There is an increasing number of cancers worldwide due to epidemiological transition. Longer life spans resulting in aging population is among some of the reasons for growing burden in cancer worldwide. The number of new cancer cases is expected to increase by nearly 75% by 2030 (107,000 additional cases per annum), with 60% of cases in the elderly (aged ≥65). The extent of cancer related morbidity and mortality is directly linked to the effectiveness of efforts to prevent, control and treat cancer, particularly in the developing world. In 2012, almost 57% of all cancer cases and 65% of cancer deaths occurred in low-and middle-income countries. If the current trend continues, the burden of cancer will increase to 22 million new cases annually by 2030, with 81% of new cases and almost 88% of mortality occurring in less developed countries. Cancer care in a country like Pakistan is challenging because of lack of strategic information and national planning for cancer control. Cancer registry provides important information that helps in directing and planning cancer prevention and care. Lack of national cancer registry limits estimation of true burden, identification of areas that require special need and thereby proper treatment strategy. Health systems required to deliver comprehensive life-saving treatments are limited in the country. Out of pocket payments and private health care usage remains high. A number of patients are not covered by insurance and individuals face catastrophic expenditure in seeking treatment. As a result, there is disparity in access to quality care. High incidence of later stage disease is very common due to social stigma associated with cancer treatment, myths, lack of awareness and preference for alternative treatment options. Drugs that have lately revolutionized cancer management are either not available in the country and if present, are extremely expensive for a common person to afford. Palliative care and access to supportive care medicines is almost nonexistent. Pain management is restricted to analgesics without narcotics. With cancer rates steadily rising in low- and middle-income countries, the disease will inevitably frustrate global development efforts unless urgent action is taken.