The state of oncology in 2014 and the role of palliative care for advanced and metastatic malignancies

In 1971, when United States President Richard Nixon declared war on cancer, he stated, “The time has come in America when the same kind of concentrated effort that split the atom and took man to the moon should be turned toward conquering this dread disease” (1). In that year, approximately $250 million was spent on cancer research and 337,000 patients died of malignancies. In 2014, an estimated 585,720 cancer deaths are projected to occur in the United States (2), and the National Institutes of Health now estimates that the annual overall cost associated with cancer to be $216.6 billion, with $86.6 billion for direct health care costs and $130 billion for loss of productivity due to morbidity and mortality (3).