Confronted with serious illness, patients seek the best care tailored to their needs. Some will seek care that is considered “the best,” while others may prioritize a care center that is nearby or within an affordable insurance network. Optimal cancer care involves delivery of patient- and family-centered care with values and preferences understood by the clinicians and implemented throughout the course of care. Implementing this model of care presents a challenge, requiring a flexible approach grounded in practical reality and focused on the negotiated goals.