Lots of everyday illnesses can make you feel like staying home. The flu, a stomach virus, even a bad cold can make you want to stay in bed and pull the covers up over your head. Not only can these sicknesses make you feel lousy, but they're also contagious. Staying home when you have them not only lets you get the rest you need but also helps prevent other people from getting sick.

But when a person has a more serious illness, like cancer, it's a different story. Kids with cancer may have to stay home — not because their cancer can spread to other people (it can't), but because it can be dangerous if other people's germs spread to them.

Ordinarily, a healthy kid's body can handle germs just fine, especially with regular hand washing. But when a kid has cancer, the disease itself and the treatments used to fight it can weaken the body's immune system (the system that fights illnesses and infections). Even a simple cold can last an extra-long time in a kid with cancer and make him or her way sicker than usual.

To protect themselves, kids with cancer often have to stay home until their immune system gets strong again. But being stuck at home can certainly seem like a raw deal. Missing out on school, time with friends, and fun family outings — even for a while — can leave you feeling angry, sad, left out, and even jealous of siblings and friends.

The good news is that for many kids with cancer, having to stay home is only a temporary setback. Once the immune system recovers, they should be able to get back in the swing of things.

Until that happens, we've got some advice on making the best of a not-so-great situation.

What Is Neutropenia?

If a kid has cancer and has to stay home, chances are it's because he or she has a condition called neutropenia (say: new-troh-pee-nee-ah). Neutropenia is when the body has very low levels of certain white blood cells called neutrophils (say: new-troh-fills), which are the body's main defense against illness and infection.

When a germ enters the body, a healthy immune system springs into action, sending an army of neutrophils to the area to attack. Even more amazing, the next time those same germs enter the body, the neutrophils will "remember" them and try to head them off before they can cause any serious trouble.

When a person has cancer, though, fewer neutrophils are on hand to protect the body. With fewer neutrophils, a kid who has cancer is more likely to get infections. But what happens to the neutrophils? In some cases, the cancer itself damages the bone marrow, the spongy material inside the bones where all new blood cells — including neutrophils — are made. (This is especially common with cancers like leukemia and lymphoma.)

Other times it may be the cancer treatments doing the damage. Both chemotherapy (or chemo, powerful cancer-fighting medicine) and radiation (high-energy X-rays) work by killing the fastest-growing cells in the body — both bad and good. Since blood cells are among the quickest growing cells in the body, they often get accidentally destroyed along with cancer cells.

How Doctors Check for Neutropenia

Doctors use a blood test called an absolute neutrophil count (ANC) to judge how careful kids with cancer should be about avoiding germs. Sometimes they can also give special medications to encourage a kid's body to produce more neutrophils. But often it's safest just to remain home for a while. The doctor will decide how long.

Places like schools, malls, and even church, where people are close together and germs spread easily, are just too risky. To your immune system, it would feel like standing at the edge of a forest fire with only a water gun for defense.

Making the Best of It

So what can a kid do to make the best of all that time at home? Plenty — though it may depend on how he or she feels. Some days, cancer treatments can make a person feel tired and worn out. Other days, a kid might have more energy.

When that energy strikes, here are some ideas for beating boredom at home:

Stay connected. With all the ways to keep in touch these days — texting, IM, Skype, and more — it's easy to stay in the loop with friends and family. Kids can chat, send photos, or make up funny quizzes for friends to take and return to them. If the doctor says it's OK, a friend may be able to come for a sleep-over.

Get creative. Art is a great way to express feelings, so a kid can paint, draw, or make a scrapbook or a collage of favorite photos. Maybe a parent will join in a larger project, like building a model or making clothing or jewelry. Keeping a journal is a great way to keep track of experiences. Later, it can be a helpful reminder of how far the person has come.

Redecorate. With help from mom or dad, try a room makeover. It's a good time for a kid to turn his or her room into a totally cool and comfy space that's full of personality. Some ideas include painting the walls a happy color or turning a bed into a funky sofa with lots of cozy pillows. Final touches might be hanging new posters and creating a spot for favorite music, books, and photos.

Get outside. Even when a crowded place is off-limits, fresh air usually isn't. A kid can sit on the porch or in the yard and read a book or listen to music. Art projects can be taken outside. (But sunscreen and a hat are important because chemo can make skin more likely to burn.)

Keep up with schoolwork. Keeping up with school — normally not cause for excitement — can be a good way for kids to keep some of their normal routine.

Find ways to feel strong. What makes someone feel strong? It depends on the kid, but here are some ideas for kids dealing with cancer:

• Coordinate a fundraiser for cancer research or something else, such as animals, the environment, school.
• With a parent's help, set up a website or a blog.
• Join an in-person or online cancer support group.
• Make a list of stuff you want to do when you're feeling better. Thinking beyond the here and now can help make the time go faster and keep spirits positive.
• Read inspiring stories about survivors, like this one: Shanon's Story.

Reviewed by: Christopher N. Frantz, MD
Date reviewed: August 2011