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Over the past 5 years, a small group of cancer patients who stated their physicians had determined there were no additional available antineoplastic therapeutic options (including potential investigational strategies) were seen for a ‘second opinion' in a cancer hospital-based oncology program and subsequently experienced what can reasonably be characterized as having achieved meaningful ‘clinical benefit' (functioning at a fairly high level for a minimum 1 year in the work, home, and/or family environments) following the further delivery of a variety of treatment approaches. While recognized to be limited (or even simply ‘anecdotal'), this experience emphasizes several clinically relevant conclusions, including the overall utility of a ‘second-opinion' strategy and the potential that the reported statement of an individual practitioner or cancer program that all rational options have been attempted may be inaccurate.

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