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A sudden change in roles and routines with a child’s cancer can deeply affect the whole family, including 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 support and people they can trust is very important for siblings.

Some common stressors for siblings might be:

• Less attention from parents
• Uncertainty about what is going on with their sibling
• 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 and independence

What parents can do to support siblings

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

You might not be able to change the fact that you need to be with your sick child to care for them. But you can provide siblings with reassurance and comfort.

Be honest and open

• 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.
• 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.”

Help siblings feel included

• Make special plans. Siblings can feel jealous when they’re not able to spend as much time with you. If you’re able, plan individual time with the sibling. You could take them 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.

Keep daily life stable

• Keep a routine. If you’re able to, let family and friends help keep the child’s routine as normal as possible by taking them to their usual activities like sports practice or visiting a friend’s house.
• 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.

Get siblings support

• 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. Remind them 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.
• Reach out for help. Ask the cancer care team if they know of resources or support for siblings of kids with cancer.

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

Supporting siblings by age

Every child responds differently depending on their age. Find tips below based on your child's age.

Knowing when your child needs extra help

It’s normal and OK for kids to struggle with stress. Keeping open and honest communication is one of the most important things you can do for your child’s mental well-being.

Some children might benefit from extra support. Your child may need more support if they:

• Feel sad or cry all the time
• Become very irritable or angry
• Withdraw from family and friends
• Skip school or other activities they used to enjoy
• Are unable to sleep or sleep too much
• Eat a lot more or a lot less than usual

Don’t ignore these signs. Tell your cancer care team about your concerns. Specialists like psychologists or social workers support the whole family through these difficult times and have resources that can help.