Evolving paradigms and perceptions of cancer

The word cancer produces widely differing perceptions between the general public, and the scientific and medical communities. These different ideas lead to very diverse understandings of the disease. The paradigms affect both the focus and design of research and also impact upon patient care. The cultural perception is very pessimistic: a relentless, incurable, extremely painful disease, the treatment of which is conceived as difficult, with little chance of a simple cure. Within the medical and scientific communities, however, there are a number of quite different views of the disease. Both the orderly extension of disease described by Halsted, and the systemic nature of cancer even when it appears to be localized, are perceptions within the professional community. The promise of a 'magic bullet' is in sharp contrast to the incremental advances seen in clinical oncology. What is needed is a clear recognition of how these varying perceptions of cancer affect and limit communication among the cancer-related disciplines as well as between these disciplines and the public. Both professionals and the general public should consider cancer as a group of diseases for which cure is related to tumor type, stage and available treatment.