What really matters in cancer? : Putting people back into the heart of cancer policy

Twenty-first century cancer is framed by the biomedical revolution. The cancer patient today enters a world dominated by the success and failures of biomedical science from gene to statistic. By any measure, bibliometric, financial, media profile or simply the lingua franca of everyday discourse about cancer, biomedicine occupies the majority of the cultural discourse around cancer. Yet the reality is that patients are people who are diagnosed, treated, survive and die with cancer in a world bounded by their personal and social experiences. Others they have known with the disease shape their values and concepts. The social determinants of cancer are of far greater importance in terms of prevention, treatment and care than is acknowledged in policy terms. In light of the demographic trend of a rapidly ageing population, increasing costs of healthcare and the urgent need to be able to deliver affordable cancer care set against the population’s almost insatiable ability to absorb all types of healthcare, there is an urgent need to redress policy balance in terms of both understanding the social determinants of cancer and bringing new insights into evidence-based national cancer planning and delivery of services.