A surgeon's view of oncology

The past thirty years has seen a profound change in emphasis and direction in the management of cancer. In many countries this has been away from traditional surgical management towards specialists trained primarily in medical oncology or radiotherapy. This trend has occurred despite the fact that surgery is still by far the most effective method of treatment of most common cancers. The effectiveness of sound cancer surgery and the importance of local disease control as an element in improving cure rates and palliation needs to be emphasised so that patients are not denied optimal treatment. The case for surgery can best be developed by encouraging special training and expertise in the field of surgical oncology, as one element in the provision of a surgical service for cancer patients.