Dr. Kohn: Once a patient is involved in one of our trials, if an intervention doesn't optimally affect her cancer, we do go ahead and discuss not just clinical trial options but we always discuss what options are there for the patient in the community setting as well. We don't always know all the clinical trial options for a patient at any given time so we can't give them a global review but part of our core consent process is to be sure that the patient understands that she has multiple other options.