Cancer is a major issue in the provision of health care. It is estimated that one in four people in developed countries are likely to develop it at some time. As longevity steadily increases, the incidence of malignant disease is expected to rise further. Important advances in the control of cancer have taken place and curative treatment has improved, notably in some of the rarer tumours, particularly in children. Advances in the more common cancers have been less marked, although adjunctive systemic treatment and population screening are lowering mortality from the most prevalent cance- carcinoma of the breast. Despite this progress, complete control of malignant disease is still a long way off. However, our understanding of the molecular biology of cancer has increased enormously in recent years and the application of this knowledge holds considerable promise for developing new therapeutic strategies. As for prevention, the cause of most cancers is still poorly understood although it is clear that tobacco avoidance would prevent most lung cancers and several others. Cancer is studied at many different levels: molecular and cellular biology, pathology in patients (particularly clinical trials), and prevention and populations (epidemiology). The psychosocial problems caused to patients and their families are being increasingly recognized and subjected to systematic study. Workers in the field, therefore, range from basic scientists to epidemiologists, from hospital specialists to community support teams. Each needs to have at least some knowledge of the role the others play.
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Section 1. Non-Curative Surgery.- 1. Non-Curative Surgery for Upper Gastrointestinal Malignancy.- Oesophageal Carcinoma.- Gastric Cancer.- Liver.- Cholangiocellular Carcinoma.- Pancreatic Cancer.- Conclusion.- References.- 2. Non-Curative Surgery for Cancer of the Large Bowel.- Common Clinical Situations in Palliative Colorectal Cancer.- Surgical Options.- Local Procedures.- Palliative Colorectal Surgery in the Elderly.- Anal Cancer.- Conclusions.- References.- 3. Non-Curative Surgery for Gynaecological Malignancy.- Breast Cancer.- Gynaecological Pelvic Malignancy.- Miscellaneous.- Conclusions.- References.- 4. Non-Curative Urological Surgery for Cancer.- Ureteric Obstruction.- Fistula.- Urological Tumours.- Conclusions.- References.- 5. Non-Curative Neurosurgery for Malignant Brain Tumours.- Historical Background.- Independent Factors.- Operative Treatment.- Tumour Biopsy.- Open Procedures.- Gliomas in Specific Sites.- Technical Advances.- Results of Surgery.- Role of Surgical Intervention Following Recurrence.- Rehabilitation.- Conclusions.- References.- 6. Non-Curative Surgery for Thoracic Malignancies.- Lung.- Pleura.- Chest Wall.- Mediastinum.- Conclusions.- References.- Section 2. Non-Curative Radiotherapy.- 7. Non-Curative Radiotherapy for Lung Cancer.- Non-Small Cell Lung Cancer.- Specific Problems.- Retreatment.- Small Cell Lung Cancer.- Endobronchial Techniques.- Conclusions.- References.- 8. Non-Curative Radiotherapy for Bone Metastases.- Introduction: Prognosis and Clinical Course.- Pathophsiology.- Symptoms.- Radiotherapy in the Treatment of Bone Metastases.- Local External Beam Radiation.- Pathological Fracture.- Spinal Cord Compression.- Extended Field Radiotherapy.- Radioisotopes.- Conclusions.- References.- 9. Part 1 ― Non-Curative Radiotherapy for Upper Gastrointestinal Tract Cancer.- Oesophageal Cancer.- Stomach Cancer.- Pancreatic Cancer.- References.- 9. Part 2 ― Non-Curative Radiotherapy for Lower Gastrointestinal Tract Cancer.- Rectal Cancer.- Anal Cancer.- References.- 10. Non-Curative Radiotherapy Treatment for Gynaecological Cancer.- Local Problems Amenable to Palliation with Radiotherapy.- Distant Problems.- Doses and Techniques.- Sites for Radiotherapy.- Measuring Outcome.- References.- 11. Non-Curative Radiotherapy for Neurological Cancer.- Problems Encountered in Brain Tumour Patients.- Measurement of Treatment Efficacy.- Conventional Radiotherapy of High-Grade Glioma.- Recurrent High-Grade Glioma.- Low-Grade Gliomas.- Brain Metastases.- Spinal Cord Compression.- Conclusions.- References.- 12. Non-Curative Treatment for Head and Neck Cancer.- Radiotherapy.- Chemotherapy.- Chemo/Radiotherapy.- Unusual Tumour Types.- Conclusions.- References.- Section 3. Non-Curative Chemotherapy.- 13. Non-Curative Chemotherapy for Breast Cancer.- Health Economics.- Hormone Therapy.- Chemotherapy.- Special Sites.- Conclusions.- References.- 14. Non-Curative Chemotherapy for Small Cell Lung Cancer.- Quality of Life in Patients with SCLC.- Staging.- Single Agent Chemotherapy.- Combination Chemotherapy.- Treatment Duration.- Planned vs. “As Required” Chemotherapy.- Non-Cross-Resistant Regimen.- Dose Intensity.- Chemotherapy for Brain Metastases.- Conclusions.- References.- 15. Non-Curative Chemotherapy for Non-Small Cell Lung Carcinoma.- Surgery and Radiotherapy in NSCLC.- Chemotherapy.- Does Chemotherapy Prolong Life in NSCLC?.- Effects of Chemotherapy on Symptoms and Quality of Life.- Conclusions.- Acknowledgements.- References.- 16. Non-Curative Chemotherapy for Gastric Cancer.- Systemic Therapies.- Locally Directed Therapies.- References.- 17. Non-Curative Chemotherapy for Colorectal Cancer.- Systemic Therapies.- Locally Directed Therapies.- Conclusions.- References.- 18. Non-Curative Chemotherapy for Gynaecological Cancer.- Epithelial Ovarian Cancer.- Cervical Cancer.- Endometrial Cancer.- Vulvar Cancer.- References.- 19. Non-Curative Chemotherapy for Patients with Unknown Primary Cancers.- Poorly Differentiated Neoplasm.- Adenocarcinoma of Unknown Primary Site.- Squamous Carcinoma of Unknown Primary Site.- Poorly Differentiated Carcinoma of Unknown Primary Site.- Conclusions.- References.
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