This integrative literature review examines the facilitators and barriers to open and clear parent-child communication in the context of childhood cancer (for this literature review, child refers to ages 0 to 19 years). The Resilience in Illness Model (Haase et al., 2017) was employed to organize the findings and link to resilience outcomes among children with cancer. In a search of three international databases (PubMed, CINAHL, and PsycINFO), 18 studies met inclusion criteria and were selected for review. The major barrier to open communication was the desire of parents and children to protect each other from the pain that shared knowledge and discussion of cancer treatment and risks may bring. In contrast, parents' desire to improve their relationship with their children worked as a facilitator. For children with cancer, the timing of communication, children's illness condition, and psychological status were critical factors in the decision to communicate. There was a noticeable absence of the child's voice, including adolescents, across the studies reviewed. To develop interventions to improve parentchild communication, an understanding of the perspectives of children is needed, along with perspectives from dyads of children and their parents. These studies will assist in the development of interventions focused on the positive results that come from engaging in open and clear parent-child communication in families of children with cancer.