The eradication of cancer has become the most
compelling medical challenge of our time (Ho 2009).
Contemporary cancer management is intertwined
with developments in diagnostic methods to define
the disease ever more narrowly and to predict
the clinical outcomes of particular therapies with
increasing precision (Pusztai 2008). It is widely
accepted that clinically relevant developments in
oncology will occur, not only by progress in the
various treatment modalities themselves, but also by
enhancements in the co-ordination of multimodality
treatment. This close mutual dependency of the
main oncological treatment modalities is crucial for
systematic and individualised high-quality treatment
and will result in more appropriate tailoring of
treatment to the needs of the individual patient
(Widder and Pötter 2006).
It may be worth considering the likely future
burden of cancer, as such a projection can help to
estimate the future demand for health services.
Owing to the lengthy latency period between
carcinogenic exposure and development of some
cancers, predicting future cancer occurrence is
fraught with uncertainty (Bray and Møller 2006).
The expected number of future cancer cases is
substantially affected by changes in the population,
and the projected increase in life expectancy over
the next 50 years will have important consequences
on cancer burden. Quantitatively, age is the most
important time-related variable that influences the
risk of cancer. Ageing exemplifies the cumulative
exposure of the body to carcinogens over time, and
the accumulation of a series of mutations necessary
for the unregulated cell proliferation that results in
cancer (Bray and Møller 2006). Thus, it is inevitable
that much of the future cancer burden will be
among older people, a proportion of whom will have
inherent comorbidities.