Over the past three years I have had the opportunity to be involved in two integration projects regarding cancer services. Both projects crossed jurisdictional, geographical and healthcare-provider boundaries and used cooperation and collaboration to work toward the goal of an integrated, quality, multi-disciplinary, seamless, patient-centred approach to cancer care. The projects have provided a perspective of what worked well and what could be improved when integrating healthcare services across organizational and provider boundaries. Governance emerged as a key determinant of project progress and successful change.