Sunderland have had so many must-win games, it feels they have finally run out of chances.
Relegation is a near certainty, but the season cannot be allowed to end with a whimper, as is threatening to be the case.
So how can they topple ailing West Ham? Here are three key areas...
Kone must stand tall
The Ivory Coast international could have been a true cult hero on Wearside, but the events of last summer have put an end to that.
Add to that a decline in performances and few will rue the day when he finally heads for another Premier League side.
He has been beaten too often both on the floor and in the air this season, even if he remains the best centre-half at the club. Andy Carroll is fit for the Hammers, who in their current malaise will not miss any opporunity to go direct to him.
Kone will have to impress if the Black Cats are to have any chance of staying in the game.
Make the most of Victor
Victor Anichebe is far short of full match fitness but even so, he offers a very different outlet.
As shown against the Manchester United defence last weekend, when he can receive the ball close to goal and back into defenders, he is a bully and borderline unstoppable.
He was not far off recreating that superb Bournemouth goal on a couple of occasions, and the trick for Sunderland is to ensure he gets the ball deep in enemy territory and with team-mates close to him.
What the Black Cats must do is resist the temptation to look to him too often, too far away from his own goal.
Even with a proper target man patient build up can be key. Sunderland have not looked after the ball well enough this season and it continues to undermine them.
Turn midfield suspension into a positive
Sunderland are drifting, unable to score, unable to excite.
With hope all but lost, can David Moyes try to use Seb Larsson’s suspension to change the tempo?
Lee Cattermole (pictured) is back, but Moyes has rightly pointed out that his side have not played well with four attackers on the pitch, and it is fairly clear that he will not turn to Wahbi Khazri.
Nevertheless, replacing the Swede must inject some pace and energy into the side. Fans have had too endure too many pedestrian showings of late.