Quality cancer care is often threatened by poor communication and lack of coordination. Prior research has described cancer patients' perspectives related to communication breakdowns, but this study used focus groups with primary care physicians, oncologists, and nurses to explore the clinician viewpoint. Many insightful quotes are included throughout the article illustrating complex interchanges between patients, providers, and health systems in the high-stakes arena of longitudinal cancer care. One highlighted problem related to some patients' reticence to discuss adverse effects of therapy due to fear that they will no longer be offered further treatments. Clinicians often found it challenging to balance hope with reality and to provide accurate information to patients and their families. They also expressed frustration with systems factors, such as appointments that are too short for having serious in-depth conversations. The authors suggest a number of potential solutions for facilitating open communication between patients and providers.