(CHAPEL HILL, N.C.) -- When Elizabeth Edwards died of breast cancer Tuesday, she left behind two young children -- Emma, 12, and Jack, 10 -- who must now carry on without their mother.
Learning her disease was terminal, Edwards said she didn't fear death but was "very sad" for her youngest children, whose mother might never guide them through maturity.
"I'd like to be seeing them off in life, not as a distant mother playing Legos on the floor," she said last June on Larry King Live.
Child development experts say how well the Edwards children cope depends to a large extent on the support they receive from surviving loved ones in the years ahead.
Their adjustment, however, may be complicated by their parents' recent separation and the scandal over their father's affair and three-year-old daughter he had with Rielle Hunter.
The death of a parent can be devastating for children, who, as adults, continue to describe the loss as a "piercing" indelible pain. Pop star Madonna, whose mother died of breast cancer when the performer was six, said her mother's death was "like having your heart ripped out of your chest. Like a limb missing. The ultimate abandonment."
Actresses Rosie O'Donnell and Jane Fonda, Prince William, Beau and Hunter Biden and scores of other high-profile adults have described the loneliness and anguish they felt at the early loss.
Chronicles of Narnia author C.S. Lewis, whose mother died when he was nine, wrote, "With my mother's death all settled happiness, all that was tranquil and reliable, disappeared from my life. There was to be much fun, many pleasures, many stabs of Joy; but no more of the old security. It was sea and islands now; the great continent had sunk like Atlantis."
One out of every four adults diagnosed with cancer in the United States has children younger than 18, according to the National Cancer Institute, and an estimated three million children live with a surviving parent after the death of their mother or father, a number Dr. Paula Rauch, a pediatric psychiatrist and expert in families coping with terminal illness, believes is underestimated.
"It's amazing how resilient children are when they are supported," she said. "While children who lose a parent early in life have some increased risk of anxiety and symptoms of depression, the majority of children who are well-supported will cope well."
Copyright 2010 ABC News Radio