Your teenager’s siblings are also affected by your teenager’s diagnosis and treatment. Siblings experience a wide range of emotions including fear, worry, anger, sadness and confusion. They may also resent the fact that family life now revolves around your teenager with cancer, and they might feel alone, forgotten or like their needs don’t matter anymore.
Your other children might also:
- be confused about cancer and treatment
- fear they too might get cancer, or that cancer is contagious
- fear that their sibling is going to die
- feel guilty that they are healthy
- feel that they somehow caused their sibling to get cancer
- resent not being like other families
- feel jealous of their parents’ and family’s attention toward the child with cancer
- be embarrassed by their sibling’s changed appearance
Let your other children know that these types of feelings are normal. Make time to allow siblings to openly discuss their feelings. Encourage them to talk about their efforts and challenges in adjusting to having a brother or sister with cancer. Depending on the age of your child, they will likely express themselves in different ways. Younger children may express their feelings through play or drawing, or sometimes by acting out. Older children and teenagers may be more comfortable talking about their feelings.
Cancer in the family can certainly have negative effects on siblings; but when they’re supported, the experience can help them build strength as they get older. There are ways to help them cope with their sibling’s cancer. Your teenager’s health-care team, including social workers and psychologists, can be good resources of information and can provide strategies to help support them.
Explaining cancer to your other children
Children benefit from an explanation of what is happening to their sibling in a way that they can understand. It is often helpful to:
- describe possible symptoms, such as hair loss and nausea
- reassure your other children that cancer is not contagious and that no one or nothing they did caused their sibling to get sick
- describe treatments and procedures (possibly with pictures) before they happen
- give them time to ask you questions, even if they can’t think of them right away
Encourage siblings to get involved. Having a sibling with cancer can be a frightening, isolating and lonely time. If appropriate, bring them to the hospital to meet the health-care team, and give them a chance to ask any questions. Seeing what is happening at the hospital can help to dispel any fears or misunderstandings.
Keep some consistency, but have flexibility
When possible, let siblings help make decisions that affect them, such as who will be picking them up from school or where they will be spending the night when you’re away. Try as much as possible to keep schedules consistent. Parents often worry about keeping life normal for siblings; but in reality, life just isn’t normal when a brother or sister has cancer. Allowing a sibling to miss school every once in a while to spend time in the hospital or at home with the family can help the sibling feel more included.
It is important to try and have similar rules and expectations for both your teenager with cancer and their siblings. For example, try to find ways to adapt chores for your teenager with cancer so that they can continue to contribute as a productive member of your home.
Adjusting to siblings’ feelings and actions
Sometimes siblings feel pushed aside. Acknowledge these feelings, and try to balance the time you spend with each of your children, making sure you have regular alone time. Keep privileges and rewards fair, consistent and developmentally appropriate to help reduce resentment.
Sometimes, depending on their age, your other children become more independent during their sibling’s treatment. They need to do more for themselves, make their own decisions and deal with a lot of adult issues. This helps them grow up more quickly. It can be difficult for you to adjust to this when treatment ends and life goes back to 'normal'.
Even when the major threat to their sibling’s life is over, your other children may still struggle to express themselves. During these times, they can really benefit from the opportunity to share how they’re feeling. Depending on their age, this can be through art, play or discussion. Remember that the effects of cancer on a family don’t end after treatment. It is something you will deal with well into the future.
Helping siblings with mental health
Dealing with their sibling’s cancer and the resulting changes in your family can be a major source of stress for your other children. Many children feel sad during their sibling’s illness. This is normal. For some children, the stress and sadness can be overwhelming and can have an impact on how they function day-to-day.
Some signs that your child is struggling include:
- having trouble in school, either academically or behaviourally
- having difficulty sleeping or wanting to sleep all the time
- complaining of unexplained aches and pains
- having temper tantrums or fighting often with you or others
- crying a lot
- overeating or eating very little
- having frightening thoughts
- showing very patterned or ritualized behaviour
- using drugs or alcohol
- being more irritable
- withdrawing from friends and/or family
- showing less interest in activities they used to find fun
- expressing their worries more often
If your child is really struggling or displaying behaviour that you find alarming, bring it up with a member of your child’s cancer team, such as the psychologist or social worker. It is not uncommon for a sibling to develop depression or anxiety. Asking for help in supporting your children shows you care about them and does not mean that you have failed as a parent. A member of your child’s cancer team can connect you with a professional who can help your child deal with their emotions. They may also connect your child with a sibling program in your community or online, or suggest workshops or summer camps where they can meet other children who are living with cancer in their families. Some suggestions for summer camps and sibling programs are included in the list of resources at the end of this session.
Although dealing with a sibling’s cancer can be very challenging for many children, it also offers an opportunity to develop coping skills that will be useful in future life situations. With support, siblings can experience an increase in self-esteem and maturity from confronting this type of crisis.