A cancer diagnosis for a child or young person can bring sudden and unexpected changes to family life. Everyday routines will shift while attention is necessarily focused on treatment and care. Parents may spend more time in hospital, while other trusted adults take on a greater role at home.
This means siblings are adjusting to not only their brother or sister being unwell, but also to a new and uncertain reality. While this can be challenging, siblings can still feel included and held in family life.
How might a sibling feel and respond?
Siblings can respond in many ways. They may feel unsettled, anxious, sad, frustrated, or angry. It’s also common for love and pride to sit alongside more difficult feelings like fear or guilt. They may worry about their own health or that of other family members. At times, siblings may feel on the outside, when time and attention is directed elsewhere. There is no ‘right’ way to feel, and responses will be shaped by their age, relationships, and changes within family life.
School can offer a helpful sense of routine and familiarity, but it can also be a place where some of these changes begin to show. Siblings may find it harder to concentrate, manage friendships, or respond to questions. Some may prefer to keep school separate from what is happening elsewhere.
Many siblings also show remarkable strength and adaptability, and families often share with us how their children care for and look out for one another.
What might help?
Siblings benefit from support to understand what’s happening in ways that match their age and level of understanding. This helps reduce potential misunderstandings and supports them to make sense of treatment. Healthcare professionals, including doctors, nurses, or play specialists, can support this understanding and help siblings feel included.
It’s important to acknowledge how difficult changes in routine and parent availability can be. Small, regular moments of connection, such as a few minutes spent together doing something they enjoy, can help them feel remembered and secure.
Trusted adults can create opportunities for siblings to share thoughts and feelings, while recognising that not all children will want to talk. Some siblings may be highly sensitive to the worry and stress a diagnosis brings and may not always feel able to express their own feelings or needs. Gentle, curious comments, such as “I wonder if this might feel really confusing” can help children feel understood and normalise feelings, without an expectation for them to respond.
Supporting a child through cancer treatment places extraordinary demands on family life. It may not always be possible to meet every need as you might wish, and this does not reflect a lack of care – often, it’s quite the opposite.
Supporting sibling relationships through change
Sibling relationships are often among the earliest and most influential in a child’s life. A sibling can be a first friend and confidant, as well as someone to test boundaries and work through disagreements with.
When one child is diagnosed with cancer, these relationships can change. Time together may be reduced due to hospital stays, and there may be times when their brother or sister feels too tired to interact as they did before. This can feel confusing or upsetting, especially if not well understood.
Younger children may make sense of what’s happening in personal ways and might wonder if they have done something to cause these changes. Older siblings may understand more but still struggle with the emotional impact, including feelings of loss or uncertainty about how to relate to their sibling. Some may hold back through concern, while others take on a more caring role.
It’s important to reassure siblings that there’s no ‘correct’ way to be with their brother or sister, and that their relationship remains important even if it looks or feels different for a while. Supporting small, manageable ways for siblings to stay connected, such as sharing a meal or exchanging messages when apart, can help maintain closeness.
Developing through difficult circumstances
When a child’s diagnosed with cancer, family life can feel like it’s changed overnight and it’s natural to worry about how siblings will be affected. While this can be extremely challenging, many siblings navigate these experiences in ways that build resilience and empathy. They may develop a deeper awareness of others’ feelings and learn ways to offer comfort or support. These strengths can grow alongside the difficulties they face.
What matters most
Supporting a child through cancer treatment places extraordinary demands on family life. It may not always be possible to meet every need as you might wish, and this does not reflect a lack of care – often, it’s quite the opposite.
What it means to be ‘good enough’ will look different in these circumstances. What matters most is that siblings feel safe and held in mind, particularly when things feel difficult or uncertain. Often, small everyday moments, such as a thoughtful gesture or focused attention, offer powerful reassurance that they’re loved and important.
Tips for supporting siblings when family life feels stretched
- Name what’s happening and offer reassurance. You might say “things feel different right now, and it’s okay to feel unsure, we will keep talking and you can ask any questions”
- Prepare them for any changes in their brother or sister’s energy, mood or appearance, using simple explanations or pictures
- Keep at least one predictable routine, such as a weekly walk or movie night, that feels familiar
- Offer small gestures to show they’re thought about, such as preparing their favourite meal, sending video messages, or bringing them back something small from the hospital
- Identify their ‘village’ of trusted people and keep them updated
- Let school staff know what’s happening so they can offer support and flexibility
- Understand that siblings may not always want to talk, while keeping the door open
Younger children might not fully understand their sibling’s diagnosis but are sensitive to changes and disruptions. Try to:
- keep routines consistent where possible
- recognise difficulties separating and other changes in behaviour or sleep as important communications
- use simple, reassuring explanations to prevent misunderstandings
- include them through small roles, such as choosing a toy for their sibling
- use storybooks about a sibling’s illness, written for young children, which can support understanding
- make hospital visits more familiar where possible, by spending some time in a play area or visiting a cafe
Primary school–aged children may understand more but are still developing their sense of fairness and can be particularly sensitive to changes in time and attention in the family. Try to:
- keep them informed in simple terms and prepare them for any changes
- normalise a range of feelings
- create opportunities for expression through play or drawing
Teenagers may be navigating a growing need for independence alongside a heightened sense of responsibility to their family. You could:
- keep communication open and honest
- offer choice in involvement. For example, “Do you want to help?” or “Do you need to take a break today?”
- discuss what they'd like shared with school or college
- give permission to ‘just’ be a teenager and support them to have normal teenage experiences
- stay connected through short messages
From Contact magazine issue 111 | Summer 2026
