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Forty years ago, a group of physicians gathered in Nice, France, with a shared optimism for the promise of systemic therapies to treat cancer. This conference became the inaugural meeting of what is now the European Society for Medical Oncology (ESMO), which today convenes nearly 20,000 individuals from around the world. At that time, in 1975, it was becoming clear that contemporary scientific discoveries related to the properties of chemotherapeutic agents were spring-loading the oncologist's ability to address malignancies. Clinicians were able to employ adjuvant chemotherapy for the treatment of early-stage breast cancer, and combination chemotherapy for patients with testicular cancer, both of which would soon lead to marked improvements in overall survival. Medicines such as cyclophosphamide, cisplatin, bleomycin and others—which we often take for granted in our practices today—were then new instruments in the clinician's anticancer toolkit.
The number of systemic therapies and treatment approaches we currently have to address the needs of our patients with cancer is vast. With advanced techniques in radiology, pathology, radiation oncology, surgical oncology and other subspecialties, the benefit of medicines can be further augmented for certain types of cancer. A woman diagnosed with early-stage breast cancer in Europe today has an 80% chance of long-term survival. Similarly, a child diagnosed in Europe with acute lymphoblastic leukaemia has a nearly 90% chance to live a long and relatively healthy life after treatment. Overall, the notion that cancer is a universal death sentence has shifted from reality to fallacy in wealthy parts of the world.
Yet, as these tremendous gains in advanced economies have resulted in improvements in life expectancy, and undoubtedly economic gains from productivity life-years (not to mention the social and moral imperatives implicit in cancer care), the conception of cancer as a death sentence is not a fallacy in many impoverished …
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