The main aim of the present study was to investigate whether patient-nurse dis/agreement concerning cancer patients' situation was of importance to patients' satisfaction with care. Another aim was to describe cancer patients' satisfaction with care and to investigate its relationship to cancer patients' emotional distress. A consecutive sample of individual patient-nurse pairs (n = 82) was recruited and followed during 3 days. Each pair consisted of a cancer patient newly admitted to an oncological/haematological ward and a nurse responsible for that patient's care. The known phenomenon of nurse overestimation of cancer patients' problems did not appear to be of importance to patients' satisfaction with care. However, patients whose depressive problems were underestimated by nurses were significantly less satisfied with the care they received. Furthermore, anxious and depressed patients were less satisfied with some aspects of the care they received than were the remaining patients. Although the patients' ratings and experiences of received care indicated a high degree of satisfaction, the patients also expressed negative experiences of care. To improve the quality of cancer care, nurses need to improve their ability to identify cancer patients' emotional distress if they are to satisfy patients' needs.