This article describes some of the problems of palliative cancer therapy and proposes possible solutions. The topics discussed include the reasons for death in cancer patients, the definition of intermediate and indirect as opposed to direct and measurable goals of treatment, the insufficient outcomes of palliative therapies and the problems associated with the separation of palliative treatment and palliative care. As a solution to these problems, a concept of Tumor versus Host Disease (TvHD) is discussed, and different end points for palliation are defined for daily oncology practice and oncology research. Finally, a way to collect data outside randomized trials is proposed, and the need for data collection is emphasized. © 1993.