How to tell siblings that their brother or sister has cancer

• Don’t wait too long.
  • Better to start with brief information that you do know. 
  • Be the one who talks to them before they hear from someone else. 
  • Use age-appropriate, real terminology
    • Name of cancer, part(s) of body it affects, type of treatment that is likely
    • Physical changes that may occur due to cancer/treatment (i.e., nausea, vomiting, hair loss, loss of appetite, mouth sores, tiredness, diarrhea, constipation, skin rashes, etc)
  • It doesn’t have to be a one-time conversation. It can be spread out over several conversations.

(You know your children best... Are they asking questions? Curious to know more? OR Are they 

Withdrawing? Changing the subject? Disengaged from the conversation? 

• Follow their lead. 

It's okay to explain that there are a lot of things you are still learning about and will share as you find out more. 

• Communicate that they are just as loved and important as they were BEFORE their sibling’s diagnosis.
• Be Realistic (Better to be honest about the time and energy that this is going to require from you, than to make promises and have to break them). 
• Communicate that just because there is so much focus on their sibling with cancer, doesn’t mean that there won’t be time for them, it just may look different for a little while.
• What to expect (including changes and unpredictability)
• Cancer is NOT contagious. There’s no need to fear getting cancer just because their sibling has it. 
• They didn’t do anything to cause their sibling to get cancer, nor did their sibling. 

• Keep them informed of new information as it comes 
  • Be truthful about the seriousness of a diagnosis, while also maintaining a realistic sense of hope.
  • Continue open dialogue about coming to you with any questions or concerns they have, or with things they might hear that they are unsure of. Remember, HONESTY builds TRUST.
  • Communicate that this is something you will go through as a family “team.”
  • Recognition of and appreciation for their willingness to embrace unpredictability and change.

• Follow a normal routine as much as possible, but communicate the need for flexibility with that.
• Continue to set limits as you normally would. 
• Communicate expectations to those helping with care.
• Don’t over-promise your time. If something special IS planned, follow-through is critically important.
• Include the siblings 
  • Work together to come up with “plans” for talking to others about the diagnosis, new routines, and schedules. (This reinforces the “Family Team” and validates tha their opinions/feedback matters)
  • Allow siblings to visit the hospital (if permitted), video calls, etc. to foster connections as a “team.”
• Seek Resources
  • Talk with Social Workers, Child Life Specialists, and other staff at the hospital about navigating options.
  • Support groups- some of the best resources are other parents who’ve been through it. 
  • Individual therapy 
  • Search Online- social media support groups specific to child’s type of cancer, geographic region, etc.

• Attention-seeking behavior
• Not wanting to talk about it/ withdrawing
• Showing inconsistent emotions
• Reverting to developmentally younger/past behavior