The current state of cancer care in North America

Cancer treatment is slowly becoming more effective against both common (lung, breast, colorectal, prostate) and uncommon cancers (gastrointestinal stromal tumors, chronic lymphocytic leukemia, and relapsed leukemia) due to advances in targeted treatments and immunotherapy. At the same time, the incidence of cancer is rising due to longer life-spans, cigarettes, diet, and obesity. An added stress is the rising cost of cancer treatment with new treatments priced at US$14,000 a month or more, with little relationship to value. This confluence has stressed health care systems in resourced and under-resourced countries. We present data that illustrate palliative care, when used together with oncology and other specialties, improves the quality and quantity of life for patients and reduces caregiver distress. By reducing end-of-life hospitalizations when not desired and encouraging home care when possible, palliative care reduces costs, making it “better care at a cost we can afford.”