When your child is diagnosed with cancer, your family’s world changes overnight. Between doctor appointments, hospital stays and emotional ups and downs, it’s easy to focus all your attention on the child who’s sick. But if you have more than one child, you may also worry about how they're doing as well.
It’s common for siblings to feel left out, confused or scared during this time. They may not understand what’s happening or why things have changed so much at home. While you can’t take away their fears entirely, you can help them feel more secure, seen and supported.
We spoke with Erin Clark, a certified child life specialist with Banner Children’s, about how you can support your child when their brother or sister has cancer.
Understand what they’re going through
Your child may not be the one in the hospital, but they’re going through a lot too. Children often pick up on stress even when no one says anything out loud.
Depending on their age and personality, they may react in different ways:
- Infants and toddlers: They may not understand illness but can sense changes in the home. They may become fussy, clingy or unsettled because their routines are disrupted.
- Preschoolers and young children: “Younger children may act out behaviorally to get attention or regress in skills they have mastered,” Clark said. This could include bedwetting, tantrums or wanting help with tasks they’ve already learned.
- School-age children: Kids in this age group might feel jealous, sad or angry. They may act out at home or struggle in school.
- Teens: Older children may pull away or feel guilty for being healthy. They might hide their feelings to avoid adding more stress.
Talk honestly in age-appropriate ways
It’s natural to wonder how much to share with your child. You may worry that talking about cancer will scare them. But not talking can make things worse. Children tend to imagine things that are often scarier than the truth.
“Caregivers often want to shy away from using the word ‘cancer,’ but it’s important to give it a proper name and explain what it means,” Clark said. “Children usually don’t have a connection with the word, so it becomes what you tell them it is.”
A good first step is to find out what your child already knows or has noticed. Then answer their questions honestly. You don’t have to go into detail unless they ask for it.
Tips by age:
- Preschoolers: Use short, simple words. Keep conversations brief and revisit later. Pretend play with dolls or stuffed animals can help them process.
- School-age kids: Use clear, accurate terms for diagnosis and treatment. Keep explanations simple and revisit as needed.
- Teens: Be open and honest. Share enough for them to feel informed, then let them lead with questions. Conversations during shared activities, like driving, can help teens feel comfortable. Encourage emotional outlets and ongoing conversation.
A child life specialist can help guide you through these conversations and even help facilitate them if needed. They can offer age-appropriate suggestions, tools or visuals to help your child better understand what their sibling is going through.
Keep a routine
Cancer can disrupt normal life in many ways. School, meals, bedtime – everything may feel up in the air.
Children feel safer when they know what to expect. Lack of routine can increase anxiety, so try to keep a normal routine as much as possible:
- Stick to regular mealtimes and bedtimes
- Keep them in school and after-school activities, if you can
- Let them know ahead of time about changes, like hospital visits
“Predictability gives a sense of control,” Clark said. “It helps with their emotional security and reduces anxiety and stress.”
Make time for a one-on-one connection
Your healthy child still needs your attention. Even small amounts of time together can make a big difference.
“Siblings often feel sidelined even when their basic needs are still being met,” Clark said. “Try to set aside time each day to give them your full attention. Let them pick an activity or just talk about their day.”
Here are some ways to connect:
- Read a book together before bed
- Go for a short walk or drive
- Write notes to each other
- Cook or play a board game
Include them when you can
Siblings may feel left out or unsure of their role during a health crisis. Let them be involved in their sibling’s care in age-appropriate ways when appropriate. This can help them feel helpful and connected instead of powerless or excluded.
Some ideas:
- Let them help pack a hospital bag
- Encourage them to make cards or drawings for their sibling
- Bring them to short hospital visits when it feels right
- Talk about ways they can help their sister or brother
Watch for signs they need extra help
It’s normal for siblings to show some emotional changes. But if their behavior shifts dramatically or doesn’t improve over time, they may need more support.
Warning signs include:
- Ongoing sadness or withdrawal
- Trouble sleeping or eating
- Aggressive or disruptive behavior
- Changes in school performance
- Physical complaints like headaches or stomachaches without a clear reason
If you’re concerned, contact your child’s provider, a counselor or a child life specialist. Many hospitals, like Banner Children’s, offer sibling support programs or individual sessions.
Help them express their feelings
Sometimes, children can’t find the words to express their emotions. Giving them other ways to express emotions can be healing.
A few things to try:
- Journaling: Let them write or draw their thoughts.
- Art: Drawing, painting, or crafting can release big feelings.
- Play: Play therapy, or simply pretending with dolls or figures, can reveal emotions.
- Books: Reading stories about illness or strong emotions can spark good conversations.
Use available resources
You don’t have to do this alone. Many organizations and hospital-based programs exist to support the entire family, including siblings.
Your child’s cancer care team and social worker can help connect you with support groups, sibling programs and mental health services.
Here are a few resources that may help:
- Children’s Cancer Network: Arizona-based family support programs
- Leukemia and Lymphoma Society: National resources for families
- Southwest Kids Cancer Foundation: Arizona Camp Sunrise and Camp Sidekicks
- Amanda Hope Rainbow Angels: Parent and sibling support
- Cancer Support Community: Emotional and social support
- Beads of Courage: A beading program for patients and siblings
- SuperSibs: A program specifically for siblings of children with cancer
Takeaway
When your child has cancer, your whole family feels it, including siblings. They may not be sick, but they are deeply affected. With love, honesty and support, you can help them feel secure and valued, even in the middle of uncertainty.
