Communication between nurses and patients is a pivotal dimension in cancer care. However, one aspect that has received little investigation is the nature of goal-related communications between patient and nurse. This study was designed to investigate the goal-directed communications of nurse–patient interactions in outpatient cancer clinics in Norway. The field study was a naturalistic inquiry involving audio-recordings of eight naturally occurring patient–nurse conversations. Data were content analysed for recurring communication themes and patterns of communication goals. Data revealed three main themes: the medical treatment plan, the patient’s cancer situation and prognosis and the patient’s psychosocial reactions to their illness. The extent to which each theme was discussed and the types of nurses’ and patients’ goals varied depending upon the patient’s situation. Nurses should be participative in goal-setting and pay great attention to patients’ goals and be particularly sensitive to signs of uncertainty. More research is required in order to fully understand the processes involved and help nurses to effectively deal with the core issues involved in these consultations.