An evidence-based investigation into the practices that improve daily well-being for pediatric cancer patients, and a proposal for an institution that addresses each of the outlined practices.
"I was always happy and excited to be at the place where I was getting treatment. But there were a lot of people there who were not having nearly as good a time as I was. That last part has stuck with me throughout my life."
Sander · Burkitt's non-Hodgkin Lymphoma survivor, age 4
Sophomore, Grace Church School, New York City
Survey respondents — including doctors, nurses, non-profit program directors, and volunteers from MSK and Project Sunshine — rated each of these practices on a scale of 1–5 for their contribution to patient happiness. Every single practice scored 4 or above.
Patients are happier when they form genuine bonds with the people around them during treatment. Social support is one of the strongest predictors of emotional resilience in pediatric oncology — research shows children with cancer who experience trusting relationships with staff demonstrate better overall psychological adjustment.[1] During my time in treatment I was lucky enough to have people who really cared about me, and who I really cared about. One of those people was my primary nurse. I was the ring bearer at her wedding several years after I was cured, and this was naturally the first category I thought of when determining where this project would go. If my research confirms anything, it is that connections with caregivers are necessary.
Playful interventions reduce anxiety during medical procedures, improve treatment compliance, and give children a sense of normalcy. Certified Child Life Specialists use play-based approaches that have been shown to improve well-being across chronic illness and long-term hospitalizations.[2] The Play Room at MSK is a great example of this. I have a lot of memories from there.
A 2025 systematic review and meta-analysis of 452 patients across five countries found statistically significant reductions in anxiety and depression among children who received art therapy.[3] Despite this, most hospital art programs rely on philanthropic funding.
Natural light reduces depression, regulates circadian rhythms, and is associated with shorter hospital stays. A comprehensive review by the Center for Health Design found that patients in sun-facing rooms had meaningfully shorter lengths of stay.[4] On the first day of my treatment, when they were doing tests, there was a room with a retractable light and I just remember looking up and thinking "cool." I was interested in whether these spaces could actually be stress-reducing.
Nutritional status directly impacts quality of life, treatment tolerance, and long-term outcomes. Research confirms that malnutrition is prevalent in pediatric cancer patients and adversely affects health-related quality of life.[5] The point is food is such a big part of living happily. Everyone likes food a specific way, and I believe hospital food should maybe be prioritized more.
When families feel supported, patients cope better and are happier. Research from Nemours Children's Health found that when families feel their emotional and social needs are met, their children tend to do better in treatment.[6] During my time in recovery, my parents — but more specifically, my mother — really took on a lot of responsibility for my care, and I think that if more support was offered it would have been beneficial to both of our mental recoveries.
A multisite randomized controlled trial found that parents of children receiving therapy dog visits showed significantly decreased parenting stress. The human-animal bond stimulates oxytocin release and reduces cortisol.[7] However, some studies note limitations in sample size and the need for more research.[8] As someone who really loves animals, when I was developing this question it came from a place of curiosity — because I never had animal therapy.
All seven practices were rated between 4.0 and 5.0 by respondents — signaling a rare level of expert consensus. The more important finding: institutions are not fully delivering on what the evidence demands.
Every respondent — from a doctor at Memorial Sloan Kettering to program directors at Project Sunshine — gave every practice a rating of 3 or above. Most rated them 4 or 5. There is a rare and powerful consensus here.
When asked how well their institution performs these practices, scores were consistently lower than belief scores — particularly for Animal Therapy and Food. This gap is the central argument for action: the evidence is there, but it isn't being fully put into practice.
Respondents from non-profits (Project Sunshine) and hospitals (MSK) showed different patterns. Non-profit professionals rated their institutional performance higher on art and play. This points to a clear division of labor and a clear opportunity for more non-profit involvement.
These findings led to two tailored proposals: one for hospitals seeking to strengthen their internal practices, and one for non-profits looking for evidence-based programs to fund or implement in partnership with hospitals.
Each proposal is for a specific audience but both focus on my original research, peer-reviewed studies, and the belief that every child deserves to be happy during treatment.
A case for implementing and strengthening all seven practices within a hospital's pediatric oncology department including specific recommendations for each.
A partnership proposal identifying where non-profit organizations can fill the gap between what hospitals know works and what they can actually afford to offer — with three partnership models to choose from.
I had Burkitt's non-Hodgkin Lymphoma when I was four, and during treatment, I was always happy and excited to be at the place I was getting treatment. However, there were a lot of people there who were not having nearly as good a time as I was. That last part has stuck with me throughout my life. For this project, I aimed to learn more about how hospitals enhance the daily lives of pediatric cancer patients and how outside organizations contribute to this effort, and I want to see if there is room for improvement in the methods that are employed to help kids feel happier during treatment.
The definition of happiness I used throughout: a genuine interest in offerings, visible contentment, and a subjective sense of well-being. Because happiness during cancer treatment is specific — and it matters more than people may realize.
All seven practices identified in this project are supported by peer-reviewed academic literature. The following sources were consulted in the development of this research and the two formal proposals.