It is my privilege to introduce this Handbook on Advanced Cancer Care,
which belongs to a series of publications initiated by the European Society
for Medical Oncology (ESMO). There is a great need, especially for medical
oncologists, to have a comprehensive overview of the essential elements
needed for the care of patients with advanced cancer. This handbook fulfills
The Handbook on Advanced Cancer Care provides useful definitions and
surveys of treatment principles.
Patients with stage IV disease (outside the abdomen or invading the bladder or rectum) are treated palliatively with irradiation, surgery, and platinum-based chemotherapy. Progestational agents produce responses in ~10–20% of patients. Well-differentiated tumors respond most frequently, and response can be correlated with the level of progesterone receptor expression in the tumor.
There is a weak evidence base for the effectiveness of complementary therapies in terms of pain control,
but they may improve wellbeing. Safety issues are also a consideration in this area.
Patients with cancer pain spend most of their time in the community until their last month of life. Older
patients and those in care homes in particular may have under-treated pain. Primary care teams supported
by palliative care teams are best placed to initiate and manage cancer pain therapy, but education of
patients, carers and healthcare professionals is essential to improve outcomes.