Brain cancer has left Tayden Ybarra, 16, legally blind in her left eye, says her mother, Tammy Ybarra. “She doesn’t see side to side, up, down, only like a pinpoint in the front.”
At school, bullies have called Tayden “cross-eyed,” “crazy,” and “retarded” and have pulled her glasses off her face, Tammy says. Tayden, who lives in Katy, Texas, was diagnosed with cancer 10 years ago. When she was younger, a girl mocked her for using a cane when she struggled to walk. Another girl bit her. And the bullying still happens.
“I keep on getting bullied over and over again,” Tayden says. She’s targeted, she says, because “I’m different.”
Children with cancer are more likely to be bullied than students in general, according to a 2019 study published in the Journal of Pediatric Hematology/Oncology Nursing. It showed that overall, 1 in 4 students are bullied compared to 1 in 3 who have cancer.
The latter might be an underestimate, says Rhonda Robert, PhD. She’s a clinical psychologist and section chief for behavioral pediatrics at the University of Texas MD Anderson Cancer Center in Houston.
“I would say they’re twice as likely to be bullied,” Robert says, noting that the same is true for other children with chronic health conditions.
Targeted Because of Appearance
Cancer and its treatments can change children’s appearances. They might lose their hair, gain or lose weight, and develop problems with vision, hearing, or walking. Some need amputations or prosthetics.
Those changes can draw the attention of bullies. The bullying takes many forms:
- Physical (hitting, kicking, spitting, damaging property)
- Verbal (name-calling, threats)
- Relational (social exclusion, spreading rumors, cyberbullying)
It happens in the classroom, on the playground, and online. Families have reported that kids yanked the wig off a child with cancer and mocked and pushed a 12-year-old boy with stage IV brain cancer to the ground when he tried to stand up for himself. A teenager said that a former friend shared her medical information on social media without her consent and that peers at school taunted her as “the bald girl” or “cancer girl.”
This is “pathological” bullying, Robert says. It’s far from good-natured teasing among friends or blurting out something awkward. “With bullying, there’s an intention or purposeful, willful harm,” Robert says. “It’s meant to diminish the sense of self-worth for the target. When the target’s distressed, the bully’s going to ramp it up because it’s what the bully is going for.”
Some bullies have been bullied themselves and perpetuate the abuse. Some feel bad about themselves and want others to feel bad, too. Others have conduct disorder, which has symptoms that include bullying, Robert says.
Out of Sight, Out of Mind
For kids who have been through cancer, the transition back to school can be hard. Some have missed more than a year of school. If they had to be isolated during treatment to help prevent infections while their immune system was weak, that can erode their relationships.
“When they go back to school, a lot of times, they’ve lost their friend group,” says Chawncey Stewart, a pediatric education coordinator with the MD Anderson Cancer Center. “The social part is a big deal.”
Being left out isn’t always malicious, says Angie Hayes, senior program manager for the National Children’s Cancer Society. Often, it’s “out of sight, out of mind,” she says.
While some return to a welcoming school community, others feel shunned and hurt. “One of the biggest forms of bullying is exclusion,” Robert says.
Tayden has felt isolated throughout her school years. “Some people think my cancer is contagious: If they touch me or get by me, they’ll get it somehow.”
‘They Want to Get Back to That Normal Life’
Among younger children, fear drives much of the exclusion, says Kris Frost, a pediatric school coordinator at MD Anderson. “If they’re afraid, they’re going to ignore the child, not let them play with them on the playground.”
During middle school and high school, Tayden found it hard to make friends. She finds strong support and kindred spirits, she says, at Camp Periwinkle, a weeklong overnight camp for children who have been treated at Texas Children’s Cancer Center.
Sometimes, children’s social skills become delayed if they’re away from peers for long periods of time – but they can also mature beyond their years, Hayes notes.
“Children with cancer spend a lot of time with adults during their treatment. It makes it hard to relate to peers when they return to school,” Hayes says. “Imagine fighting for your life and then going back to school and people are obsessed with clothes and hair. They want to get back to that normal life, but they’ve changed.”
Envy can also play a role in bullying. When a child comes back to a warm welcome at school, some bullies might be jealous of the attention, Frost says. When a child with cancer needs special academic accommodations, that can also prompt envy, Hayes says.
“If a child’s appearance has changed with scarring or an amputation, some children lose so much self-esteem that they start to refuse to go to school,” Frost says.
Signs for Parents to Watch For
Children don’t always tell parents that they’re being bullied. Robert advises parents to watch for signs, such as social withdrawal.
Tayden feared that her mother would get involved if she told her about the bullying. Instead, Tammy found out about Tayden’s struggles through her writings in a hospital program.
If parents discover that their child with cancer is being bullied, Robert has this advice:
- First, discuss concerns with school staff to make sure that the child is safe.
- Consider consulting a mental health professional who can help the child to process the events and develop self-help and social skills moving forward. You may want to ask your child’s pediatrician or school guidance counselor for referrals.
- Maintain open communication with the child and keep watching for signs of distress or behavior changes.
Typically, social workers, school liaisons, and hospital psychology departments help with school reentry, school refusal, and mental health issues. MD Anderson has a school reentry program that prepares elementary and middle schools for a child’s return.
Education is key, Frost says. “Especially with these younger kids, we have to make sure that they know that they can’t catch cancer.”
MD Anderson’s pediatric school coordinators bring puppets into classrooms to show children what their classmate with cancer experiences at the hospital. “We have puppets for every diagnosis,” Frost says.
At the elementary school level, the program helps classmates to remember their absent peer through “Monkey in My Chair.” A toy monkey sits in the child’s empty chair, alongside a book and backpack. A small camera and notebook allow classmates, Frost says, “to take pictures of what’s going on in class and give them letters.” The child’s relatives gather the pictures and messages to deliver to the home or hospital.
At the upper-middle school to high school level, MD Anderson can do a slideshow presentation to explain to classmates what the student with cancer experienced during treatment at MD Anderson. That might include hair loss or amputation, Frost says, “so that there might be a little more understanding if they look a little different than when they left.”
‘It’s Just Not Right’
Having been pained by Tayden’s hardships, Tammy wishes for greater kindness and empathy toward children with cancer, she says. “It’s just not right to pick at someone.”
Since Tayden’s cancer has affected her optic nerves, she has feared losing more vision.
“I’m scared and sad about that,” she once wrote during a hospital stay. “I worry about my eyes. I’m afraid to go to school because people will laugh at me and talk about me.”
“One day, I might have a seeing-eye dog. She’d be named Tator Tot. I could take her anywhere. And she’d protect me. She’d be my best friend forever.”