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Together is a new resource for anyone affected by pediatric cancer - patients and their parents, family members, and friends.

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Parenting Siblings

Cancer turns the world upside down for brothers and sisters, too.

Siblings of children with cancer need attention and support. They need to know that their parents love them unconditionally and understand their fears and emotions. Parents should encourage siblings to share their feelings and give them ways to express their emotions.

Family members and friends can help. Hospital staff such as child life specialists, social workers, chaplains, and psychologists can provide support as well.

Every child reacts to stress in a different way:

  • Fear
  • Sadness
  • Isolation
  • Jealousy
  • Guilt
  • Embarrassment
  • Confusion
  • Uncertainty
  • Loss of control
Pediatric cancer patient plays with modeling clay in a hospital bed with his sister.

During the time their brother or sister is treated for cancer, siblings should try to keep life as 'normal' as possible.

Explain the unknown

  • Siblings are often scared because they don’t understand this new experience. Be honest and open with your children. If you explain what’s happening, it should lessen fear and confusion. The care team at your pediatric center can help with talking to children.
  • Provide an age-appropriate description of cancer.
  • Clear up commonly held misconceptions. For example, many kids wrongly think cancer is contagious. Some may have heard that people always die when they have cancer when, in fact, most children (80 percent) survive.

Keep life as ‘normal’ as possible

Siblings should try to keep up with everyday routines to so life can be as predictable and stable as possible. They should:

  • Continue to go to school
  • Continue to participate in extracurricular activities
  • Remain in the family home if there is a caregiver who can stay there with the sibling

Make time for siblings

  • Carve out special one-on-one time. Read a book, take a walk, or do a fun activity together. This special time can give families much-needed stress relief. Even a 10-minute conversation makes a difference.
  • Support siblings’ favorite activities. If you can’t find time, ask friends and family to provide transportation.
  • Siblings may often hear how “strong” or “brave” the child with cancer is. Be sure to verbally recognize the admirable qualities they also display.

Relieve guilt

Some siblings may think they caused their brother or sister to get cancer because of something they thought, said, or did.

Some may feel guilty that they are healthy while their brother or sister isn’t.

Some ideas that can help include:

  • Tell siblings there is nothing anyone can think, say, or do to make someone else get cancer.
  • Allow them to help their brother or sister in different ways. They will feel less powerless.
  • Show siblings it’s OK to have fun even when their brother or sister is sick.

Acknowledge difficult emotions

It’s normal to get angry when a loved one is critically ill. Children can get angry at the cancer itself or at God for letting it happen. They might feel anger at parents’ shifted focus or even towards the sibling for getting sick. Some suggestions to help them:

  • Give children and teens a way to express their anger. Encourage your children to draw a picture or write down their feelings in a letter or a journal.
  • Provide the sibling a safe, physical outlet for emotions.
  • Teach ways to relax such as deep breathing.
  • Explain that walking away is better than lashing out.

Some siblings may imagine that being at the hospital is fun because the patient gets gifts, does not go to school every day, and spends extra time with their parents. They may only see pictures of the ill child smiling and having fun. If so, it is OK to share age-appropriate information about a more typical day, such as waiting for appointments, taking medicine, and having procedures.

Prepare for uncomfortable situations

It’s natural for children to feel uncomfortable when others see their brother or sister sick. People may ask questions about the cancer the siblings don’t know how to answer.

  • Encourage siblings to share what it feels like when someone stares at their brother or sister in public.
  • Watch for signs of bullying or teasing at school. Check in regularly with the sibling’s teachers. Help the child identify a support person they can confide in at school and home.
  • Some siblings may become overwhelmed with adults at school asking about their brother or sister. Consider if you are comfortable with the sibling’s school discussing the diagnosis in a group setting with the sibling present.

Nurture the relationship between siblings

The relationship between siblings is important for everyone’s emotional well-being. Some ideas to nurture it:

  • Find opportunities for them to have fun together — board games, movies, telling jokes, reading, making crafts, or playing video games.
  • If the patient will lose hair because of treatment, siblings can shop for and wear hats and bandannas together if they both choose to. Care providers generally discourage making siblings shave their heads. It can often create misunderstandings about the reason for hair loss such as, “Am I sick too?”
  • A child undergoing treatment tends to get gifts from friends and extended family, which after a long period of time, may lead to feelings of jealousy. Children who are sick often enjoy giving as much as getting. Siblings can brainstorm ways to help others.

Creating these opportunities for communication between the siblings can help them feel connected.

Pediatric cancer patient performs puppet show with his sister

Creating opportunities for connection with siblings can help them feel connected.


  • SuperSibs, a program of Alex’s Lemonade Stand Foundation, offers services, information, camps, and parent toolkits

Reviewed: June 2018