Summary: The potential of next-generation sequencing to revolutionize cancer treatment by enabling personalized therapies is still more promise than reality. Despite the best intentions of leaders at academic cancer centers, the translation of sequencing technology’s potential into medical practice remains in its infancy, and adoption is excruciatingly slow for people like me with a cancer diagnosis. What is the hold up? Where can the disruptive breakthrough occur? The greatest hope for accelerating personalization in cancer treatment is for people with a cancer diagnosis to educate themselves about their treatment options and be an advocate for their treatment.