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Considering the needs of pediatric cancer patients’siblings

juliaandsiblings.jpgBy Morgan Henry,Department of Social Work

When a child is diagnosed with cancer,the whole family is affected. Understandably,parents and caregivers tend to focus on the pediatric patient while their other siblings may be unintentionally overlooked. 

Siblings and their interactions contribute to the family’s overall function and it’s important to consider their needs throughout the cancer experience. 

Challenges siblings face
Siblings of pediatric patients can experience a range of intense emotions including,but not limited to:

  • Feelings of burden as they assume greater responsibilities and chores at home
  • Conflict about having their own needs
  • Fear of upsetting parents with worries related to cancer
  • Feelings of isolation/exclusion
  • Loss of companionship with their sibling,the pediatric patient

These feelings can be complicated by the constant changes and disruptions families face when a child is diagnosed with cancer. Often siblings feel they receive less attention and have fewer interactions with their parents during the cancer journey. 
These children tend to spend less time with both parents and more time
with parental substitutes such as grandparents,family friends and
neighbors,which may lead to a breakdown of familiar family dynamics and
roles. 

What can be done to help siblings?

While
all of these feelings and challenges are common among families facing a
pediatric cancer,there are many approaches you can take to address the
complex emotional needs of these children.

  • Communicate and provide information:
    Family communication is one of the most important factors in siblings’
    adaptation to cancer. Providing children with honest,age appropriate
    and accurate information can help siblings master change and incorporate
    it into their new view of the family. 
  • Involve siblings: Actively involving siblings in the pediatric patient’s treatment process
    is important because it helps to maintain the connection between the
    siblings and increases the sense of family. Involving siblings
    familiarizes them with the hospital environment,while demystifying the
    cancer experience.
  • Set aside special time:Since parents
    understandably tend to focus on the pediatric patient during treatment,
    setting aside special time for parents and the other children only can
    be very meaningful. Even if parents spend just an hour of one-on-one
    time with each sibling,it can alleviate feelings of exclusion and
    preferential treatment.

  • Allow siblings to express themselves:Giving
    siblings the opportunity to tell their stories of the cancer experience
    through talking,art and journaling can ease many difficult feelings.
    These activities may also allow siblings to assign meaning to the
    illness,which can be very relieving to them.

  • Maintain sense of normalcy:
    Recognizing and maintaining consistent roles within the family (parents
    remain parents,children remain children) can help promote a sense of
    normalcy during what can often be a chaotic time. Evaluating and
    shifting priorities may be necessary,but a new normal can be
    established. It’s also important to encourage siblings to maintain their
    interests,activities and school throughout the cancer experience.

  • Seek support: Establishing a social support system
    for siblings is vital. Arranging for them to spend time with friends
    and other family members less directly involved in the patient’s care
    can be extremely comforting.

The voice of experience
Jennifer Cobb is not only married to a former MD Anderson patient,but also has four children under the age of 10,one of whom is a pediatric patient at MD Anderson Children’s Cancer Hospital.

“As much as you can level with kids that age,we tried to explain that their father had cancer and would need surgery. They didn’t understand what cancer or surgery was,so we had to explain all of that as best we could,”she says.

In December 2011,when Julia was diagnosed with Ewing’s Sarcoma,things were a little easier to take in.
 
“By the time Julia was diagnosed,we had already been dealing with cancer in our family,so it was no longer some unknown,scary monster. Out of everything we have been through,having to tell our 7 year old that she had cancer was definitely the most heart breaking. But,fortunately,our children were a little older and understood the idea of cancer and saw their daddy get better. I think in some way,since we had already faced cancer,we were more prepared,making it a little easier to deal with Julia’s diagnosis and understand what was going on. As we go through treatment,we keep an open discussion and a 100% honesty policy so that everyone understands what is going on,”says Cobb.

Do siblings only experience the negative aspects of cancer?

Research
shows that siblings of pediatric patients can demonstrate positive
changes throughout the cancer experience as they undergo personal growth
and gain greater independence. Siblings tend to have increased empathy
for and desire to help others. They also benefit from closer
relationships with family members that happen as a result of cancer.

Where can siblings find help?

If you or your children need additional support,MD Anderson’s Department of Social Work
consists of licensed social work counselors who can help provide
counseling,guidance and support,as well as discuss available community
resources. Please call 713-792-6195 if you would like to speak with a
social work counselor. 

MD Anderson’s Child Life program offers sibling support through education and activities.

SuperSibs!
is a national nonprofit organization ensuring that siblings of children
with cancer are supported,honored and recognized to help them redefine
the cancer experience to face the future with strength,courage and
hope. To refer a sibling,call 847-462-4SIB (4742) or visit the website
at www.supersibs.org.

Watch a video about SuperSibs.

References
Wilkins,
K. and Woodgate,R. (2005). A review of qualitative research on the
childhood cancer experience from the perspective of siblings:A need to
give them a voice. Journal of Pediatric Oncology Nursing.

Cancerwise | Cancer blog from MD Anderson Cancer Center

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