"You have a big tumor on your pelvis. One patient has localized disease and one of has then disease in their spine. They're treated the same. One of them is cured and one of them goes on to die. That's sort of the example of what we don't understand about why patients that have metastasis do so much worse than patients--and they are a real--there's actually a stunning example of a young woman who was pregnant and developed pain and was told it was due to her pregnancy. Delivered the kid, still had pain. Said ah, it's residual sciatica. Finally after six months someone got an x-ray and she had this big tumor in her pelvis. She died because it had metastasized.

"The other example was an Army--twenty year old kid in the Army. Same thing and his tumor was even bigger. But he hadn't spread. Now both patients responded to the therapy. The tumor went away. The patient who has metastatic disease it always comes back."