Balancing cost and benefit in treatment of late cancer.

Developed nations overall have failed to moderate the spiralling expenditure on high-technology medical investigation and treatment. In the absence of open public and political discussion on how best to ration scarce resources, a short-term solution can be achieved by health professionals. In the case of cancer management, physicians can regulate their expenditure by clinical budgeting and by selecting treatment which is clinically appropriate for each individual patient. As resources are limited, it is no longer justifiable for one physician to spend twice as much money as another on treating patients with similar diseases. The leaders of the profession in the UK have accepted the need for instruction of physicians on the relative values of different procedures for clinical investigation and treatment. Leading medical journals in Britain have begun to point out that "doctors will need to...integrate costs into clinical decision making"....