The science of treating cancer with specific chemicals as an adjunct to surgery and radiotherapy developed in the second half of the twentieth century, from the use of single agents to the administration of drug cocktails, with spectacular results for some types of cancer. By the beginning of the next millennium these had been joined by the first ‘targeted’ agents, namely kinase inhibitors and the first monoclonal antibodies. These advances have significantly expanded treatment options but one of the biggest obstacles remains that of drug resistance. The astonishing success of vaccines that prevent infection by human papillomaviruses (HPVs) is already making a major impact on the incidence of cervical carcinoma and other types of cancer caused by oncogenic forms of these viruses.

In parallel with these therapeutic and preventative advances, developments in imaging methods, both for tumour detection and monitoring response to therapy, are showing promise. The pressing need to define tumour biomarkers that can be detected at the earliest possible stage has brought the emerging sciences of proteomics and metabolomics to the fore while gene expression profiling has already made substantial contributions to the diagnosis and classification of tumours.