Last year, The New York Times ran an interesting series of articles assessing how we are doing in the 40-year war on cancer. It would seem that the answer depends very much on your perspective.

There has certainly been progress on several fronts, and perhaps the most obvious would be the development of effective targeted therapies such as imatinib and trastuzumab, which have revolutionized the treatment of chronic myelogenous leukaemia and ERBB2-positive breast cancer, respectively. Other targeted therapies have met with less success, in some cases because it has taken time to identify the patients who best respond to them, such as erlotinib in patients with lung cancer with certain epidermal growth factor receptor mutations, and in others because drugs that target crucial processes such as angiogenesis are not as effective in all solid tumours as one might have originally predicted.

The growing number of cancer survivors suggests that we are winning the war, but this might be due to the ability of clinicians to more effectively manage life-threatening side effects from anticancer therapies, rather than a substantial effect from new drugs. Screening and prevention are held up as effective measures, but progress in this area has not been as rapid as hoped. Perhaps some of the disappointment arises from the expectations of the general public in terms of cancer treatment. Many are involved in raising and donating money for cancer research and they expect to see results when loved ones develop this disease.

However, one cannot escape the fact that cancer is a complex disease and probably unique at the genetic and epigenetic level in each cancer patient. It would seem that a greater understanding of this disease and assessments of each patient might be one ideal, if costly, way forward.