Objectives To provide an overview of the complex issues and communication needs of patients and families coping with advanced cancer and discuss issues related to their physical, psychosocial, spiritual, and emotional needs. Data Sources Published articles and personal experience. Conclusion The response to illness throughout the disease continuum is a dynamic process for both patient and caregiver. The nurse has a responsibility to be a patient advocate, and serve as a trusted caregiver and resource. Implications for Nursing Practice Oncology nurses are in a pivotal position to assure that communication throughout the continuum demonstrates and incorporates awareness of patient and family beliefs and quality-of-life needs.