Siblings of children with cancer often have the greatest difficulties around the time that their brother of sister is first diagnosed. They are upset by their brother’s or sister’s illness, their parents are frequently absent and preoccupied, and they are worried about the future. The usual routines are discarded as they, themselves, may spend hours or days at the hospital with their family. Or, they may find themselves in the care of relatives who may not live in the same neighborhood or town. Attendance at school may be impossible and communication about homework may be non-existent.

While things may not get back to normal, things usually stabilize for your family once a treatment plan is in place. Knowing the plan allows you to make more convenient living arrangements so your other children can return to school. Being in school and having schoolwork to do provides structure and distraction from their worry about their brother or sister.

During the first few weeks following a child’s diagnosis, it is helpful for you, or a designated representative, to talk with all of the schools that children in the family attend. You will want to explain the upheaval in the family during this time and ask that the school possibly relax some rules for your children during the first months. This could include allowing siblings to re-take tests or turn in assignments late. Schools should be encouraged to have open communication with you to help sort out whether tolerance or structure is what the siblings need most. It may also be helpful for you to encourage a teacher or a counselor to give siblings the opportunity to voice their worries, anger, or jealousy that their ill brother or sister is taking up so much of your time and energy.

Siblings, like children with cancer, can respond in many different ways. Some siblings like to be the expert on their brother or sister’s illness and to report on it to their teachers or peers. Others resent being asked how their ill brother or sister is but never how they are. Work with your children and their teachers to decide if the siblings want to share their new information about cancer or hospitals or if they would rather that the teacher answers their classmates’ questions. Depending on age, your different children may give different answers.

Siblings tell us later what a profound impact their brother or sister’s illness had on them, but they are sometimes reluctant to talk much about it at the time and may act as if it is “no big deal.” This may be an effort to avoid feelings about things being out of control — even out of their parents’ control. They may crave normalcy and need to have their own wants and activities share the center of their parents’ attention. Some siblings experience significant suffering during this period, often feeling guilty that they are not sick or that they would rather be with friends than at the hospital. In fact, being with friends, who are usually your child’s confidants, becomes increasingly important as your child ages. Teens may be extremely reluctant to talk with adults about their experiences, but spend hours talking or texting with friends about their worries and about the injustices of life for their brother or sister, and for themselves.

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