| Abstrakt: |
Mr President, Ladies and Gentlemen. We all wish to improve the treatment of cancer and all must rejoice in success. It is both legitimate and necessary that we should turn our endeavours to alleviating or anticipating suffering and to prolonging life with at least a satisfactory quality, but in the last resort the measure of our success must be the cure of our patients.Biologically speaking, “cure” can only mean the total elimination of the population of neoplastic cells that have the quality of unlimited proliferation, that is to say, the clonogenic cells. Unfortunately there can be no absolute evidence that this complete elimination has been achieved. It is true that the statisticians can deal in terms of probabilities of cure which, in the case of some types of tumour, may give very high values, but the uncertainties involved do not provide a sure foundation for advance. Patients today often receive several forms of treatment and in the event of success it is generally not possible to identify which aspect of the management decisively turned the scales or at what stage in the course of treatment this point was reached.Failure, on the other hand, is all too definite. The timing of its occurrence may well be clear, the part of the body in which the treatment has failed may be obvious and the particular aspect of treatment at fault can often be identified. |
