Grief-related symptoms may persist beyond 6 months after losing a parent or sibling to cancer.Individuals who have lost a parent or sibling to cancer at a young age may experience grief-related symptoms for a prolonged period, with a more pronounced effect after sibling loss, according to a review and meta-analysis.
“Prolonged grief in young individuals following a parent’s or sibling’s death from cancer is an underexplored area in child psychiatry. We found an elevated pooled prevalence (48 percent) of self-reported prolonged grief-related symptoms in young individuals following the loss of a parent or sibling to cancer,” the investigators said.
In the stratified analyses, the pooled prevalence of self-reported prolonged grief-related symptoms—defined as the presence of grief symptoms at least 6 months following the death of a parent or sibling—was 28 percent after a parent’s death and 59 percent after losing a sibling. [J Clin Med 2026;15:1060]
The higher prevalence of sibling bereavement could be due to the unique sibling relationship, which is anticipated to outlast the parent-child relationship, the researchers noted. “Therefore, the loss of a sibling can trigger an intense experience of loss.”
Parents’ inadequate emotional support and discouragement of openly expressing grief could also account for the more pronounced effect of sibling loss. [Afr J AIDS Res 2011;10:15-24] Parents’ emotional unavailability may also stem from their own grief, as they themselves are grieving the loss of a child. [Sch Psychol Q 2018;33:363-371]
Other factors associated with prolonged grief-related symptoms in young individuals are pre-existing depression, insomnia, and pre-existing emotional problems, such as emotional numbness, self-harm tendencies, and conduct issues. [Support Care Cancer 2016;24:3095-3103; Psychooncology 2013;22:683-691]
Depression is associated with behavioural changes, including social isolation and anhedonia, which hamper healthy grief processing. [J Affect Disord Rep 2023;14:100631] Moreover, evidence shows that depression and grief involve similar neurobiological alterations in the amygdala and prefrontal cortex, which are involved in emotional control and processing, the researchers noted. “Hence, pre-existing depression can disrupt these neurological pathways, making young individuals more prone to grief-related emotional stressors.”
For young individuals, the distress may be evident even before the loss, as they might have to witness the progressive decline of their loved ones, possibly for a longer period. [BJPsych Open 2024;10:e207] The situation may also compel them to assume caregiving duties, leaving no room to process their emotions. [Child Dev Perspect 2010;4:55-61] Furthermore, cognitive immaturity may limit their concept of terminal illness or death. [Palliat Support Care 2024;22:213-220; Philos Trans R Soc Lond B Biol Sci 2018;373:20170266]
“This challenging experience can increase their vulnerability to prolonged grief that persists beyond the loss,” the researchers said. “[U]nderstanding prolonged grief-related symptom burden in this population is important to identify risk factors, improve supportive care, and inform developmentally sensitive interventions.”
The review, conducted by researchers from the National University of Singapore, included 13 studies (n=3,231) evaluating prolonged grief-related symptoms in young individuals following a parent’s (eight studies) or sibling’s (five studies) death from cancer. A meta-analysis of five studies was conducted.
Young individuals were defined as those aged ≤25 years before losing a parent or sibling to any cancer. The mean age at the time of study ranged from 12.8 to 27.4 years, and at the time of loss from 12.4 to 25 years.
The researchers noted that the results should be interpreted with caution, given the substantial heterogeneity, including outcome measures, non-validated symptom measures, symptom thresholds, assessment time window, and predominance of cross-sectional studies.
“Future larger and methodologically rigorous studies using validated grief instruments across diverse settings are needed to clarify grief trajectories and guide developmentally appropriate intervention strategies,” they said.