Helping Siblings of Children with Cancer

Sisters and brothers of children with cancer carry a unique stress. In fact, they feel stress from many directions. They realize their family routine is changing and feel anxiety, guilt, anger and sadness throughout this time. They fear for their sibling, wonder if they did something to contribute to the cancer’s development and even feel lost in the focus on the other child. When one child gains a cancer diagnosis, their siblings often experience problems at school, with social relationships and even at home. Parents can help siblings of the child with cancer by keeping communication open, explaining what is happening, checking in on the children’s feelings, listening to their concerns and ensuring these sisters and brothers continue feeling secure in their position in the family. When one child gains a cancer diagnosis, the siblings need clear information about the disease, treatment and what is happening during this time. Parents need to be honest and open according to what is appropriate for the children’s ages and development stages.

Ways to help your child’s siblings come to terms with the cancer diagnosis include:

• Arranging visits to see your child in the hospital
• Introducing the siblings to your child’s cancer treatment team
• Talking with the treatment team about support groups or services for siblings
• Using appropriate language for your child’s siblings to understand cancer and treatment
• Encouraging open communication with the siblings
• Scheduling daily time between the parent(s) and individual siblings for focus on their needs
• Sharing information about the cancer experience with the siblings’ schools
• Engaging other family members and friends to help maintain normalcy in the household
• Reassuring the siblings of their importance in the family and how their feelings matter

Very young children from infancy to age three benefit from some special care and attention during their sister or brother’s cancer treatment. Important ways of reassuring your young child include:

• Keeping the baby near you when possible
• Asking the treatment team if the young child can spend the night with their sibling in the hospital
• Using phone calls and video to enable your young child to see you and hear you when you must be by your other child’s side
• Recording lullabies, messages and stories for your young child
• Reminding them you love them and will be home soon
• Allowing them to wait to toilet train or achieve major developmental goals after your routine is calm
• Cuddling and hugging often

Help your children ages 3 to 5 cope with their sibling’s cancer in the following ways:

• Giving simple answers to questions about their brother or sister’s illness
• Keeping caregivers informed about the cancer situation
• Maintaining limits and rules just as you did before the diagnosis
• Understanding that children in this age group sometimes act out like younger children, such as in breaking toilet training or having tantrums in response to stress
• Enabling the toddlers to preschoolers to participate in their sibling’s treatment and care
• Giving simple reasons for your own emotions, such as by saying that you cry when you are sad
• Involving a child expert or social worker at the hospital to help reinforce your child’s supportive role and place in the family

Ways to help your school-age child cope with their sister or brother’s cancer include:

• Enrolling them in a support program or sibling camp
• Answering all questions honestly, leaning on support from social workers when needed
• Offering reassurance that no one is to blame for the cancer
• Supporting continued socialization and fun without guilt, despite the sibling’s illness
• Suggesting contact through drawings, pictures, texting, emails or voice messages to their hospitalized sibling
• Reassuring them that sadness or crying are okay, but the family will be fine
• Letting them have some decision-making power in choosing where to go to school or who to have caring for them during the parent’s absence for the sibling’s care

Teens need reassurance and help with coping during a sibling’s cancer, too. They appear more mature and stronger, but do not underestimate their need for love and support during the difficult time. Ways to help them cope include:

• Arranging for them to tour the clinic or hospital and ask questions as needed
• Finding out if the cancer center has an age-appropriate support group for siblings
• Discussing their spiritual concerns related to diagnosis
• Letting them choose where to go to school or how they will be cared for when parents cannot be around
• Providing assurance that the family will work together to handle the difficult time
• Encouraging them to continue enjoying their teen life, school and activities
• Ensuring you do not overload them with too much caregiving, housekeeping and other adult tasks
• Monitoring them closely for signs of new problems, stress or risky behaviors
• Gaining the support of psychologists or social workers as needed