This paper addresses trade-offs in adaptive feedback cancellation (AFC) for hearing aids. Aggressive AFC for improved added stable gain (ASG) reduces speech quality. In this paper, the hearing-aid speech quality index (HASQI) is used to investigate AFC performance before the system becomes unstable. It is demonstrated that for a desired speech quality, multiple AFC algorithms can be evaluated for their ASG and computational efficiency. An example is presented with HASQI = 0.8, baseline AFC, and two advanced approaches. For the advanced AFCs, ASG gains of 4 and 7 dB were obtained at additional computational complexity of 8% and 11%, respectively.