Seventeen years ago, Wolfe and colleagues1 demonstrated pervasive symptoms and suffering among children with cancer at the end of life. In this issue of JAMA Oncology, Levine and colleagues2 have extended this work by evaluating experiences of children with cancer and their parents in the first year after diagnosis. This work demonstrates that children with cancer report significant symptoms in their first month of cancer treatment, with a majority suffering from nausea, anorexia, pain, anxiety, and constipation and half suffering from depression. These data suggest that pediatric oncologists such as myself do not sufficiently meet one of our fundamental obligations to these children—we are not adequately treating their suffering. We must think about how best to respond and remedy this gap.