As a community oncologist, I enjoyed James DeGregori and Robert Gatenby's article “Darwin's Cancer Fix.” Their approach to treating metastatic prostate cancer by managing its growth, rather than trying to kill all cancer cells, to avoid drug-resistant tumors is intriguing and deserves a large randomized phase III trial. But it is very important to remember that, biologically, cancers are extremely heterogeneous, and there are caveats to the principles the authors outline.