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Support for the Child without Cancer

by Lynne Kaplan, PhD

“Your brother is sick.” “Your sister has cancer.” For a child, these are life-changing words. As the family attends to the needs of the child with cancer, roles and responsibilities change and daily routines are disrupted. Siblings may be pushed to the sidelines, yet they see their parents’ distress and their brother or sister feeling ill. They may worry that their sibling will not survive and may feel alone with those thoughts. Siblings report a range of reactions to having a brother or sister with cancer: worry, fear, jealousy, guilt, abandonment, sadness, and anger, but also increased empathy, compassion, responsibility, self-esteem, maturity, and coping ability. Parents and caregivers can help to support their child without cancer in many ways.

Communication
Be available to listen. This shows that you value your child’s thoughts and feelings. Let your child know that you understand he or she may be worried, angry, or sad. Share some of your feelings, “I’m scared too, but we’ll get through this.” This allows your child to see that it is okay to share scary or painful feelings and makes it easier for him or her to express these feelings to you.

Knowledge
Children’s ideas about cancer and its treatment are often worse than the reality. Explain cancer and its treatment in terms they understand. Encourage them to ask you questions and to ask questions of the oncology team. Be sure they understand that cancer is not contagious and that it is not possible for them, their friends, or family to “catch” the cancer. Be sure they understand that they did not do anything to cause the cancer. Assure them that no other friends or family members did anything to cause the cancer.

Children’s ideas about cancer and its treatment are often worse than the reality.

Maintain Connections
Bring pictures of the healthy siblings and your child with cancer to and from the hospital. Have brothers and sisters make cards, write notes, and record messages or songs. These things help siblings stay connected to one another. Include siblings in decision making when possible. They could make some decisions about chores, or decide how they want to spend time alone with their parents or caregivers. This shows them that they are still important members of the family. Allow siblings to be involved in medical aspects of the cancer experience if they want and when appropriate. Allow siblings to come to the hospital during inpatient stays or clinic visits; encourage them to participate in activities with other siblings or with child life specialists.

Special Support for Siblings
Include the sibling in conversations when people ask about or comment on your child with cancer. If people talk about how brave the child with cancer is, you may comment that your child without cancer is doing a great job of helping out, that he or she is doing well in school or in a sport. Spend time alone with each child. Give lots of hugs and kisses if your child wants them. Recognize accomplishments, such as achievement in school or on an athletic field, and reward them with lots of praise.

Inform teachers that their student has a brother or sister with cancer. You may provide them with information about the disease and common sibling reactions. Stay in contact with them and allow the school to provide extra support as needed. Encourage a close relationship between your child without cancer and a neighbor or other adult that you trust. They can provide care and love, too. Take advantage of workshops, support groups, or camps for siblings. These can be of great value and can provide fun and friendships with others with similar experiences.

Make and keep routines whenever possible. Routines create a sense of normalcy and help children know what to expect. Consistent bedtimes, mealtime routines, and family rules are important. Be patient with your child and remember it is common for siblings to be distressed or develop some behavior problems.

Ask for help from extended family, neighbors, friends, or teachers to provide support for your child without cancer. If siblings continue to struggle, reach out to the medical team or mental health professionals for additional help.

Coping with cancer is tough. With time, love, support, and knowledge, brothers and sisters of children with cancer are better equipped to cope with the ups and downs of the cancer experience.

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