Young children are egocentric; they feel that the world revolves around them. It is logical to them to feel that since their sister has cancer, they caused it. They may have said in anger, "I hope you get sick and die," and then their sister got sick.
This notion should be dispelled right after diagnosis. Children really need to be told, many times, that cancer just happens, and no one in the family caused it. They need to understand that just because you think something or say something, it doesn't make it happen.
Beyond feeling guilt for causing the cancer, virtually every sibling feels guilt for their normal responses to cancer, such as anger and jealousy. They think, "How can I feel this way about my brother when he's so sick?" Assure them that the many conflicting feelings they are experiencing are normal and expected. As a parent, share some of your conflicting feelings (anger at the behavior of a child on prednisone, guilt about being angry).
Some children even feel guilt for being healthy! They think, "Why should I feel great when she's so frail and sick?"
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