Ietje Perfors

109 Background Cancer is the second leading cause of death globally. In 2018, over 17 million people worldwide were diagnosed with cancer, a number that is expected to reach 21 million patients by the year 2030. 1 As cancer mainly affects the elderly, the increase is to a large extent caused by aging. Cancer treatment should be personalised. This means that, besides tailoring treatment choice to tumour characteristics, for every patient the treatment option should be chosen which best fits a patient’s preferences and circumstances. This is increasingly complex because of several reasons. First, the spectrum of treatment modalities for cancer expanded in recent years. Second, 70% of cancer patients has at least one co-morbidity, which may interfere with cancer treatment. 2, 3 Furthermore, treatment decisions become more complex at higher age, due to co-morbidities, declining life expectancy and changing life perspectives and priorities. Consequently, personalised treatment decisions require a balanced decision-making process between patients and healthcare professionals, with thorough weighing of curative treatment options in the light of patient preferences and personal context. Although many general practitioners (GPs) do participate in follow-up care after completion of cancer treatment, structural guidance and care by the GP starting from the moment of diagnosis onwards is uncommon. 4, 5 In view of their position this seems to be a missed opportunity. GPs are well equipped to support the patient during their cancer care pathway: they usually have a longstanding and personal relationship with their patients and work with an integral and personalised approach, including psychosocial support. In that regard, of all care-givers involved, GPs are probably best positioned to balance treatment options in the perspective of the patient’s medical history and personal preferences. 6, 7 It is therefore that professional and patient organisations advocate a structured and expanded role for the GP in the cancer care pathway, starting from the moment cancer is diagnosed. 6 Personalised cancer care requires active involvement of the patient in treatment decision by shared decision making (SDM). For successful SDM in complex decisions several steps are required; i.e., creating awareness of 5