Not all the news coming out of the European Society for Medical Oncology (ESMO) Annual Meeting 2025, held in Berlin, Germany, from October 17 to 21, is positive. Alongside major discoveries expected to soon change clinical practice and new ideas to improve cancer care, data presented at the meeting revealed that the global oncology workforce is facing a serious crisis — one that could slow, or even compromise, progress in treatment and patient access to care.

From the sharp decline in the number of oncologists to the unmet training needs of younger professionals, these challenges dominated several sessions that prompted widespread discussion and concern.

Where Are the Oncologists?

New cancer therapies risk being ineffective if patients cannot access them — and that requires having enough specialists to deliver care. Yet, data presented at ESMO 2025 painted a troubling picture.

David J. Benjamin, MD, medical oncologist at the Hoag Family Cancer Institute in Newport Beach, California, presented findings from a study mapping the global distribution of the oncology workforce.

The analysis identified just under 83,000 medical oncologists in 105 countries, with the vast majority (92%) based in high- and upper-middle-income nations. In high-income countries, there is approximately one oncologist for every 256 new cancer cases compared with one per 169 cases in upper-middle-income countries. The ratios drop sharply in lower-middle-income countries — one for every 597 new cases — and become alarming in low-income nations, with one oncologist for every 7160 new cases.

Benjamin emphasized the urgent need for global data collection and workforce-strengthening strategies to address inequities in access to life-saving cancer care.

“This is an issue that ESMO began addressing about 10 years ago,” said Giuseppe Curigliano, MD, PhD, of the European Institute of Oncology in Milan, Italy, and ESMO president-elect. He noted that oncology training programs in Italy are also under strain, with particular shortages of pathologists and radiologists, both essential for accurate cancer diagnosis and treatment.

To help address the gap, ESMO has launched training programs for medical students, held twice a year, designed to introduce young clinicians to modern oncology. In 2025, these sessions took place in Valencia, Spain, and Naples, Italy. “I believe scientific societies such as ESMO and AIOM (the Italian Association of Medical Oncology) have a duty to teach the importance of oncology as a discipline,” Curigliano said. “We must engage students and show them the value and the beauty of this work.”

Jean-Yves Blay, MD, general director of the Léon Bérard Center, an integrated cancer institute in Lyon, France, and ESMO director of public policy, echoed those concerns in comments to Univadis Italy, a Medscape Network platform. “We are too few, and the outlook is not encouraging,” he said. “We must inform policymakers and keep emphasizing that training must be the key priority in this context.”

New Curriculum for a New Oncology

The oncology workforce crisis begins with education — particularly training in psychosocial aspects, which every oncologist must navigate in daily practice. This was underscored by findings from a survey presented at the meeting by Rille Pihlak, PhD, clinical lead of the Estonian Cancer Network.

Despite growing recognition of the crucial role psychosocial factors play in patient outcomes, medical training continues to overlook the humanistic dimensions of oncology, focusing instead on biomedical, technical, and technological skills.

The global survey included 292 oncology professionals from 71 countries (60% women; mean age, 45 years, with an average of 15 years of experience). Importantly, 41% of participants came from low- or middle-income countries, providing broad international insight.

More than half (56%) reported being highly involved in providing psychosocial support to patients, and another 30% said they were partially involved. Yet 7 in 10 oncologists indicated that less than 10% of their education covered psychosocial or humanistic competencies, and only 14% were satisfied with their training in these areas.

None of the respondents had completed the ESMO/American Society of Clinical Oncology joint psychosocial training curriculum, and an overwhelming 88% expressed a desire for additional education on these topics.

When asked what prevents the integration of these subjects into oncology training, participants cited several key barriers:

• Lack of dedicated programs (76%)
• Lack of institutional support (70%)
• Low awareness of the topic’s importance (63%)
• Financial constraints (42%)

Cultural barriers also play a role, including stigma surrounding mental health and end-of-life care (60%). Notably, there were no major differences between high-, middle-, and low-income countries — underscoring the global nature of the problem.

Pihlak stressed that psychosocial skills must become an integral and mandatory part of oncology curricula from the earliest stages of medical training. Addressing concerns that oncology education is already saturated, she disagreed: “I don’t think oncology training has reached saturation,” Pihlak told Univadis Italy. “There is room for education on psychosocial topics. We just need to think about how to integrate this knowledge into a single, comprehensive curriculum. But we can no longer afford to neglect this side of oncology.”

She also highlighted the need to involve psycho-oncologists — specialists who complement medical oncologists but remain underrepresented in cancer care teams.

Pihlak reported receiving travel and educational support from Servier, Chugai, Bayer, AstraZeneca, Merck, and Takeda. Benjamin reported advisory or consultancy roles with AIMED Bio, Astellas, AVEO Oncology, Bayer, Dendreon, Eisai, EMD Serono, Exelixis, GlaxoSmithKline, Janssen, Janux, Merck KGaA, and Seagen; speaker bureau activities for Merck Sharp & Dohme; and travel and accommodation support from DAVA Oncology, Janux, Merck KGaA, Merck Sharp & Dohme, and Seagen.

This story was translated from Univadis Italy.