# Less is more: inverting the paradigm across the cancer care continuum

**Authors:** Julien A.M. Vos, Sahar Barjesteh van Waalwijk van Doorn-Khosrovani, Hans M. Westgeest

PMC · DOI: 10.1016/j.eclinm.2025.103599 · eClinicalMedicine · 2025-10-24

## TL;DR

This paper argues that cancer care should shift from excessive interventions to a more thoughtful, patient-centered approach that prioritizes quality over quantity.

## Contribution

The paper introduces practical strategies to reduce overuse in cancer care and advocates for a 'less is more' paradigm shift.

## Key findings

- Current cancer care practices often lead to unnecessary burdens for patients and healthcare systems.
- The Netherlands is leading efforts to de-escalate ineffective cancer care practices.
- A 'less is more' approach is proposed to prioritize value over volume in cancer care.

## Abstract

Cancer care often operates under the assumption that ‘more is better’, resulting in frequent testing, intensive treatments, and constant follow-up. However, this approach has unintended consequences and places significant burdens on patients, providers, and healthcare systems. At the same time, cancer care is evolving rapidly and the number of cancer survivors continues to grow, highlighting the urgent need for reform.

In the Netherlands, important efforts are taking place to de-escalate and de-implement ineffective practices across the cancer care continuum, from screening to palliative care. The purpose of this viewpoint is to highlight these efforts and stimulate reflection across disciplines. Building on these examples, we propose practical strategies for all stakeholders, from patients to payers and policymakers, to help reduce overuse and prioritise value over volume. Through this work, we challenge the existing paradigm and advocate for a shift toward a ‘less is more’ approach in cancer care.

This viewpoint received no funding.

## Linked entities

- **Diseases:** cancer (MONDO:0004992)

## Full-text entities

- **Diseases:** Cancer (MESH:D009369)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC12593689/full.md

## References

32 references — full list in the complete paper: https://tomesphere.com/paper/PMC12593689/full.md

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Source: https://tomesphere.com/paper/PMC12593689