The Science of Cancer Treatment

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Many of the most effective treatments for disease have been discovered empir­ ically. Nowadays, however, we think that understanding the biology of a disease will lead us to design better treatments, and to improve the application of treatments we already have. To accomplish this, vast sums are expended on cancer research. Even so, to the casual observer of clinical oncology the proliferation of studies and trials of ever-different combinations of therapies looks like empiricism, at the best. In the first part of this book, we have asked practising clinicians in different specialities to assess the contributions of biology and of empiricism to current approaches to treatment. In the second part, we have asked researchers in different areas of biology applied to cancer to assess the present and likely future impact of their type of biology on cancer treatment and control. IX 1 Surgery M.BAUM OBJECTIVES OF CANCER TREATMENT The objectives of cancer treatment can be defined according to population requirements or according to the needs of the individual. As far as the population is concerned, Government authorities are entitled to expect that cancer treatment will lead to mortality reductions and cost containment.