Radiotherapy in Vietnam represents a stark contrast to the level of care available in the United States. The issue of efficient administration of cancer care with available resources is common to both nations. The challenge for each country is to develop treatment strategies and political policies for effective and accessible care within budgetary constraints. Results of therapy, defined as the restoration of function, must be the measure of efficacy and efficiency. This demands a balance between control of tumor-related symptoms and treatment-related morbidity. The most inefficient use of resources is an ineffective treatment that results in complications, as we observed in Vietnam. As health care policies continue to develop in the United States, we must not fail to focus upon therapeutic outcome as the single most important parameter for measuring success relative to the personal and public investment in medicine.