One of the recommendations of the Cambridge Primary Review (CPR), contained in its final report, was for health education to become a mandatory component of the primary curriculum in England for the first time. Drawing on extensive, well-documented evidence, the Review concluded that there is an urgent need to introduce a domain within the curriculum focusing on physical and emotional health. It noted (page 93): ‘Health concerns which once focused on infectious diseases, malnutrition and inadequate hygiene now revolve around obesity, diet, lack of exercise, and the increased risk of heart disease, diabetes, cancer and liver disease in adulthood’.

We are constantly reminded of these modern ‘epidemics’. Dire warnings about rising childhood obesity levels, for example, continue to make headlines on an almost daily basis. A timely warning came from the Teenage Cancer Trust last week, as schools head to the summer holidays, when it reported that young people risk developing skin melanomas in later life because they believe that sun cream is unnecessary in a country which enjoys so little sunshine. If, as CPR warns, many children’s health is at risk as a result of lifestyle choices and misinformation, then it is essential that they are educated to make better informed and more sensible decisions, and they learn to recognise symptoms, psychological problems and physical changes that require medical attention or therapeutic intervention.

According to Cancer Research UK, cancer is likely to affect one in two people in the UK at some point in their lives and yet it is estimated that cancer occurrence could be reduced by up to 40 per cent by lifestyle changes. Clearly, the earlier children are encouraged to make lifestyle changes that enable them to prevent cancer developing, the greater the chance that they will avoid this health problem blighting their future lives. Similarly, early diagnosis depends on being able to recognise changes in the body that necessitate medical investigation so children and adults should be alerted to these warning signs.

But talking about such a sensitive and potentially frightening subject in the classroom is no easy task. Children may be worrying about a family member, or even a cherished pet, who is suffering from cancer or who has died of the disease, and some may even be under treatment themselves. How should teachers approach this important but challenging health topic? Should we talk about cancer in the primary classroom? Within CPRT’s Eastern Regional Network we believe the answer to this question is an emphatic ‘Yes’. Children need to learn about cancer in a sensitive, balanced and well-informed way, and given the right advice and training, schools and teachers can play a vital role in protecting children’s health and well-being.

CPRT’s Eastern Regional Network has been looking at these issues in collaboration with the Teenage Cancer Trust in a pilot scheme called Cancer Education for Children, Teachers and Students (CANECTS). CANECTS aims to equip initial teacher education students with the skills they need for talking about cancer in the primary classroom.

There are two facets to the CANECTS scheme: one focuses on developing teachers’ skills for responding to the challenges, questions and situations relating to cancer that can arise in primary schools; the other explores ways of communicating healthy messages to young children which support cancer prevention and early diagnosis. The scheme introduces ways of helping a child and family with a recent diagnosis of cancer and offers advice on responding to children who are facing bereavement: and the scheme also focuses on teaching about cancer in an age-appropriate, sensitive way as part of the CPR curriculum’s domain on physical and emotional health.

The pilot CANECTS scheme is the brainchild of former primary head, Carol Bordoli, who originally approached Teenage Cancer trust for advice and support in her own school which had a pupil with a recent diagnosis of cancer. Unsure of how to help this child and his family, or how to answer questions being asked by other children, Carol contacted Susie Rice, Head of Education and Awareness, at the Teenage Cancer Trust. Susie’s expertise proved invaluable to Carol and her staff, and providing this training and support in a primary school context led Susie to look at ways of extending the Teenage Cancer Trust’s work with younger age groups.

As a result of this experience, Carol and Susie approached CPRT’s Eastern Regional Network with the idea of sharing their expertise with initial teacher trainees as part of the Early Years and Primary PGCE programme at Cambridge University. The CANECTS scheme’s first year has been run with the support of Penny Coltman, CPRT Eastern Regional co-ordinator, and Julia Flutter. Two presentations introduced The Teenage Cancer Trust’s work and offered a basic foundation for talking about cancer with young children, and these sessions were followed by a short series of lunchtime workshops for students who were interested in developing their skills further. These workshops provided guidance on talking about grief and bereavement, modelled good practice in teaching young children about cancer and healthy lifestyle choices, and introduced educational materials and resources on cancer for use in the primary classroom.

During the CANECTS sessions, two trainees gave moving accounts of their own experiences of being diagnosed with cancer whilst they were at primary school and their stories illustrated vividly how schools and teachers struggle to respond to these challenging situations.

The evaluation carried out at the end of the pilot year has shown that students felt the CANECTS training was worthwhile, with all students reporting that the project had increased their knowledge and understanding of cancer education and enabled them to develop an effective pedagogy for talking with children about cancer. Here are some students’ thoughts on taking part in the CANECTS scheme:

• I feel more confident in talking about cancer with pupils now. I see the importance of de-mystifying some aspects of cancer so that children are comfortable asking questions and becoming more aware. I can also see myself using the practical activity to demonstrate what cancer is with classes as a teacher. Thank you for organising a great series of workshops.
• I will carry this knowledge with me throughout my career. Of most value is the knowledge gained of where to seek help or resources if needed.
• It has given me really practical ways which I can use to introduce cancer to children of different ages. I feel much more confident to be able to talk about cancer, without fearing I don’t know enough about it as I did before.

What next for the CANECTS scheme?

CPRT’s Eastern Regional Network will be continuing to offer CANECTS workshops for teacher trainees next year and will be increasing the number of sessions to cope with the high demand from students interested in attending the workshops. To find out more about the CANECTS scheme for ITE students, please contact Julia Flutter and for further information on The Teenage Cancer Trust please see the Trust’s website.

We would also like to hear about any initiatives and resources which you have come across that are focusing on health education issues in the primary classroom. Please let us know about your experiences and share your thoughts on how to ensure that schools teach children how to stay physically and emotionally healthy throughout their lives – it is probably one of the most important lessons we can teach them.

Other resources (there are many resources available online and through health organisations – these are just a few examples which may be helpful and offer signposting to other educational resources and support services)

Cancer Research UK SunSmart Policy for Preschools and Nurseries, and for Primary Schools and Primary School Teachers’ Notes

Royal Marsden Hospital booklet, Pupils with Cancer: a Guide for Teachers, written by Bette Petersen Broyd, Professor Kathy Pritchard Jones, and Dr Lesley Edwards

Macmillan Cancer Support, website with information about supporting children with cancer

CLIC Sargent, booklet, No Child with Cancer Left Out: the impact of cancer on children’s primary school education

Childhood Bereavement Network offers resources for supporting children experiencing grief and bereavement

This blog was co-written with Carol Bordoli and Susie Rice.