancer Council Australia .......................................................................................................................................... www.cancer.org.au

The Cancer Council NSW ............................................................................................................................. www.cancercouncil.com.au

International

American Cancer Society ............................................................................................................................................................ www.cancer.org

MacMillan Cancerbackup ................................................................................................................................. www.cancerbackup.org.uk

US National Cancer Institute ............................................................................................. www.cancer.gov/cancer_information

School support services

Schools can access support from several different areas, including:

• student welfare teams, which may include school counsellors

• disability programs consultants or special education teams

• staff welfare officers

• the NSW Department of Education and Training’s Physical As Anything, which provides health information, or resources from the The Association of Independent Schools of NSW or the Catholic Education Commission NSW.

73Support services, resources and information

The Cancer Council services

The Cancer Council NSW offers a variety of services which may help you support someone during their cancer journey.

The Cancer Council Helpline (13 11 20) is many people’s first point of contact if they have a cancer-related question. This telephone information service, which is only the cost of a local call, gives you an opportunity to discuss your concerns confidentially with oncology health professionals.

The Cancer Council also produces publications about cancer. The Understanding Cancer series is a good source for basic information about cancer. For a list of titles in the series, visit www.cancercouncil.com.au and go to the Patient Support/Booklets and Information section or call 13 11 20.

You can access other cancer-specific information at the Cancer Council’s consumer library, located in Woolloomooloo. Contact our librarian on (02) 9334 1900 or email [email protected] to organise a loan.

Patients, carers, friends and family members can participate in several peer support programs that can be accessed via the Cancer Council. These include:

• face-to-face support groups, which are often held in community centres or hospitals

• tumour- or situation-specific telephone support groups, which are facilitated by trained counsellors from the Cancer Council

• online discussion forums, such as www.cancersupportonline.com.au, where people can connect with each other any time

• Cancer Council Connect, a program that matches a person with cancer with a volunteer who has been through a similar cancer experience

• the Understanding Cancer program, a one-day course that offers practical information about many issues for people affected by cancer. Call 13 11 20 to learn more.


Other organisations that can help

There are several other not-for-profit organisations that support people with cancer. These organisations include:

• Camp Quality – an organisation committed to bringing hope and happiness to every child living with cancer through educational puppet shows, camping programs and other events. See page 68, go to www.campquality.org.au or call (02) 9876 0500.

• CanTeen – the national support organisation for young people (aged 12 to 24) living with cancer, offspring of people with cancer and siblings of people with cancer. Visit www.canteen.org.au or call 1800 226 833 to learn more.

• Make-A-Wish Australia – this organisation grants wishes to young people with a life-threatening illness. Visit www.makeawish.org.au or call 1800 032 260.

• Redkite – a foundation that offers financial, emotional and educational support for children with cancer and their families. Telephone and email support is also available for young people diagnosed with cancer and their families. Go to www.redkite.org.au or call 1800 334 771.

• Ronald McDonald House Charities Learning Program – an educational catch-up program for young people whose education has been disrupted due to serious illness. Contact Learning Links on (02) 9534 1710 or visit www.learninglinks.org.au.

• Starlight Children’s Foundation Australia – a national organisation that supports seriously ill children by providing in-hospital programs, granting wishes and organising family escapes. To learn more go to www.starlight.org.au or call (02) 9437 4311.


Sample letters to communicate with parents

A letter about a child with cancer

School’s address

and contact details

Date

Dear parent/guardian,

I am writing to advise you that our school currently has a student who is

receiving medical treatment for cancer. Currently he/she is actively

involved in the school community and recovering from treatments and

their side effects.

As this student has a compromised immune system (which makes him/

her more vulnerable to disease), it is important that you do not send your

child to school if he/she is unwell. For example, if your child has an

infectious disease (such as the measles, chickenpox or flu), he/she should

stay at home until no longer contagious. For more information about how

long an illness is contagious, contact your GP or visit the NSW Health

website at www.health.nsw.gov.au.

I would also appreciate it if you would notify me if your child has an

infectious disease. This will allow me to assess if the student with cancer

was exposed, and to notify the student’s parents, if necessary.

We appreciate your cooperation. Please do not hesitate to contact me if

you have any questions.

Yours sincerely,

School principal/teacher


A letter about a cancer awareness day

School’s address

and contact details

Date


I am writing to advise you that our school is planning to host a cancer

awareness day on Monday, 1 February. We currently have a student

undergoing treatment for cancer, and we would like to educate other

students about cancer.

On this day, our students will present some information about different

types of cancer, recent research and prevention measures. We are also

asking students to donate a gold coin to a cancer research fund. This is

voluntary.

Attendance at cancer awareness day activities is not compulsory, but we

encourage participation. If you would rather your child not attend,

alternative activities will be provided.

Please notify me by 25 January if you do not want your child to attend

the cancer awareness day. Thank you.

Yours sincerely,



A letter about a staff member with cancer

School’s address

and contact details

Date


I am writing to inform you that one of our staff members, Mr Glen, is

undergoing treatment for cancer. Mr Glen asked me to share this

information with you.

Mr Glen will be taking an extended leave of absence commencing

immediately. Mrs Lee, the head of the English/History Department, will be

covering his classes while he is away.

Your child has been told that Mr Glen has cancer, and may have questions

about it. Please let me know if I can help you talk to your child. You can

also call the Cancer Council Helpline on 13 11 20 to learn more about

communicating with your child about cancer.

Mrs Lee and I will endeavour to ensure that your child’s education is not

disrupted by these changes and that any of your child’s needs are

addressed. Please feel free to contact me if you have any concerns about

changes to your child’s schedule.

Yours sincerely,



School’s address

and contact details

Date


It is with sadness that I write to inform you that Ms Christine Jones,

a teacher in our Science Department, passed away yesterday. Ms Jones had

been undergoing treatment for cancer over the last few months.

Ms Jones was a well-respected staff member. She was passionate about

teaching young people and she will be sorely missed. We have informed the

students of Ms Jones’s death and about the school counselling services

available to them. Please encourage your child to access these services, if

appropriate.

Many students have expressed a desire to attend a service honouring

Ms Jones. I have been in contact with the Jones family, and am organising

a memorial for Friday, 7 May, in place of our weekly assembly. Parents are

welcome to attend the service, which will be held in the assembly hall from

10-11am. The P&C will be holding a morning tea in the staff common room

for staff and parents following the service.

If you would like to attend the memorial service for Ms Jones, please contact

the school office by 6 May. On behalf of our school community of students,

staff and parents, I will be sending our sincere condolences to the Jones

family.

Yours sincerely,


A letter about a death in the school community

This glossary, which includes definitions suitable for

young children, teenagers and adults, may help you define

and explain common cancer-related words.

An index is also included in this chapter. You can

use the index to navigate this book, as it lists the key topics

addressed in each chapter.

Glossary and chapter index

79

Chapter Ten


WordDefinition for older children, teenagers or adults

Definition for younger children

Cancer

Benign

Cells

Chemotherapy

Malignant

Metastasis (advanced cancer)

Palliative care

Cancer is the name for more than 100 diseases in which abnormal cells grow and rapidly divide. These cells usually develop into a lump called a tumour. Cancer can spread to other parts of the body.

Cells that are not malignant (cancerous).

Cells are the microscopic building blocks of the body. Our bodies constantly make new cells: to enable us to grow, to replace worn-out cells, or to heal damaged cells after an injury.

Special drugs that kill cancer cells or slow their growth.

Cancer. Malignant cells can spread to other parts of the body.

When cancer has spread from one part of the body to another.

Treatment that controls symptoms without trying to cure the cancer.

Cancer is when bad cells – or troublemaker cells – stop the good cells from doing their job. These bad cells can grow into a lump and can spread to other parts of the body.

Not cancer.

The body is made up of millions of tiny things called cells, and each has a job to make your body work and stay healthy.

Medicine that kills the bad cancer cells.

Another word for cancer.

When the bad cells have travelled to another part of the body.

Sometimes the doctors and nurses can’t stop the cancer from growing, and they will give someone medicine to make them feel better and ease any pain, even though the cancer can’t be stopped.

Glossary

81Glossary and chapter index

WordDefinition for older children, teenagers or adults

Definition for younger children

Prognosis The likely outcome of a disease. This helps doctors decide on treatment options.

What the doctors think might happen after treatment, and someone’s chances of getting better.

Radiotherapy

Recurrence/relapse

Remission

Side effects

Surgery

The use of x-rays to kill or injure cancer cells so they can’t grow or multiply.

When the cancer comes back because not all cells were destroyed by treatment.

When cancer cells and symptoms disappear. Remission doesn’t necessarily mean the cancer is cured, but that it is under control.

The unwanted effects of treatment, such as nausea, hair loss, weight loss or gain, and fatigue.

An operation to remove the cancer. Sometimes large parts of the body will be removed with the cancer, such as a breast or the bladder.

X-rays or a laser beam that go into the body to kill cancer cells and make the cancer smaller.

If cancer cells are left in the body, they can start to grow again, and the cancer comes back.

When the doctors can’t see any more cancer cells in the body.

Problems that can make someone feel sick or tired or lose their hair after treatment. Someone might gain or lose weight or experience other changes. This is because the treatment stops some good parts of the body growing as well as the bad parts.

When someone has an operation and a surgeon cuts out the cancer.


Chapter index

Cancer in the school community: 10 ways your school can help ..................................................................................... 4

Chapter One: Information about cancer ......................................................................................................................................................... 7

What is cancer? ...................................................................................................................................................................................................................................... 8

Cancer treatments and their side effects ............................................................................................................................................................................... 10

Who gets cancer ................................................................................................................................................................................................................................. 12

Common young people’s cancers .............................................................................................................................................................................................. 12

Chapter Two: Talking about cancer ................................................................................................................................................................... 13

Talking to someone with cancer .................................................................................................................................................................................................. 14

Importance of respecting privacy ................................................................................................................................................................................................ 15

Appointing a school liaison person ............................................................................................................................................................................................. 16

Understanding cultural differences ............................................................................................................................................................................................ 16

Balancing everyone’s needs .......................................................................................................................................................................................................... 17

Communicating with people of all ages ................................................................................................................................................................................... 17

Where to get information or assistance .................................................................................................................................................................................. 22

Chapter Three: When a student has cancer ............................................................................................................................................. 23

When a student is diagnosed ....................................................................................................................................................................................................... 24

Setting up a communication channel ........................................................................................................................................................................................ 25

Supporting a student during treatment .................................................................................................................................................................................... 26

Supporting the student’s classmates ........................................................................................................................................................................................ 29

Supporting a student after treatment ....................................................................................................................................................................................... 30

Making practical modifications for students .......................................................................................................................................................................... 33

Dealing with teasing and bullying ............................................................................................................................................................................................... 34

Supporting the student’s parents ................................................................................................................................................................................................ 34

Helping young people understand cancer .............................................................................................................................................................................. 35

Helping students talk to a friend with cancer ....................................................................................................................................................................... 35

Advising students on how to act ................................................................................................................................................................................................. 36

Planning a lesson about cancer .................................................................................................................................................................................................... 36

Special provisions for the HSC ..................................................................................................................................................................................................... 37

Gaining access to tertiary study ................................................................................................................................................................................................... 38

Chapter Four: When a parent has cancer ................................................................................................................................................... 39

How cancer affects family members ........................................................................................................................................................................................ 40

How young people react ................................................................................................................................................................................................................. 41

Changes in school performance .................................................................................................................................................................................................. 41

How your school can help .............................................................................................................................................................................................................. 42

Talking about a parent’s cancer .................................................................................................................................................................................................... 42

Helping classmates understand ................................................................................................................................................................................................... 43

When a sibling has cancer .............................................................................................................................................................................................................. 44

83Glossary and chapter index

Chapter Five: When a staff member has cancer ................................................................................................................................. 45

How cancer affects school staff .................................................................................................................................................................................................. 46

How people may react ..................................................................................................................................................................................................................... 47

When the staff member is a parent ........................................................................................................................................................................................... 47

Choosing to tell students ................................................................................................................................................................................................................ 48

Choosing to tell parents ................................................................................................................................................................................................................... 49

Dealing with side effects ................................................................................................................................................................................................................. 50

How parents in the community can help ................................................................................................................................................................................ 50

Chapter Six: A principal’s guide for supporting staff .................................................................................................................... 51

Cancer in the workplace .................................................................................................................................................................................................................. 52

Talking to a colleague with cancer .............................................................................................................................................................................................. 52

When a colleague has a serious illness ................................................................................................................................................................................... 53

How cancer affects someone’s colleagues ........................................................................................................................................................................... 54

How cancer affects students and families ............................................................................................................................................................................. 54

Ways to reduce cancer-related stress ...................................................................................................................................................................................... 55

Addressing HR concerns ................................................................................................................................................................................................................. 56

Chapter Seven: Cancer, death and the school community .................................................................................................... 57

How to prepare for a cancer death ............................................................................................................................................................................................. 58

Action to take when someone dies ........................................................................................................................................................................................... 59

How to help the bereaved .............................................................................................................................................................................................................. 60

What young people understand about death ........................................................................................................................................................................ 61

When a student dies ......................................................................................................................................................................................................................... 62

When a parent dies ............................................................................................................................................................................................................................ 63

When a student’s sibling dies ....................................................................................................................................................................................................... 63

When a staff member dies ............................................................................................................................................................................................................. 64

Planning a memorial .......................................................................................................................................................................................................................... 64

Seeking professional support ........................................................................................................................................................................................................ 65

Chapter Eight: Events and fundraising .......................................................................................................................................................... 67

Hosting a school cancer education day .................................................................................................................................................................................... 68

Fundraising options ............................................................................................................................................................................................................................ 69

Chapter Nine: Support services, resources and information ................................................................................................. 71

Finding information ............................................................................................................................................................................................................................. 72

School support services ................................................................................................................................................................................................................... 72

The Cancer Council NSW services ............................................................................................................................................................................................. 73

Other organisations that can help ............................................................................................................................................................................................... 74

Sample letters to communicate with parents ....................................................................................................................................................................... 75

Chapter Ten: Glossary ....................................................................................................................................................................................................... 79

Regional offices ........................................................................................................................................................................................................................ 85

“Since his treatment, he’s had some

difficulty remembering numbers like

the times table. He’s having tutoring

now and he’s got a few tricks that

the tutor’s taught him.”

Rebecca, mother of a secondary school student with cancer

“I think it’s really important to keep

him at school for the social contact.

I’m not worried about the academic

side. You can always get extra

tutoring. School takes his mind off

himself, gives him something else

to think about.”

Kim, mother of a primary school student with cancer

“Her friends are very caring, and

they’d all have a good cry together

out of the blue. I’d ask, ‘What’s

going on?’ and they’d say, ‘No,

it’s got nothing to do with you.’

You know, certain things they just

don’t tell you.”

Sarah, mother of a secondary school student with cancer

“After my surgery, I said to the students, ‘I’m going to be writing on the bottom of the

board, so you’re going to have to cope.’ One of the students asked why and I said I’d

had some lymph nodes removed and I couldn’t reach up to write on the top of the board.

They just adapted to that.”


“There was one administrator I went

to for help when I was back at

school. She was so helpful. When

I was on crutches or in a wheelchair,

she made sure all my classrooms

were close by. That helped me get

around easily.”



Central Coast Region

127 Erina Street, Gosford NSW 2250

Ph: (02) 4325 5444 Fax: (02) 4325 5688

Far North Coast Region

101-103 Main Street, Alstonville NSW 2477

Ph: (02) 6681 1933 Fax: (02) 6681 1936

Hunter Region

22 Lambton Road, Broadmeadow NSW 2292

Ph: (02) 4961 0988 Fax: (02) 4961 0955

Mid North Coast Region

121 High Street, Coffs Harbour NSW 2450

Ph: (02) 6651 5732 Fax: (02) 6652 1530

North West Region

Shop 2, 218 Peel Street, Tamworth NSW 2340

Ph: (02) 6766 1164 Fax: (02) 6766 7053

South West Region 1/37 Tompson Street, Wagga Wagga NSW 2650 Ph: (02) 6937 2600 Fax: (02) 6921 3680

Southern Region 1 Lowden Square, Wollongong NSW 2500 Ph: (02) 4225 3660 Fax: (02) 4225 1700

Sydney Metropolitan Region and Head Office 153 Dowling Street, Woolloomooloo NSW 2011 (PO Box 572 Kings Cross NSW 1340) Ph: (02) 9334 1900 Fax: (02) 9334 1739

Western Sydney Region 43 Hunter Street, Parramatta NSW 2150 Ph: (02) 9687 1399 Fax: (02) 9687 1118

Western Region 84 Byng Street, Orange NSW 2800 Ph: (02) 6361 1333 Fax: (02) 6361 1863

At the Cancer Council NSW we’re dedicated to defeating cancer. As well as funding more cancer research than any other charity in the state, we advocate for the highest quality of care for cancer patients and their families, and create cancer-smart communities by empowering people with knowledge about cancer, its prevention and early detection. We also offer direct financial assistance for those people in hardship as a result of having cancer. These achievements would not be possible without community support, great and small.

There are many ways that you can make a contribution to support our efforts. You can make a donation, join a Cancer Council community fundraising event, or become a Cancer Council volunteer or advocate. Also, every purchase of sun protection products from our retail stores contributes financially to our work.

To find out more about how your school community, or you and your family and friends can help, please call 1300 780 113.

Regional offices

How you can help

Cancer Council Helpline 13 11 20For support and information on cancer and cancer-related issues, call the Cancer Council Helpline. This is a free and confidential service.

Cancer Council Helpline ............................ 13 11 20 (cost of a local call)

TTY ................................................................................. (02) 9334 1865 for deaf and hearing-impaired

Cantonese and Mandarin ......................... 1300 300 935

Greek ............................................................................ 1300 301 449

Italian ............................................................................ 1300 301 431

Arabic ........................................................................... 1300 301 625

For further information and details please visit our website:

www.cancercouncil.com.au

CAN/08/02A Date: 03/08 ABN 51 116 463 846

Cancer in the · A tumour can be benign (not cancer) or malignant (cancer). A benign tumour does...

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