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Considering the needs of pediatric cancer patients' siblings

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By Morgan Henry, Department of Social Work

When a child is diagnosed with cancer, the whole family is affected. Understandably, parents and caregivers tend to focus on the pediatric patient while their other siblings may be unintentionally overlooked. 

Siblings and their interactions contribute to the family's overall function and it's important to consider their needs throughout the cancer experience. 

Challenges siblings face

Siblings of pediatric patients can experience a range of intense emotions including, but not limited to:

  • Feelings of burden as they assume greater responsibilities and chores at home
  • Conflict about having their own needs
  • Fear of upsetting parents with worries related to cancer
  • Feelings of isolation/exclusion
  • Loss of companionship with their sibling, the pediatric patient
These feelings can be complicated by the constant changes and disruptions families face when a child is diagnosed with cancer. Often siblings feel they receive less attention and have fewer interactions with their parents during the cancer journey. 

These children tend to spend less time with both parents and more time with parental substitutes such as grandparents, family friends and neighbors, which may lead to a breakdown of familiar family dynamics and roles. 

What can be done to help siblings?


While all of these feelings and challenges are common among families facing a pediatric cancer, there are many approaches you can take to address the complex emotional needs of these children.

  • Communicate and provide information: Family communication is one of the most important factors in siblings' adaptation to cancer. Providing children with honest, age appropriate and accurate information can help siblings master change and incorporate it into their new view of the family. 
  • Involve siblings: Actively involving siblings in the pediatric patient's treatment process is important because it helps to maintain the connection between the siblings and increases the sense of family. Involving siblings familiarizes them with the hospital environment, while demystifying the cancer experience.
  • Set aside special time: Since parents understandably tend to focus on the pediatric patient during treatment, setting aside special time for parents and the other children only can be very meaningful. Even if parents spend just an hour of one-on-one time with each sibling, it can alleviate feelings of exclusion and preferential treatment.

  • Allow siblings to express themselves: Giving siblings the opportunity to tell their stories of the cancer experience through talking, art and journaling can ease many difficult feelings. These activities may also allow siblings to assign meaning to the illness, which can be very relieving to them.

  • Maintain sense of normalcy: Recognizing and maintaining consistent roles within the family (parents remain parents, children remain children) can help promote a sense of normalcy during what can often be a chaotic time. Evaluating and shifting priorities may be necessary, but a new normal can be established. It's also important to encourage siblings to maintain their interests, activities and school throughout the cancer experience.

  • Seek support: Establishing a social support system for siblings is vital. Arranging for them to spend time with friends and other family members less directly involved in the patient's care can be extremely comforting.

Do siblings only experience the negative aspects of cancer?


Research shows that siblings of pediatric patients can demonstrate positive changes throughout the cancer experience as they undergo personal growth and gain greater independence. Siblings tend to have increased empathy for and desire to help others. They also benefit from closer relationships with family members that happen as a result of cancer.

Where can siblings find help?

If you or your children need additional support, MD Anderson's Department of Social Work consists of licensed social work counselors who can help provide counseling, guidance and support, as well as discuss available community resources. Please call 713-792-6195 if you would like to speak with a social work counselor. 

MD Anderson's Child Life program offers sibling support through education and activities.

SuperSibs! is a national nonprofit organization ensuring that siblings of children with cancer are supported, honored and recognized to help them redefine the cancer experience to face the future with strength, courage and hope. To refer a sibling, call 847-462-4SIB (4742) or visit the website at www.supersibs.org.

Watch a video about SuperSibs.

References
Wilkins, K. and Woodgate, R. (2005). A review of qualitative research on the childhood cancer experience from the perspective of siblings: A need to give them a voice. Journal of Pediatric Oncology Nursing.

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