Brothers & Sisters Of A Student Who Has Cancer

Key points about brothers and sisters of a student who has cancer

• brothers and sisters of cancer patients often face difficulties and challenges
• they may experience feelings of guilt, rejection, fear, depression, or anxiety

Challenges experienced by siblings

Brothers and sisters of cancer patients often have a difficult time during their sibling's cancer treatment. Younger children in particular sometimes don't have the ability to articulate their feelings about what is happening. This can cause issues in other areas of their life such as school or friendships.

It is normal for children experiencing a stressful life event like a sibling having cancer to 'act out' or behave differently as they struggle to come to terms with what is happening. This can have an impact on their academic achievement or result in physical symptoms such as stomach pain or headaches.

Below is a list of common reactions that brothers and sisters may experience.

Worrying about their sick sibling

A cancer diagnosis can have a significant effect on the whole family, but brothers and sisters may get information about their sick sibling second or third hand. Sometimes they hear the news from grandparents or other relatives who are caring for them while parents are at the hospital. This can lead to misunderstandings about their sibling's cancer and the treatments. If you think your student may be struggling to understand, it is best to talk with the family.

It is a good idea for someone at your school who has a good relationship with the sibling to check in with them regularly to see how they are doing. Often people ask how the child's sibling is and not how they are.

Feeling sad

A cancer diagnosis in a family is a very stressful event. Children often mirror the level of anxiety shown by other family members, including parents. Classmates may need more information to understand what their friend with a sick sibling is going through. 

There are resources about cancer that may help.

Resources About Cancer

Feeling guilty

Some children will feel that they should have been the one to get sick, or that they somehow caused the illness. If you notice any confusion, encourage your student's family to have an open discussion to clear up any misunderstandings and help them feel less distressed. 

Many siblings carry guilt around for some time. Having negative thoughts about family during tough times is hard to carry and especially hard to talk about. Any opportunity to normalise these feelings will help your student feel heard and supported and reduce the amount of guilt they carry.

Feeling jealous and left out

A child with cancer gets a lot of attention from the family, community and hospital staff. Parents often have to leave other children at home or with friends or relatives while they care for their sick child. A sibling may see treatment days as 'special' outings for the parent and the cancer patient. Teachers and parents can help brothers and sisters by making them feel important too. Often a little extra attention can go a long way.

Feeling angry

As treatment progresses and the child with cancer starts to look and act 'healthy', brothers and sisters can start to resent the continued attention given to them. Parents often complain of behavioural problems with siblings as treatment continues. Frustration and unmet needs often cause anger. Helping children identify what the unmet need is rather than focusing on disciplining behaviour can help teachers and parents develop strategies to pre-empt angry thoughts or behaviour. Discussing appropriate ways of letting go of anger can also be helpful.

Worrying about what is happening at the hospital 

A child not paying attention in class may instead be thinking about their sibling in hospital. On a 'bad' treatment day their sibling with cancer may come home sick, and their parents could be upset. If blood counts are low, there is also a chance their sibling and parent will need to stay in hospital. It is a normal emotional reaction for brothers and sisters to worry about their sibling dying.

Worrying about other whānau members getting cancer

There are still many mistaken beliefs about cancer in the community. Cancer cannot be caught and does not necessarily end in death. In fact, many childhood cancer patients have excellent recoveries. There is also a low likelihood that other whānau members will also have cancer. It is a good idea to encourage children to write down any questions they may have.

Missing parents

Caring for a sick child takes time and energy, whether they are at home or in hospital. Unfortunately, this means that siblings often have to 'make do' until things improve.

For some siblings this can mean stepping up and taking on other roles within the family, or having another caregiver for a period of time. It can also mean missing out on social events or activities if there is no adult available to help.

In some cases, the primary caregiver for the child with cancer will have to give up work resulting in a huge drop in income and financial challenges for the whānau. This can also affect the siblings who may miss out on opportunities or activities because their whānau cannot afford it. Child Cancer Foundation and Canteen Aotearoa offer personal development grants to help siblings with the costs.

Worrying about parents

It is hard to see anyone that you love upset by something that no one can control. Often older brothers and sisters feel the need to support parents during the 'crisis' times. They may also feel lonely because they don't want to worry their parents about their problems. They often feel pressure to be good all the time or to take on much more household responsibility than is usual for their age.

Siblings may feel they have to rely on friends and teachers for support. If your school has a counsellor, talk to them to arrange help.