If your child is diagnosed with cancer, it can tip your world upside down, both physically and emotionally. It can be hard to focus on anything else but your child’s wellbeing - and yet you may have to juggle school, work, home and other family responsibilities. It may feel as if you’re being torn in many directions.
Not everyone reading this blog will be the parent – you could be a close family member, a grandparent or teacher. Your focus, understandably, may be on the child having cancer treatment. For periods of time, they will become the centre of everyone’s attention. One or both parents may be absent from home, supporting the child in hospital. All talk at home may temporarily revolve around the child’s health and treatment.
However, if the child has brothers and sisters, they too are facing something new and unknown. Their world may have changed overnight, routines scrambled, and an awareness that something big is happening. School friends can also be affected – with a range of concerns and anxieties. Thankfully, childhood cancers are rare, but this often means limited awareness of what cancer means. If children have heard of cancer, it may be in negative way, adding to their worries.
Emotions
Children, however young they are, can tell when something is not right at home. They may recognise their brother or sister is unwell, even if they don’t understand why. Whatever age they are, they may feel sad, scared, and anxious. Whilst children are able to feel love and empathy towards their sibling – they can also feel intense jealousy and guilt. They may resent the attention their sibling is getting. Younger children may worry that they have somehow caused their brother or sister to become unwell, through their behaviour, play or actions.
It’s not unusual for a healthy sibling to feel sadness and loss for the way life was for the family. They may not be able to see beyond the treatment phase – imagining life may always be like this. They may be scared their sibling will die.
Children, including teenagers, often report feeling lonely, as the focus is on the child with cancer. Life may revolve around appointments, hospital and treatments. Friends may not come around as much in case they give the child on treatment an infection. The healthy siblings can also miss their brother or sister deeply, especially, if the child is in hospital for any length of time.
School friends and classmates may also be affected. They may be fearful that they will develop cancer too, and misinformation can spread around school quickly. If your child is able to attend school during or post treatment, their appearance may be temporarily changed – and school friends may not know how to react. Everyone may be treating the child with cancer differently – pupils can sometimes resent this, seeing it as preferential treatment.
Behaviours
You’ll know your children best, and may soon recognise some behavioural changes, as the family adjusts to the new and challenging situation. Brothers and sisters may bottle up feelings at home, as they can see how upset their parents are. However, it may be at school or at play that they start behaving differently, as a result of the stress they are experiencing. Children are often not very good at explaining how they feel, so show their feelings in other ways.
Things to look out for include:-
- Being withdrawn, quiet and clingy
- Having trouble sleeping, and bad dreams.
- Sometimes the healthy child can develop headaches, tummy aches, and other physical symptoms.
- Not wanting to go to school or leave your side
- Regressing – becoming more childlike – reverting to behaviours such as bed wetting, talking babyishly, and attention seeking.
- Becoming angry for no apparent reason.
- School age siblings may become disruptive in class, crying easily and falling out with classmates.
- School marks may drop, and attention span in class may be reduced.
- Sometimes children can become rebellious and disrespectful – testing boundaries more than usual.
- Children may try to be ‘too good’ – wanting to please their parents, and make the situation better for everyone. They may stop focusing on play and laughter.
What can we do?
Not every child will be affected – some children are emotionally resilient, and may seem to sail through the whole experience. However, it’s normal for children to find things changed and worrying for a while. As a parent, you can’t always protect children from life’s challenges, but here are some suggestions to help the children cope with what is happening:-
- Be open about what is going on. Talk about the cancer within the family. Explain that their brother or sister is unwell, but the doctors are helping to make them feel better. Encourage questions, and give regular updates.
- Involve the nursery/school or college – let the teachers know about your child’s cancer, and that their siblings may show their feelings or behave differently at school. The teachers can help by educating the class about the child’s cancer (with your permission), and support your children and their school friends. They can also report back to you, any concerns or support issues they’ve noticed.
- Prepare the children at home, for any temporary or permanent physical changes they may see in their brother or sister with cancer. Chemotherapy and medication may cause hair loss, and they may be weak and tired.
- Both your child in hospital and those at home will value seeing each other – regular visits, or phone calls, texts, etc. Things feel much scarier if left to the imagination. Seeing hospital as non-scary and familiar can ease present and future anxieties. They may want to draw pictures, send cards or send in a favourite toy.
- I know it’s logical, but if a parent can spend some quality time, each day, with the child/children at home – reading a story, playing a game, it’s reassuring. Assure them, that although you have to take care of the child with cancer, you love them all equally..
- On a similar theme, trying to keep some sort of normality and routine, means that some things still feel safe and familiar. While being naughty or acting up are understandable, and can be acknowledged, boundaries should still be set and maintained.
- You may find you are short tempered, and find yourself snapping and less tolerant. It’s understandable – stress levels may be immense. However, take care to say sorry if you have been impatient, and explain it’s not your children you’re cross with, but the situation.
- Don’t be afraid to ask for help. Family and friends are generally willing to help out, and can help with school runs, babysitting, and trips out, etc.
- Include the children in the ‘ask for help’ – not by overburdening them, but setting little tasks that they can do, to help them feel they’re helping you.
- Encourage play – going out with friends, play dates, having fun as a child. Children (particular older ones) can feel guilty about enjoying themselves – so may need reassurance that it’s OK to laugh and have fun.
- If your child is struggling emotionally, and you’re concerned, do ask for extra support. The specialist hospital should have social workers and counsellors who can help. If you have younger children, the health visitor may be able to arrange extra support. You can also talk with our teams in Maggie’s Centres, about support for you and the family. Maggie’s Cancer Support Specialists can help you talk to your children about cancer and what is happening. You can drop into the Centre to speak to them at any time. Maggie’s also offers one-to-one and family support with a psychologist or Cancer Support Specialist.
- Don’t forget about you – you and the rest of the family may be exhausted and stressed. If the cancer is ongoing and your child is having regular follow ups and treatment, you may be putting your own emotions on the back burner. Your own health can suffer, and that adds more pressure. Take time out, to look after you too.
If you’re the teacher
Teachers have an invaluable part to play in supporting and educating the children in their class affected by cancer. You may be teaching brothers or sisters of a child with cancer. Alternatively, you may have a pupil with cancer, and the rest of your class have questions and are anxious, curious or upset.
Demystifying cancer, and preparing children for any visual and obvious changes, can help them feel connected to their brother/sister or friend in hospital. Encourage the class to keep in touch with the child through letters, messages, artwork etc.
Liaising with the parents of the child with cancer is invaluable. Find what information you can share to support the other children in the class. Children are may exhibit behavioural problems at school rather than at home. You’re also in a good position to notice, and understand if their school work is affected or the children are withdrawn or acting out in the classroom.
There are useful teacher resources from The Royal Marsden Hospital, and Macmillan Cancer Support’s ‘Information for teachers and schools’, as well as in the useful links at the end of my blog.
And finally
Families do get through what life throws at them. It may not always feel like it, when you’re in the midst of things and trying to support your children. Don’t be alone – seek the help and support of others, if you’re concerned. We’re here for you, too – messages and comments are welcome.
Useful links
How to help healthy children cope when a sibling has cancer Cancer.Net
The effect of your child’s cancer on their brothers and sisters Kids Health
Helping siblings of children diagnosed with cancer American Cancer Society
Keeping your family strong WebMD
Supporting siblings of children with blood cancer Leukaemia Care
Keeping your family strong WebMD
Helping brothers and sisters (downloadable booklet) Children’s Cancer and Leukaemia Group
My brother/sister has cancer Teenage Cancer Trust
My friend has cancer Teenage Cancer Trust
When a friend has cancer Kids Health