Supporting Siblings of Children with Cancer

A sudden change in roles and routines with a child’s cancer diagnosis can deeply affect the child’s siblings. Feelings of sadness, anxiety, anger, and guilt are common and normal. If these feelings aren’t acknowledged and addressed, they can lead to negative thoughts and behaviors. Having strong social support is very important for siblings.

Some common stressors for siblings might be:

• Less attention from parents
• Not being able to see or talk to their sibling everyday
• Not getting to hang out with friends or do activities as much
• Added responsibilities

What parents can do to support siblings

Be honest with siblings about what’s going on and explain things in a way each child understands. Not every child will understand why parents or caregivers have to spend so much time away.

You might not be able to change the fact that you need to be with your sick child for treatments, appointments, and everything else. But you can provide siblings of sick kids with reassurance and comfort.

Some things that can help kids are:

• Acknowledge the situation. Try saying something like, “I know that this is really hard for you. I know that we aren’t spending as much time together as I would like. But I want you to know how much I love you and miss you when I’m away.”
• Talk about the cancer. If they can understand, explain in simple words what cancer their sibling has and what that means. Tell them they can ask questions. Reassure them that they can’t catch it and they didn’t cause it.
• Encourage them to talk to someone if they’re struggling. Some siblings might not say anything because they feel guilty or selfish when they know their sibling is sick. Remind them often that they can talk to you (or another trusted adult) and that you want to know when they’re sad or upset so you can get through it together. Reassure them that feeling this way is normal and not selfish.
• Make special plans. If you’re able to, take the sibling to dinner or somewhere fun where you can give them your full attention.
• Visits and phone calls. Bring the sibling to the hospital to visit. Introduce them to the cancer care team. Show them around. Make them feel like they’re an important part of this experience, too.
• Share with other adults in their life. Tell your child’s school or daycare as much as you feel comfortable with. Even if it’s just that they might need a little extra attention or they’re having a tough time.
• Keep a routine. If you’re able to, let people help keep their routine as normal as possible by taking them to their usual activities like sports practice or visiting a friend’s house.
• Reach out for help. Ask the cancer care team if they know of resources or support for siblings of kids with cancer.

See Helping Your Child Adjust to a Cancer Diagnosis to learn more about talking to kids about cancer and cancer treatment.

Infants and very young children (0-2 years)

• Keep them close if possible or use video calls.
• Record stories and messages for them.
• Reassure them you’ll be back soon.
• Cuddle and hug them a lot.

Toddlers and preschoolers (3-5 years)

• Tell them simply that their sibling is sick, and doctors are helping.
• Keep their routines and rules the same.
• Remember they might act younger when stressed (such as having tantrums or having accidents even if they’re potty-trained).
• Reassure them they didn’t cause the cancer.
• Give simple and honest reasons if your child asks why you’re crying or sad. You can just say something like, "I am crying because I am sad."

School-age children (6-12 years)

• Consider programs or camps for siblings.
• Answer their questions honestly, with help if needed.
• Reassure them they didn’t cause the cancer.
• Encourage them to have fun and not feel guilty.
• Suggest siblings write, call, or send drawings, pictures, text messages, emails, or voice messages to their sibling.
• When possible, let the sibling help choose where to go after school and have a voice in who cares for them when a parent can’t be there.

Teenagers (13-18 years)

• Let them ask questions to the cancer care team.
• Ask if there’s a support group for siblings.
• Talk about any spiritual worries.
• Encourage them to stay active in school and other activities.
• Ask them to help at home, but don’t overload them.
• Watch for any changes and ask for help if needed.