ABSTRACT
The modern treatment of a patient with cancer requires great expertise, adequate resources and a multi-disciplinary approach. Much of this approach is derived from the experience of multicenter controlled trials and the focused experience of specialist cancer centers. The experience of institutions such as Memorial Sloan Kettering Cancer Center in New York, Institute Gustave Roussy in Paris and many more has been to the forefront in clinical trials of newer approaches and the introduction of better care. This has developed pari-pasu with significant strides in research and these centers of excellence have improved our understanding of the genetics of cancer and targeted therapy. The degree of specialization within these and other modern cancer centers is such that entire teams are devoted to the management of the patient with specific diseases such as a breast service or a hepatobiliary service etc. This level of specialization is now accepted as the norm and allows the development of unique skills and expertise