Experiencing a diagnosis of cancer has the potential to dramatically alter the way in which a person experiences intimate and sexual aspects of their lives. This article draws on data from a larger study into issues of intimacy and sexuality from the perspectives of patients and health professionals in cancer and palliative care. A 3-stage reflexive inquiry involved semistructured participant interviews (n = 82), textual analysis of national and international clinical practice guidelines (n = 33), and participant feedback at 15 patient and health professional educational forums. This article will present the analysis of 50 patient interviews, which showed 5 clusters of responses to a cancer diagnosis: "focus on survival," "trust in health professional," "desire for choices," "search for normality," and "need for negotiated communication." Most patients were searching for a reflexive, patient-centered and negotiated style of communication from the health professional of their choice, at a time and in a manner that suited their individual needs. Many patients were disappointed by the lack of information, support, and practical strategies provided by health professionals to assist them to live with the sexual and intimate changes they had experienced in the face of a life-limiting disease. Implications for nursing practice are discussed.