How to Help Healthy Children Cope When a Sibling Has Cancer

May 23, 2017
Sonja Hibbs

When a child is diagnosed with cancer, family dynamics will change. Those changes can be extra hard for their siblings. Understanding their viewpoint—and all of the emotions and behaviors that go with it—makes it easier to meet their needs.share on twitter 

And while there may be challenges, at the same time, many children respond to a sibling with cancer with enormous love, care, and support. Parents often see other, positive changes in siblings of a child with cancer, including more empathy and compassion, greater self-esteem, closer relationships with siblings and parents, and greater insight into the things that really matter.

These 3 steps can help you keep your family together during a cancer diagnosis, treatment, and recovery.

1. Recognize emotions that siblings may feel

Brothers and sisters of a child with cancer experience a lot of emotions, many of which are similar to those felt by you and other adults. Age and coping skills affect how a sibling may react. Here are some common feelings:

  • Fear and anxiety. Younger children may fear they caused the cancer somehow or that they might “catch” it. Others worry about what will happen to the family because of the cancer. Or, they may fear that their brother or sister may die.

  • Anger, jealousy, and resentment. Healthy siblings can be angry with their parents for not having as much time for them. They may be angry at the child with cancer for this, too. Siblings may resent that the child doesn't have to do chores or go to school.

  • Feeling alone. Healthy siblings may feel left out, especially if most activities as a family involve the hospital and doctors’ visits. Or, siblings may feel that they’ve lost the friendship of the child with cancer. Siblings may also miss time with friends, if you can’t take them to regular social outings due to the demands of a child’s cancer treatment.

  • Guilt. Often, healthy siblings feel guilty for not being the sick child. They may feel guilty for having bad thoughts or saying mean things to the child or for having any of the common emotions mentioned above.

  • Sadness and grief. Siblings may feel sad for the child with cancer and for their parents. They may feel sad that everything seems to have changed and grieve the loss of a “normal” family life.

2. Understand what behavior to expect from siblings

Children often don't know how to talk about their feelings, so they express them through actions. Every child is different, but common and normal responses from healthy siblings can include:

  • Misbehaving or acting out in negative, attention-seeking ways at home or school

  • Increased anxiety, such as not wanting to leave their parents or to go to school

  • Withdrawing from the family or wanting to be alone

  • Acting younger, such as a preschooler wanting to go back to diapers or an older child using baby language

  • Demanding or entitled behaviors, such as wanting a new toy during every trip to the store

  • Having physical symptoms, such as headaches, stomachaches, or bedwetting

  • Having trouble sleeping and/or bad dreams

  • Being moody and irritable, including temper tantrums, fighting with parents or siblings, or crying a lot

  • Performing worse in school or having a hard time focusing on homework

  • Doing "extra good" deeds to try to take care of the rest of the family

3. Help siblings cope

There’s no way to “fix” every fear or feeling. But now that you know the emotions and behaviors to look for, you can help your children cope with the stress and emotions that a cancer diagnosis brings. Here’s how:

  • Get help at home. Family members, friends, and neighbors often are willing to help out with household chores. Give people who want to help specific tasks, such as yard work or cooking meals, and you can coordinate them using online tools. Then you’ll have more unscheduled time to spend with your family.

  • Be open about cancer. Give healthy siblings age-specific, honest information. Explain that cancer can’t spread to other people and that doctors are doing all they can to help their brother or sister get better. Encourage questions and provide frequent updates, which can help siblings feel less anxious when they have to answer questions from teachers and friends. Read more about talking with your child and talking with your teen about cancer.

  • Reassure them that they’re equally loved. Remind them that if they were sick, you’d be just as focused on helping them get better. Explain that your child’s cancer is nobody’s fault. Let them know how happy you are that they’re healthy.

  • Acknowledge feelings and worries. Reassure them that their feelings—whatever they may be—are normal and okay. Help them express themselves through writing in a journal, artwork, or play. Tell them that you also feel sad, scared, and even angry, and explain how you cope.

  • Spend time with them. When possible, at least 1 parent should spend some time with the healthy children every day. "Family time” isn’t about a big event or outing. It can be simply preparing a meal or watching a favorite show together. If you can't be there physically, talk on the phone or have a video call. Ask about their day and activities that are important to them. Tell them how much you miss them when you can't be there.

  • Let them make decisions. Try to let siblings make choices about things that affect them, such as which friend’s house they’d like to go to.

  • Ask for their help. This lets them feel more involved and less alone. Siblings can choose toys to take to the hospital. Or, allow them to read a book or play cards with their sick brother or sister. Let them know how much you value their help, but don’t overload them with extra chores. Let them know how much you value their help.

  • Help your children keep in touch. Encourage siblings to keep in touch with cards, text messages, or e-mails when your child with cancer is in the hospital. If possible, have them visit the hospital frequently. This can help ease anxiety about what goes on there.   

  • Encourage them to do things they enjoy. This includes continuing afterschool events and spending time with their friends. Tell them it’s still okay for them to have fun.

  • Be consistent. Try to keep consistent schedules, so your children will feel safe in their daily routines. For instance, let them know who’ll pick them up from school or where they’ll eat dinner each night. As much as possible, keep discipline fair and consistent at home. This helps all of your children.

  • Model good behavior. At times of frustration or stress, it’s possible to say things that add to a sibling’s guilt or fear. If this happens, apologize. Explain that it’s a stressful time and you regret what you said.

  • Seek outside help. If your healthy children are struggling despite your efforts, get help from a mental health expert, such as a social worker or child psychologist. Many hospitals have sibling support groups or can recommend counseling for siblings and families.

  • Take care of yourself. One of the best ways to help all of your children is to take care of yourself physically and emotionally. Parenting a child with cancer can be physically and emotionally exhausting. If you find yourself struggling, be sure to reach out to a member of your child’s cancer care team to ask for resources to help.