Cancer can affect anyone at any age. It reminds us of the fragility of life and makes us face issues of mortality. Treatment can be difficult to cope with and can affect family members and friends too.
When cancer is diagnosed, adults often assume that children remain unaware of what is going on. They continue to play, they request meals, treats and adult time, and are seemingly unaffected on the surface. However, as early years professionals know, children absorb information from all around them. They are acutely observant, keen to know, and not easily distracted if they feel something is being kept secret from them.
Many adults feel unable to explain situations in simple terms, some feeling that in talking to children about a difficult subject they may become too emotional, risking upsetting, and perhaps alarming or frightening them. Some adults specifically try to hide such situations from children. I truly believe they are misguided in this.
Secrets can cause anxiety, fretfulness and fear. Again, as early years professionals, we observe children displaying these emotions within their play, through changes in their behaviour or regressed development.
In 2006 I was diagnosed with breast cancer. Following surgery, I needed chemotherapy. Having always been close to my grandchildren (then aged five, three and a few months), I knew that my treatment would probably stop me from seeing so much of them, which they would find confusing.
I asked about storybooks on cancer treatment suitable for young children, but there was only material for much older age groups. Having tried bookshops, cancer charities and the internet, I decided to tell my grandchildren a story, and this led me to write 'When Granny Lost Her Hair'.
STRONG MEDICINE
Before chemotherapy started I had my long hair cut short. This surprised the children. They wanted to know why, so I sat with them and started my story
'Once upon a time there was a granny who had three beautiful grandchildren. Do you know what their names were?'
'No,' they said. I said they were Jazzy, Harry and Alfie (their names).
'Is the granny you?' asked Jasmine.
I agreed that it was me and asked if they remembered me going into hospital for an operation. They did, because their Mum and baby Alfie had stayed with me for a few days when I had come home.
I explained that the doctor had told me that I now needed to have some strong medicine all through the summer to make sure that I did not become unwell again. I used a turkey baster to demonstrate the huge needle that would be used to inject some of the chemotherapy drugs and assured them that nurses would be looking after me.
Jasmine was very impressed that some of my medicine would be bright red, and Harry was keen to have a go, asking me did I have any at home, where should he put it, and could we do it now, please? If there had been any to hand I am quite sure he would have happily injected me!
I explained that the medicine would also make my hair fall out. I felt it was important to talk about this very noticeable outcome of my treatment in advance, so that it was not such a shock to them when they saw me bald. They thought a bald Granny would be really funny and we all had a good laugh!
I made sure they understood that chemotherapy medicine is very different to medicines they take, and that their medicine makes them better, not poorly. Also, that it wouldn't make their hair fall out.
Talking honestly on this very simple level helped them accept my situation and remain unfazed by it. They felt the top of my head each time I saw them to see if there was any sign of hair growing, and even brought friends to have a feel when I attended a school event with them.
They enjoyed playing with my newly acquired headgear, sorting and choosing scarves to wear, trying on my wig. We all agreed it was a bit itchy and they thought it funny that I had named it 'Ethel' and sat it on an old flower vase.
For my birthday, Jasmine, Harry and Mummy made a special card for me. It was designed like a book with every page a picture frame of my face. They had created for me a range of new hairstyles using feathers, pasta bows, crinkly pipe-cleaners, pieces of foam and felt-pens. I told them I couldn't decide which hairstyle I would like to have. Jasmine thought the feathers would be nice.
The reactions and enthusiasm of my grandchildren for both my hair loss and its regrowth was both touching and amusing, and I used it as the basis of When Granny Lost Her Hair.
SIMPLE REASSURANCE
The book has been well received by cancer patients and oncology staff, and others who work with families facing cancer, as well as by teachers and early years practitioners.
The section on 'Notes for adults' includes advice to parents on informing teachers and early years staff about serious illness in the family, in case their child wants to talk about it.
The level and extent of what you say to children must always be in line with parents' wishes. Some may want you to simply offer reassurance, others may tell you how they have explained the situation to their child for you to back up if questioned.
Never take it upon yourself to tell a child about a family situation, whether you agree with parental decisions to keep a situation secret from their child or not. The parent's choice must always be respected.
There are, however, ways you can support a child at such times. If you observe a child showing signs of anxiety, stress or turmoil and are aware of the reason, such as illness in the family, you can help by providing:
- role-play opportunities involving hospitals, doctors, nurses, stethoscopes, blood pressure cuffs, syringes (minus needles, of course) and operating theatre masks
- creative materials for making cards, sending letters, etc
- malleable play opportunities to help children get 'stuck in' and 'let off steam'
- books related to illness and going into a hospital.
It is important to respond sensitively to drawings and paintings that may be temporarily repetitive, illustrating the extent of a child's anxiety.
If behaviour changes are causing stress to the child or to others, you may need additional one-to-one time with them, providing them with a 'safe base'. Children soon become unsettled and lose confidence if their home security is disrupted.
If a child is going to the dentist for the first time, we tend to read them a dentist story. Similarly, if they are going to be having a new baby or moving house, we do likewise. This is what When Granny Lost Her Hair is all about.
Early years settings may find it a useful addition to their book corner, to be read in much the same way as any other health-related story. Other settings may wish to keep copies to loan to parents at a time when they are faced with cancer in their family, as a very practical way of giving support to a family.
My hope for this book is that it will help young children everywhere to feel less alarmed by the whole experience. Most of the profits will be going to cancer research and patient support, enabling me to give something back to a system that saved my life. TO BUY A COPY
Copies of When Granny Lost Her Hair are available from bookshops (ISBN 978-0-9560129-0-6, priced £6.99) or direct from author Sandy Green (£4.50 plus £1.50 p&p). To order, send a cheque for £6, together with your name and delivery address, to Sandy Green, 5 Minerva Gardens, Southdown, Bath BA2 1JP, or download an order form at www.sandy-green.com.