Chemotherapy in adult cancer. When is it most useful?

Much has been accomplished in the cure of cancer with chemotherapy, but much remains to be done. The primary care physician's responsibility is to know which cancers are curable and in which a significant portion of patients may benefit from chemotherapy. Patients with a malignancy in a relatively resistant organ site represent the greatest challenge to the "art" of medicine. Even if more than half of patients with a given malignancy are cured by chemotherapy, the remainder deserve the right to participate in research protocols, an undertaking that might further improve these otherwise substantial gains. As research studies show improved cure rates with antineoplastic agents, the need to reduce both short- and long-term side effects will remain a challenge.