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
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
- 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.
The voice of experience
Jennifer Cobb is not only married to a former MD Anderson patient, but also has four children under the age of 10, one of whom is a pediatric patient at MD Anderson Children's Cancer Hospital.
"As much as you can level with kids that age, we tried to explain that their father had cancer and would need surgery. They didn't understand what cancer or surgery was, so we had to explain all of that as best we could," she says.
In December 2011, when Julia was diagnosed with Ewing's Sarcoma, things were a little easier to take in.
"By the time Julia was diagnosed, we had already been dealing with cancer in our family, so it was no longer some unknown, scary monster. Out of everything we have been through, having to tell our 7 year old that she had cancer was definitely the most heart breaking. But, fortunately, our children were a little older and understood the idea of cancer and saw their daddy get better. I think in some way, since we had already faced cancer, we were more prepared, making it a little easier to deal with Julia's diagnosis and understand what was going on. As we go through treatment, we keep an open discussion and a 100% honesty policy so that everyone understands what is going on," says Cobb.
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.
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.