If your child is diagnosed with cancer, it may feel as though you went to bed one
night and woke up in an alternate universe. Suddenly there are all these new words
— oncology, chemotherapy, radiation — not to mention a slew of new fears
Now the doctor is saying your child's immune system isn't strong enough for him
or her to go to school or even visit family.
If that's the case, chances are it's because your child has developed a condition
called neutropenia. Neutropenia is when the body has very low levels
of certain white blood cells (called neutrophils), the body's main defense against
Cancer and its treatment also may cause other problems with the immune system,
making it important to avoid crowds of people who could expose your child to viruses.
A Weakened Immune System
When a germ enters the body, a healthy immune system springs into action, sending
an army of neutrophils to the area to attack. The next time those same germs enter
the body, the immune system will "remember" them and try to head them off before they
can cause any serious trouble.
Someone with cancer, though, often has fewer neutrophils patrolling the body. In
some cases, that's because 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 themselves that are doing the damage.
(powerful cancer-fighting drugs) and radiation
(high-energy X-rays) work by killing the fastest-growing cells in the body —
both bad and good. That means that while cancer cells are destroyed, so too are healthy
blood cells, like neutrophils.
Risk of Illness
With fewer neutrophils, a person is more prone to infection. Even things the body
would normally be able to fight off without much trouble, like skin infections or
ear infections, become much more serious and long-lasting when someone is in a "neutropenic
That's why it's important to call the doctor right away if your child has a fever,
shaking or chills, or any mouth or skin sores, which can be signs of infection.
Fortunately, doctors can use a blood test called an absolute neutrophil count (ANC)
to judge how cautious someone needs to be about avoiding germs:
When the neutrophil count is below 1,000 cells per microliter of blood, the risk
of infection increases somewhat.
When it falls below 500 cells per microliter, the risk increases quite a bit more.
If it stays below 100 for many days, the risk of serious infection becomes very
Sometimes, medicines called growth factors can be given to encourage the body to
produce more neutrophils. But often it's safest for a child to remain home for a length
of time determined by the doctor. Places like schools, locker rooms, malls, and even
churches — where people are close together and germs spread easily — are
just too risky. To a child's weakened 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
Being stuck at home can be tough on anyone. When things feel out of control, most
people — and especially kids — count on the routines of daily life to
help maintain some sense of normalcy. It's only natural that losing that, even temporarily,
can leave your child feeling angry, frustrated, left out, depressed, punished, and
even jealous of siblings and friends.
So what can you do to help your child make the best of the time at home?
Plenty — though it may depend on how your child feels. Some days the cancer
treatments will wipe your child out, and all he or she will want to do is sleep. Other
days your child will have more energy.
Follow your child's lead, and when he or she seems up for it, here are some ideas
for beating the boredom:
Help Your Child Stay Connected
Even if you cracked down on screen time before your child got sick, now's
a good time to consider easing up. Allowing access to the Internet, texting, online
messaging, photo sharing, Skype, and online games with friends is more than just a
perk — it's a valuable way for your child to stay within his or her social network.
Ask the doctor or nurse if a friend can come over. In some cases, if the doctor
says it's OK, your child might be able to have a friend over for a brief visit or
a movie night. If so, a little prep work on both sides can make the evening go smoothly.
First, make sure the friend knows that your child's cancer, and related neutropenia,
isn't contagious — otherwise he or she may be reluctant to come. More important
for your child's safety, reschedule get-togethers if there's any question about whether
the visitor is sick, even if it's just a cold. And finally, always have everyone who
comes in contact with your child wash
Even though it may hurt to talk about this, let your child know that some friends
may deal with his or her illness better than others. Remind your child to try not
to take it personally if some friends don't know what to say, or if they talk about
things that your child missed out on. The good news is that there will usually be
a few true friends who will know how to treat your child like the same person he or
she has always been.
What are some things your child never gets a chance to do? Maybe your daughter
is an athlete who's always wondered if she has an artistic side; or your son is a
computer whiz who's always enjoyed creative writing.
Now's the time to explore those other sides of your child's personality. Painting,
drawing, building models, designing clothes or jewelry, learning an instrument, or
making a scrapbook or collage of favorite photos are all great ways to get those creative
juices flowing. Writing poetry or keeping journals or a blog can help your child deal
with difficult emotions — and rereading them when your child feels better will
be a reminder of how far he or she has come.
Approve a Room Makeover
With a little help from you, your child's bedroom can become the coolest and comfiest
space ever. Maybe you can turn a corner into a lounge, or the bed into a funky sofa
with fluffy pillows or a reading pillow with arms. Choose colors that make your child
feel good and be sure to keep favorite music, books, and photos nearby to really make
Even when public places are off limits, fresh air usually isn't. So encourage your
child to sit on the porch or in the yard and read, talk on the phone, or listen to
Help Your Child Feel Empowered
One of the best ways for anyone to feel stronger is to do something good —
maybe your child can coordinate a fundraiser for a favorite charity, whether it has
to do with cancer or another special cause, like animals or the environment. Maybe
he or she could start a blog about dealing with cancer that can help other kids in
the same position.
Or maybe your child can make a list of things to look forward to when this experience
is over. Getting your child to think beyond the here and now can make the time go
faster and help everyone stay positive.
Talk It Out
Feelings and worries can become overwhelming when they're held in, so find a way
to help your child let them out. A good place to start is with your hospital's social
worker, who can put your family in touch with others who've been where you are now.
Or check out some of the many cancer support websites, most with chat areas or
message boards, that make it easy to share what your family is going through with
others who understand.
Try to Keep Up With Schoolwork
And last but not least, encourage your child to stay on top of schoolwork as much
as possible. Keep in touch with teachers to find ways to stay involved in classroom
life and modify assignments, when necessary.
Staying home may be hard on kids at first, especially if a child was always on
the go. The good news for many kids with cancer is that having to stay home is only
a temporary setback. Once the immune system recovers, your child should be able to
get back in the swing of things.
In the meantime, keep your child's spirits up, look toward the future, and have
confidence that, even though things seem difficult now, your child will get through
it with help from loved ones.