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Abstract
Abstract The purpose of this review is to argue that for parents of children with cancer, bereavement begins on diagnosis, and sometimes before. Improvements in treatments have led to a situation where the prognosis in many cancers is good, and consequently the focus in paediatric oncology is on living with cancer, rather than care of the terminally ill child. Three factors are identified which are difficult for parents whose child is terminally ill: the optimism prevalent in clinics; emphasis on confidentiality which compromises social support; and centralization of specialist care. It is argued that there should be greater integration of care, such that families are offered a cohesive service throughout the entire course of the disease.