Book contents
5 - Surgery
Published online by Cambridge University Press: 07 September 2009
Summary
Surgery faces a huge challenge. Ninety per cent of all cancer patients who are cured completely are cured by surgery. Therefore, surgeons are often aggrieved when the entire cancer agenda seems to focus excessively on chemotherapy, radiotherapy, imaging and diagnostics: yet, “surgery remains the primary option for the cure of many cancers.” Surgery has become less invasive and yet remains a vital resource. Table 5.1 illustrates how overall survival and mortality following surgery has improved over recent decades.
With more day treatment and fewer major procedures the share of spending on surgery in total cancer spending has reduced. The main driver here has been the reduced number of in-patient days and lower complication rates. For the future, we anticipate important choices in terms of therapeutic options.
Principal drivers in developing surgery.
There have been four main drivers of the surgical progress. The first has been the technology and devices industry. The second is the desire on the surgical community's part to excel. The third is patient and public expectations from surgeons. And, the last is progress in parrallel fields of medicine. Fifty years ago, the factors that really prevented cancer surgery from taking off were pain, haemorrhage and sepsis and these are all now dealt with effectively as a result of progress in other fields of medicine,with surgery as the beneficiary.
The necessity for radical cancer operations has been a widely disputed issue for many years. Thirty years ago, there were still many radical mastectomies but now there are only very few.
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- Information
- The Economics of Cancer Care , pp. 73 - 80Publisher: Cambridge University PressPrint publication year: 2006