Many common solid tumours present at an advanced and surgically incurable stage. A substantial number of these cancers are relatively resistant to various forms of systemIc therapy. Fewer than 20% of patients with lung, gastric and pancreatic neoplasms will have potentially 'curative' resections, while 50% of those undergoing surgery for colorectal cancer will die from disseminated disease. Chemotherapy is not uncommonly administered to selected patients with lung and gastrointestinal cancers. Although some recent studies have shown a small but signficant impact on survival, prominent treatment-related side-effects are relatively common. It is not surprising, therefore, that the features associated with cancer and its treatment, which may adversely affect quality and duration of survival, are receiving increasing attention.