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Future developments in treatment methods other than radiotherapy.

Increasingly more cancer patients are being diagnosed at an early stage in the disease. Consequently, more patients receive curative treatment. Milder methods and better care even make curative treatment an alternative for medically frail patients. As knowledge advances, primary curative treatment is becoming more complicated and embraces more forms of treatment. The local treatment methods, surgery and radiotherapy, will continue to play at least as large, or perhaps a larger, role in the outcome of cancer. Even for patients who cannot be cured, meaningful treatment is successively improving and resulting in longer and better lives for patients. This, coupled with the expected increase in the number of cancer patients discussed in Chapter 5, will result in an increasing and rapid overall need for cancer treatment. Surgery is expected to continue developing toward becoming increasingly mild and organ-conserving. Endoscopic methods will continue to expand. Chemotherapy will advance further, mainly through increased knowledge about active mechanisms and possibilities of combination therapy. This will lead to a successive, gradual improvement in results, and chemotherapy will become a meaningful approach for treating more cancers. Bone marrow transplantation, both allogeneic and autologous, and stem cell transplantation, is expected to continue. Hormonal treatment will continue. Through the introduction of new agents and applications for more diagnoses, the use of this method may expand, perhaps mainly in adjuvant situations. Biologic therapy is at an early stage in development. It has become an established treatment approach for certain types of cancer. Continued, intensive research can be expected. The practical potential for improving treatment results is, however, expected to be somewhat limited in the foreseeable future. With most cancers, primary treatment has the potential to cure the patient, but cure becomes less attainable on relapse. The greatest progress in recent decades has not involved curing more patients, but improving the care of those who cannot be cured. This trend will continue, which will place greater demands mainly on nursing care and palliative treatment. Nothing suggests that the development of other treatment methods will reduce the need for radiotherapy. However, much suggests that local treatment methods will gain increased importance, particularly if the trend continues toward early detection of more cancers.