The human crisis in cancer : a Lancet Oncology Commission

Rodin, Gary and Feldman, Amalya and Trapani, Dario and Skelton, Mac and Unger-Saldaña, Karla and Essue, Beverley and Pihlak, Rille and Walshe, Catherine and Rosa, William E and Banegas, Matthew P and Zambrano-Lucio, Miguel and Salah Daood, Rawaz and Aggarwal, Ajay and Dewachi, Omar and Shapiro, Gilla K and Munisamy, Murallitharan and Rajah, Harenthri Devy Alagir and Atreya, Shrikant and Dhyani, Vijay Shree and Kong, Yek-Ching and Mathew, Mebin and Ochoa-Dominguez, Carol Y and Rao, Arathi Prahallada and Rao, Seema Rajesh and Simha, Srinagesh and Preston, Nancy and Lam, Wendy Wing Tak and Davis, Hanae and Zimmermann, Camilla and Namisango, Eve and Ntizimira, Christian and Smyth, Elizabeth and Li, Madeline and Salins, Naveen and Bhoo-Pathy, Nirmala and Sullivan, Richard (2025) The human crisis in cancer : a Lancet Oncology Commission. Lancet Oncology. ISSN 1470-2045 (In Press)

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Abstract

Amid unprecedented scientific progress in oncology, a growing body of evidence reveals a parallel and profound crisis in the human experience of cancer care. Despite overall survival outcomes improving, the systems designed to deliver care increasingly fall short in addressing the emotional, relational, and existential dimensions of cancer. Although examples of compassionate and attentive care can be found in every setting, patients and families across global contexts continue to report being unheard, unsupported, and, at times, actively harmed by care structures that prioritise technical precision over human presence. This Lancet Oncology Commission proposes that the human crisis of cancer is not defined by pathology, mortality, or cause, but by the erosion of meaning, connection, and compassion in the experience of cancer. This crisis is shaped by what is present and what is absent: the presence of fragmented, costly, and impersonal systems and the absence of human connection, psychological safety, and relational care. It is a crisis that spans delivery, mental health, palliative care, research, and education-one that is not peripheral to oncology's progress but central to its failures. The impacts of this crisis are felt most acutely by those already made vulnerable by inequity, discrimination, and economic precarity, but it is a system-level failure that ripples across every context, from the most resource-rich to the most resource-constrained settings. Addressing this crisis will require more than good intentions; it will demand confronting the structural incentives and ideologies that have devalued the relational foundations of cancer care. This Commission identifies a growing imbalance between technological innovation and the human dimensions of cancer care. As the field has increasingly prioritised biopharmaceutical development, genomic precision, and market-driven efficiencies, it has often neglected core practices that uphold dignity, alleviate suffering, and build trust.