When a child is diagnosed with cancer, it can immediately change the dynamics of a family. There is added pressure put on parents, which often has a big impact on siblings. A sibling may feel they have been forgotten or abandoned because their parents are busy at the hospital or preoccupied with other responsibilities, they may miss out on scheduled activities or be passed around to extended family or friends, and their structure and routine is often greatly disrupted.

The emotional impact of childhood cancer on siblings

Whether a child internalises or expresses their emotions can vary depending on their age or personality. No matter how they choose to cope with their emotions, some they may be feeling include:

Sadness

They may feel sad that everything at home is changing, not being able to spend quality time with both parents. They can feel sad and grieve the loss of the sibling relationship they once had before the cancer diagnosis.

Anger or jealousy

They can feel resentful for not getting their parents’ undivided attention. If siblings don’t know the extent of the situation, they can feel jealous they still have to go to school, do homework and chores, or even extra chores if their sibling with cancer is not there or too unwell to help. They can sometimes become jealous or angry if the sibling with cancer is showered with gifts or doesn’t get in trouble for their naughty behaviour, and they aren’t getting the same special treatment.

Fear or anxiety

They could be worried they might ‘catch’ cancer or be affected by it somehow. The normal family roles may shift due to the unexpected demands of the parent or carer needing to focus their attention on the diagnosed child. A grandparent or family friend may need to step in to help with the day-to-day activities such as driving the children to school or after school activities. Keeping with the routine is an important aspect when trying to lessen the feelings of fear and anxiousness around a cancer diagnosis.

Guilt

Siblings may feel guilty for not being sick and still being able to play and go to school or feel guilty for not being able to help. They could even feel guilty for having bad thoughts about their sibling with cancer.

Isolated

Some may feel excluded due to the many hospital and doctors’ appointments their sibling and parents go to that they don’t or may feel like they’re missing out for not knowing what is going on. A sibling may feel like they have to miss out on things like extra-curricular activities or social outings because no one can take them.

Siblings can react in different ways when feeling stressed or anxious. Some common yet normal responses to stress siblings may demonstrate are:

How you can help

Encouraging the sibling to talk to parents, grandparents, extended family, teachers or friends can help take some of the pressure off their shoulders. They may need to be encouraged to talk to someone about their feelings because they don’t want to burden anyone with their problems or questions.  Talking to an adult they trust about their feelings may provide children and young people a helpful way to take some of the pressure off.

Sometimes young people and children may need a little supportive coaching from adults to understand the underlying feeling. At times, they may stay silent because they don’t want to burden anyone with their problems or questions. If you notice a child needing help with their big feelings, offering time to connect with them may be that little nudge they need from you.  

A few ways you can connect with a sibling of a child with cancer is by:

References

1. Van Dongen-Melman JE, De Groot A, Hählen K, Verhulst FC. Siblings of childhood cancer survivors: how does this “forgotten” group of children adjust after cessation of successful cancer treatment? Eur J Cancer. 1995 Dec;31A(13-14):2277-83. doi: 10.1016/0959-8049(95)00475-0. PMID: 8652256.