Dear Virginia, I have just discovered that a very old friend of mine has bone cancer. We've always got on well, and I've found out he's in hospital and probably has only a year to live. But now it turns out that it's all a big secret, just within the family, and I'm not supposed to know. I'm someone who always wants to tell everyone when I have a problem, so I can't understand it – he has always been very good to me when I'm ill. I feel excluded and sad, but very selfish as well. What can I do? Yours sincerely, Millie

There's a great pleasure to be had from taking, but there's also a huge pleasure to be had from giving. And when you're denied that luxury, you can feel upset and cheated – as you do, Millie. I like the way you admit that you feel "selfish" in your desire to be in on this hugely important secret. It shows that you have a peculiar insight into your feelings of altruism and realise that they are beneficial to you as well as to those you care about.

I suspect there are two reasons your friend wants to keep his illness to himself. One is that he wants to retain a feeling of power. If he can keep this fact a secret, he may know that his life is going to end very soon, but at least he has one over on everyone else. He knows it, and no one else does. This feeling of power may be very important for him at the moment, and it may be crucial for him to keep this kind of integrity for a while until he is able to share it with others.

The other reason he may want to keep it secret is because he dreads the pity and compassion that you, and others, are longing to unleash on him. He may feel that he can't cope with the offers of help, or, indeed, the possible teary telephone calls, the goodbye letters, the expressions of love that would come flooding his way if he let on what was up.

Secrecy is his only defence.

Having said all this, of course, the secrecy is utterly pointless. His secret is already out. I don't know how you found out, but if you know, others know. And if others know, then the whole world knows. You can only really have a secret if you just keep it to yourself and tell no one else. I'm always amused by the number of secrets my friends think they're keeping from me. But I know all about their bisexuality, their infidelities, their unacknowledged children... and not only do I know but so do all their friends. That's why I, like you, Millie, shrink at secrets.

If I were you I would make it my business to find out about his illness legitimately. Because while it may be a comfort for your friend to keep this illness a secret, for you it's a burden. Ring up his family on some kind of pretext and add, in a concerned way, "And how is X...?" Nine times out of 10 they'll assume you know and start spilling the beans. One time out of 10 they'll say something like, "What do you mean? Have you heard?", whereupon you can say, "I did hear he was ill". If they ask you how you knew, just fudge it. "Oh, everyone knows he's ill", you could say. Or "I thought something was up", or even, "Oh, I had a funny dream about him and I keep worrying". I bet his family are dying to share their appalling news, even if he isn't himself.

Once you're let in on the secret, you know how to behave. Don't ring with shrieks of horror. Simply be there for him. Let him tell you what he wants. Pop in very briefly from time to time, and don't bring the subject of his illness up unless he does. Let him know that you know that he knows that you know, but don't make a song and dance about it. With tact, discretion and empathy, you may still be the best support he has during the coming wretched months.

Readers say

Tell him that you know

I can understand that you want to be there for him as he has been there for you when you were ill, but this might not be what he wants. He might be the kind of person who doesn't want to cause inconvenience to other people by telling them of his illness. However, as he has only a year to live, I would advise you to confront him. Tell him that you know about his diagnosis and that you are there for him if he needs you. It is then up to him to decide whether he would like you to help him or not.

Perhaps he just needs some time to come to terms with the diagnosis and that's why he hasn't told you yet.

Nowmi Zaman, St Albans

It's his decision

Respect his feelings! Surely a dying man's wishes should be respected. If he wants you to know, he will tell you. Not everyone wants to tell the world when they have a problem, and just because you would, doesn't mean he has to.

He may be going to tell you soon, as he would always have told his family first, so give him time, and if he wants to tell you he will. If he doesn't, respect his decision.

Angie Marriott, Allasey, Merseyside

Offer gentle support

You can do something to help. You'll have to be gentle and undemanding, however, if your attention is to be welcome, especially by the patient. Visit him in hospital, just for 10 minutes or so. Say you heard he was in hospital – no need to go into details – and take a gift, such as grapes or chocolate. Ask him if there is anything you can do for him, and that may give you a clue as to what to bring next time you visit.

Don't enquire into his illness; he'll tell you if he wants to. He'll probably be worn out, so your best gift will be a friendly, loving presence, cheerful and at ease.

Rosemary Pettit by email

Put it in a letter

Be honest. Write to your friend and explain you know the situation and how sorry you are. Tell him you appreciate he wants privacy, and that you won't be passing on to anyone else that he is ill. Tell him you will only get in contact with him again if he requests it. You have shown him you care, but you have given control back to him. Not everyone wants the world to know their problems.

Karen Mcmullan, Ballyclare

Be there for him

All you can do in this situation is be there for your friend. Don't let on how you are feeling or what you know. This is your friend's illness and he should be left to deal with this as he sees fit. Believe me, it will become apparent as time goes by what is going on, and these words may not need to be spoken. All that matters now is that you do know and can support your friend through this hard time.

Sharon Emery by email