Palliative care: management of the patient with advanced cancer

The incidence and mortality of cancer are increasing worldwide. Changes in lifestyle and living standards have contributed to this phenomenon, as have other factors, such as an increase in the high-risk elderly population in Western Europe and North America. This, coupled with the decline of the family unit and an escalation in the numbers of Americans living alone, is creating a significant health care problem in the United States; namely, how will we be able to provide adequate care for the increasing numbers of aged expected to develop cancer in the 21st century in ways compatible with cost-saving and cost-effective strategies currently being used in the health care industry? The bulk of current cancer research is directed at developing new curative strategies, while improving palliative measures for the treatment of the symptomatology of cancer is largely ignored. We will have to refocus our priorities if we are to be successful in addressing this problem. This paper provides an overview of current trends in the palliative management of patients with advanced cancer and offers insights into how we may begin to prepare ourselves to meet the challenges of cancer care in the years ahead.