The objectives of the Patterns of Care Study are to: 1) describe the use of adjuvant therapy, which will be verified with the treating physician; 2) characterize the practice patterns in different communities; 3) describe more completely the use of surgery as treatment; 4) compare the patterns of treatment (surgery, radiation therapy, chemotherapy, hormonal therapy) over time and by age and race/ethnicity; 5) describe the effect of co-morbid conditions on treatment, and 6) describe treatment by hospital characteristics (i.e., profit vs. not for profit, teaching vs. non-teaching, bed size, etc.) in different geographic areas of the United States. Patterns of Care Studies are conducted to satisfy a Congressional directive (under Public Law 100-607, Sec. 413 (a)(2)(C) adopted November 4, 1988) to the National Cancer Institute to ¿assess the incorporation of state-of-the-art cancer treatments into clinical practice and the extent to which cancer patients receive such treatments and include the results of such assessment in the biennial reports¿¿. To select the cancers sites the Division of Cancer Control and Population Sciences has been working closely with the Division of Cancer Treatment. This year's Pattern's of Care (POC) Study will investigate state-of-the-art therapies for small cell lung cancer, acute myeloid leukemia, multiple myeloma, and hepatocellular carcinoma.