The world federation of surgical oncology societies: The global mission

Global health from a cancer care perspective

Cancer is now recognized as one of the four leading causes of morbidity and mortality worldwide, and incidence is expected to rise significantly in the next two decades. Unfortunately, low- and middle-income countries (LMIC) suffer disproportionately from the world's cancer cases. The growing burden of cancer and maldistribution of cancer care resources in LMIC warrant a massive re-evaluation of the structural inequalities that produce global oncological disparities and a worldwide commitment to improve both prevention and treatment strategies. Efforts to improve cancer care capacity should focus on horizontal strengthening of healthcare systems that provide safe, affordable, effective and sustainable care. In response to current deficiencies, many international organizations have started to partner with LMIC to create solutions. Telemedicine and international collaboration are also promising ways to effect change and improve global oncological care.

Advancing cancer care: the quality spiral: Sir Thomas Myles Lecture

HYPOTHESIS

Good patient care, research and education should be so inextricably linked that each should drive the other towards improvements in quality of care, innovation and discovery.

DISCUSSION

Each element of good clinical cancer care, including specialisation, multidisciplinary management, audit and systematic organisation, provides a powerful stimulus to research. The qualities required for good research inevitably enhance educational activity. High quality in education and training are essential in improving cancer care. Obstacles to good medical care are identified and the importance of supporting doctors is emphasised. The question of permanent staff-grade medical appointments or the grade of physician assistants is raised. Challenges to university-based and hospital-based research are outlined. Attention is drawn to issues concerning the training of cancer specialists, particularly in surgical oncology.

CONCLUSION

Good patient care stimulates research, research drives educational activity and education improves care. Interaction of these elements of medicine and science constitutes an interdependent upward spiral towards excellence.

Kindred spirits of the endocrines: The training of the future endocrine surgeons

The growth of knowledge and complexity now seen in General Surgery, has led to the sub-specialization of the discipline. Although it is considered by some to have led to the fragmentation of General Surgery and the erosion of the specialty as we know it today, others would argue that it has and will continue to lead to a stronger division and a higher standard of care. Most would argue that a higher standard of care in focus areas stimulates research and research, in turn, improves the quality of education and training. Ultimately, improved education and training leads to better patient care. Organ-specific specialization such as orthopedics and urology evolved from General Surgery and demonstrates this principle. Further sub-specialization is likely inevitable, if the discipline of General Surgery is to remain a desired specialty. Endocrine surgery has evolved into a sub-specialty of General Surgery, and over the last few decades has matured as a discipline. With this maturation comes the responsibility of defining the standard of care to be provided by surgeons involved in endocrine surgery. To achieve this goal, endocrine surgical associations and societies must set the standard of training both at the residency and postgraduate level. Where we are as a sub-specialty, where we came from, and what it will take to meet this goal are discussed.