David Currow, PhD, MPH, FRACP, FAChPM, FAHMS, GAICD of Flinders University, Adelaide, Australia discusses the issue of symptom control in advanced cancer at the 2016 National Cancer Research Institute (NCRI) Conference in Liverpool, UK. Prof. Currow explains that the key issues in symptom control are that we underestimate the prevalence of symptoms and their severity. Therefore, we also underestimate their impact on patients and their families and their ability to tolerate therapy. He further explains that we can do high-quality studies in this area. If we ignore this issue, we risk disenfranchising patients and we limit their choices and their care. In order to make a difference, clinicians need to be aware and expect that patients will experience symptom burden that they have not discussed with them and further, more high quality Phase III studies are required. This knowledge then needs to be brought into clinical practice.