Cancer is a major issue in the provision of health care. It is estimated
that one in four people in developed countries are likely to develop it
at some time. As longevity steadily increases, the incidence of
malignant disease is expected to rise further. Important advances in the
control of cancer have taken place and curative treatment has improved,
notably in some of the rarer tumours, particularly in children. Advances
in the more common cancers have been less marked, although adjunctive
systemic treatment and population screening are lowering mortality from
the most prevalent cance- carcinoma of the breast. Despite this
progress, complete control of malignant disease is still a long way off.
However, our understanding of the molecular biology of cancer has
increased enormously in recent years and the application of this
knowledge holds considerable promise for developing new therapeutic
strategies. As for prevention, the cause of most cancers is still poorly
understood although it is clear that tobacco avoidance would prevent
most lung cancers and several others. Cancer is studied at many
different levels: molecular and cellular biology, pathology in patients
(particularly clinical trials), and prevention and populations
(epidemiology). The psychosocial problems caused to patients and their
families are being increasingly recognized and subjected to systematic
study. Workers in the field, therefore, range from basic scientists to
epidemiologists, from hospital specialists to community support teams.
Each needs to have at least some knowledge of the role the others play.
