Delorme TopoUSA is a fine product, but does have some limitations. If you take the time to get it configured correctly for your road preferences, it will usually do a reasonable job at automatic routing. It does generate cue sheets, though they tend to have quite a bit of extraneous cues. Often a stretch of road will generate multiple lines in the cue sheet at intermediate spots along that road. BTW, bikely's cue sheet function is really pretty good. Although you have to type in the cue text, bikely prints out a very usable cue sheet with good mileage data for each cue you enter. It's simple, but very effective.
Map printing with TopoUSA is not very good if you want significant detail on a long route. The problem is that as the map gets compressed, the detail shown is reduced. This is the same problem that the online map tools (google, yahoo, etc) have. TopoUSA does have a strip map printing mode that will print your route on multiple pages, if you like, but I find that feature to generate too many pages for most routes. Unless a route is overly complex, I don't use it.
By far, a good mapping program's best feature is the ability to make changes to a route and get quick recalculation of mileage and climbing profiles. Most online mapping programs, such as bikely, are very cumbersome for editing routes. Google maps new editing features are a step in the right direction, but google does not allow you to name and save routes created (yet?) so is good only for ad hoc exploration.