A new Lancet Oncology Commission co-led by researchers at King's College London warns of a growing schism between scientific and clinical advances and the experience face by people living with cancer.
Launched last month at the AORTIC conference in Tunis, The Lancet Oncology Commission 'The Human Crisis in Cancer' is the result of a two-year collaboration involving authors from 11 countries and multiple disciplines, including oncology, mental health, health economics and social science. The Commission was co-led by the Institute of Cancer Policy at King's and the Global Institute of Psychosocial, Palliative and End-of-Life Care (GIPPEC) at Princess Margaret Hospital in Canada.
Drawing on scientific evidence as well as lived experience, the Commission describes how, despite unprecedented biomedical advances and technical innovation, global cancer care is failing to meet the most fundamental needs of patients and families. It shines a light on the realities facing communities in low-resource, conflict-affected and marginalised settings, becoming one of the first major reports to directly challenge the narrative of relentless progress in global cancer care.
The central argument of the Commission is that although recent years have brought extraordinary medical advances, including targeted therapies, surgical robotics, new imaging techniques, and AI, the global cancer system continues to struggle to meet the human needs of those it is designed to serve and global equity gap continues to widen.
Care structures have increasingly evolved around efficiency metrics, technological delivery and commercial incentives. As a result, the emotional and relational aspects of cancer care are too often neglected. The report documents widespread fragmentation across services, poor communication, late or absent integration of palliative care, and minimal access to mental-health support. These systemic gaps leave many patients feeling unsupported, misunderstood, or even harmed by structures intended to help them.
The consequences are most severe for those already affected by inequality, stigma, or the instability of conflict and fragile health systems. The Commission highlights that these failures are not the result of individual clinicians, but stem from broader design choices, value systems, and political economies that prioritise a techno-centric approach to cancer over a person-centred one.
A call to rebalance global cancer care
The Commission argues that many of the interventions proven to ease suffering, from patient navigation and early palliative care to systematic distress screening and psychosocial support, are low-cost, scalable and backed by strong evidence. Yet they remain underfunded and underused because they generate little revenue.
The report calls for dignity, compassion and presence to be embedded as core components of quality cancer care. It urges integration of mental-health and palliative care throughout the treatment pathway and highlights the need to reshape workforce training, research priorities and reimbursement models to reflect what patients truly value. It also argues for a new approach to reforming national cancer plans and a research agenda that serves the interests of society, not just commerce.
Our Commission highlights how the erosion of meaning, connection, and compassion in the experience of cancer impacts outcome However, this is not inevitable and with deliberate structural change and a renewed commitment to dignity and person-centred care, we can build cancer systems that truly serve patients rather than commercial determinants."
Professor Richard Sullivan, Director, Institute of Cancer Policy and Co-Director of the Centre for Conflict & Health Security
By showing that these challenges are systemic rather than individual, the Commission highlights a single, clear message: losing sight of the human relationships at the centre of care is a key driver of cancer care's global crisis.
