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Over the past 50 years, advances in systemic therapy, radiotherapy, surgery, and supportive care have dramatically improved cancer outcomes. Yet, growing concern exists that in our race for biomedical innovation, the metrics used to evaluate progress have drifted away from the outcomes that matter most to people living with cancer. In addition, we have not built health care systems that adequately recognize the psychosocial, relational, and existential dimensions of illness. Many medical therapies approved through regulatory pathways in the past decade offer modest clinical benefit while imposing substantial burdens on patients and the sustainability of health systems globally. These patterns reflect the convergence of global structural forces-including clinical trial design, regulatory standards, practice guidelines, and reimbursement systems-that often prioritize innovation and access over greater certainty that therapies meaningfully improve clinically relevant outcomes. In this review, we examine how these interconnected forces influence patients' experiences of cancer care worldwide. We argue that sustaining meaningful progress requires a reanchoring of oncology to outcomes that reflect what patients consistently value: longer survival, preserved function, improved quality of life, and timely access to high-value care.