Children with cancer: positive benefits of camp

Camping Magazine, Nov-Dec, 2002 by Christy Winfree, Richard Williams, Gwynn M. Powell

Since childhood cancer has evolved from an inevitably fatal illness to a life-threatening chronic disease, children with cancer receive many positive benefits by participating in a camp experience. These children can have a variety of limitations, but first and foremost, they are still children-and wan to be treated the same as children without cancer with opportunities to run, play, swim, and enjoy being with other kids.

The most frequent types of pediatric cancer include leukemia; tumors of the central nervous system, sympathetic nervous system, kidneys, and bone; and lymphoma (Bleyer, 1990). I changed the punctuation in this sentence -- before, it read like you could have a "tumor of lymphoma" which according to Webster's does not make sense. Is this change OK? Because of the increase in long-term survival, quality-of-life issues have taken a more prominent role in the comprehensive treatment for childhood cancer. The trend in survivability has led to a shift in psychological emphasis from crisis intervention and confronting death to facilitating and making adjustments to a serious life-threatening chronic disease (Katz, Dolgin, & Varni, 1990).

Chronic illnesses can be devastating to a person at any age. During childhood, it can be especially destructive for the child's psychological growth and development. At a time when most children are deciding which sport to play, pediatric cancer patients have their lives disrupted as they are faced with harsh treatment methods such as chemotherapy and radiation in an attempt to eradicate the cancer from their bodies.

A number of strategies have been used to reduce feelings of anxiety experienced by pediatric cancer patients, including "diversions or activities as means of catharsis" (Goertzel & Goertzel, 1991, p. 538). One relatively new method that has been used to help children cope with their terminal illness has been the development of summer camp programs designed especially to meet their needs.

Children with cancer did not become involved in organized camping until the late 1970s and early 1980s, because it was thought that the danger for the children was too great and not worth the risk of additional pain or injury. However, it has been recognized that the camp experience is very valuable and can have positive impacts on all individuals. According to the Children's Oncology Camping Association (2002), there are currently seventy-six camps that have been established to provide children with cancer a chance to participate in the camp experience but more opportunities are still needed.

Camp Rainbow is just one example of a camp program that has proven to be an effective intervention for children with cancer. By making minor adjustments (see Sidebar on page 30) to programs and providing children with recreational activities, they are able to receive many benefits as well as learn coping skills necessary to face the many issues brought on as a result of their diagnosis and treatment process. Some of the critical issues that the camp experience helps children address are:

* psychological effects of the disease;

* bodily changes;

* how they perceive themselves; and

* coping abilities of parents and siblings.

Psychological Effects as a Result of the Disease

One of the first issues that children with cancer face is how to adjust psychologically and socially to living with this disease. As a result of the progress in medical therapy, the psychological dilemma has been transformed from one of adapting to death to coping with uncertain survival. According to Bruneau (1981), a child with a potentially fatal disease undergoes psychological reactions in four different stages:

1. suspicion of having a serious disease, which leads to a sick child's identification with the staff and is shown as an eagerness to learn about medical terms;

2. aggression that comes from the child revolting against the disease but realizing that there is no use;

3. sinking into depression; and

4. finally, experiencing feelings of grief.

Anxiety is a behavior that is commonly seen in all children with cancer when they are diagnosed with cancer and becomes aware of the seriousness of the disease (Kyngas, Mikkonen, Nouslainen, Rytilahti, Seppanen, Vaattovaara & Jamsa, 2001). Researchers have concluded that children with cancer experience significantly more anxiety related to the seriousness of their illness than children with non-fatal chronic illnesses and that children with cancer experience more anxiety during the progression of the disease and with each clinic visit. Even when children are in remission, they can still experience disease-related anxiety. It is this chronic uncertainty about relapse and survival that poses a significant threat for the child living with cancer. The amount of information children receive determines the level of their anxiety and other psychological effects that they will experience. If children are not told the truth about their disease, their anxiety levels will increase. As a result, they will have unrealisti c fantasies leading to depression, withdrawal, and fear.