In 2023, GenesisCare (GC), one of the world’s largest integrated cancer care businesses faced an extremely challenging financial position. An unsuccessful expansion into the US, the effects of the COVID-19 pandemic and ongoing regulatory issues, had all led to a substantial strain on the businesses’ liquidity and over US$1.8b in outstanding finance debt. In this session, we will talk about how this Australian headquartered business was restructured through a US Chapter 11 process (including a change in governing law and the provision of super priority DIP financing). This fascinating case study highlights the influence and importance of private capital and the US financial and legal system from an Australian perspective. The successful restructuring allowed GC to record year-on-year growth in treatment volumes despite the ongoing restructuring and to emerge with a low level of debt relative to its industry peers. Its Australian doctors have remained in place following a re-setting of their equity and incentive arrangements, allowing for further investment in patient care for cancer.