Let “Whitmore's Principle” be the Guide

As we try to balance what we can do versus what we should do for this patient (1), several of Willet Whitmore's quotes come to mind (2). "Is cure possible only when it is not necessary"; or in this context "is control possible only…." Does it do any good to control disease that is not symptomatic in someone who may have symptoms, and ultimately die, from progressive disease elsewhere? Perhaps "buying time is the name of the game"; with our goal to delay chemotherapy, or reduce the cost of prolonged bevacizumab? How about "tell me what you want to hear and I'll refer you to someone who will recommend it" versus "let's try to replace heated opinion with cold facts." The aim should not be to use stereotactic ablative body radiation therapy (SABR) for oligometastases because we can, but rather to prove it works before we use it routinely.

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