Historically, the presence of metastatic disease in most solid tumours has signified incurability and a relatively short median survival. Effective palliative therapy has been a major priority. Occasional cases of long-term survival were seen as welcome outliers. Developments in cancer biology, imaging, systemic therapy, targeted therapy, surgery and radiotherapy mean that this nihilism is no longer appropriate, with meaningful prolonged survival and even cure being possible in many situations. This presentation will set the scene for exploration of many of these issues.