["Are we treating the cancer or the person?": a provocative or enlightening question?]

Scientific literature and daily experience highlight two worrying phenomena: on the one hand, in the very advanced or even terminal stages of cancer, anticancer therapies are administered with dubious or insufficient and ethically disproportionate indications; on the other, the initiation of palliative care, whether simultaneous or end-of-life, is often too late. Moreover, this occurs despite the opposing recommendations of international and italian scientific societies, indicating the need to forgo (withholding or withdrawing) anticancer treatments that lack solid clinical indications and are ethically disproportionate. The problem can be addressed by removing the factors that hinder proper clinical practice, in compliance with the multiple oncology guidelines described in detail in the article by Rossi "The impact of cancer treatments at the end of life: a clinical, ethical and organizational problem" contained in this issue. The main strategies useful for overcoming these obstacles are a better and constant collaboration between oncology teams and palliative care teams in which shared decision-making processes are built that are more responsive to the global needs of the patient and more respectful of the criteria of therapeutic appropriateness and ethical proportionality. In this regard, it is essential to strengthen shared prognostic communication between the two teams to allow patients to make more informed decisions about which therapeutic options to accept in a situation of increasing uncertainty about efficacy due to disease progression.