Although research in the cancer communication field has produced a body of information applicable to clinical practice, there is little evidence that the new knowledge has led to any significant improvements in the health care communication experiences of patients and their families. In this article, an analysis of the existing research-based knowledge provides a basis for critical analysis of the gaps and limitations within it. Insights from the current literature are contrasted with interpretations deriving from consumer-perspective research by this author and others. The discontinuity between the problems consumers identify and the issues that attract research attention is examined in the context of the orientation to science that drives much of the research. The case is made for challenging traditional notions of what counts as evidence in developing education and practice standards for cancer care.