Popular understanding holds that genetic changes create cancer. James DeGregori uses evolutionary principles to propose a new way of thinking about cancer’s occurrence. Cancer is as much a disease of evolution as it is of mutation, one in which mutated cells outcompete healthy cells in the ecosystem of the body’s tissues. His theory ties cancer’s progression, or lack thereof, to evolved strategies to maximize reproductive success.
Through natural selection, humans evolved genetic programs to maintain bodily health for as long as necessary to increase the odds of passing on our genes—but not much longer. These mechanisms engender a tissue environment that favors normal stem cells over precancerous ones. Healthy tissues thwart cancer cells’ ability to outcompete their precancerous rivals. But as our tissues age or accumulate damage from exposures such as smoking, normal stem cells find themselves less optimized to their ecosystem. Cancer-causing mutations can now help cells adapt to these altered tissue environments, and thus outcompete normal cells. Just as changes in a species’ habitat favor the evolution of new species, changes in tissue environments favor the growth of cancerous cells.
DeGregori’s perspective goes far in explaining who gets cancer, when it appears, and why. While we cannot avoid mutations, it may be possible to sustain our tissues’ natural and effective system of defense, even in the face of aging or harmful exposures. For those interested in learning how cancers arise within the human body, the insights in Adaptive Oncogenesis offer a compelling perspective.
In 1985 the media announced a new therapy for cancer. It was expensive, labor-intensive, and toxic--but, they said, it worked. How it worked is the story Ilana Löwy tells in Between Bench and Bedside, a compelling account of the clinical trials of interleukin-2 at a major French cancer hospital. Her book offers a remarkable insider's view of the culture of clinical experimentation in oncology--and of how this culture affects the development of new treatments for cancer.
Löwy, a historian of science who trained as an immunologist, makes the life of the laboratory and the hospital comprehensible and immediate. Before immersing us in the clinical drama, she fills in the history behind the action--a background of chemotherapy and radiation, controlled clinical trials, and the long line of immunological approaches that finally led to interleukin-2. The story then shifts to the introduction of interleukin-2 in a cancer ward. Löwy conveys the clinical investigation as a complex, multilayered phenomenon that defies the stereotypes of modern biomedicine. In this picture, the miracle-makers and arrogant, self-centered professionals of myth give way to moving images of real people negotiating the tensions between institutional and professional constraints, the search for a scientific breakthrough, and the obligation to alleviate the suffering of a patient. The result is a rare firsthand look at the multiple factors that shape real-life clinical experiments and the institutional tangle and emotional muddle that surround such trials--an invaluable view at a time when medicine is undergoing such great and confusing changes.
An innovative theory proposes a new therapeutic strategy to break the stalemate in the war on cancer. It is called cancer stem cell (CSC) theory, and Lucie Laplane offers a comprehensive analysis, based on an original interdisciplinary approach that combines biology, biomedical history, and philosophy.
Rather than treat cancer by aggressively trying to eliminate all cancerous cells—with harmful side effects for patients—CSC theory suggests the possibility of targeting the CSCs, a small fraction of cells that lie at the root of cancers. CSCs are cancer cells that also have the defining properties of stem cells—the abilities to self-renew and to differentiate. According to this theory, only CSCs and no other cancer cells can induce tumor formation.
To date, researchers have not agreed on the defining feature of CSCs—their stemness. Drawing from a philosophical perspective, Laplane shows that there are four possible ways to understand this property: stemness can be categorical (an intrinsic property of stem cells), dispositional (an intrinsic property whose expression depends on external stimuli), relational (an extrinsic property determined by a cell’s relationship with the microenvironment), or systemic (an extrinsic property controlled at the system level). Our ability to cure cancers may well depend upon determining how these definitions apply to different types of cancers.
Approximately eight percent of our DNA contains retroviral sequences that are millions of years old. Through engaging stories of scientific discovery, Anna Marie Skalka explains our evolving knowledge of these ancient denizens of the biosphere and how this understanding has significantly advanced research in genetic engineering, gene delivery systems, and precision medicine.
Discovering Retroviruses begins with the pioneer scientists who first encountered these RNA-containing viruses and solved the mystery of their reproduction. Like other viruses, retroviruses invade the cells of a host organism to reproduce. What makes them “retro” is a unique process of genetic information transfer. Instead of transcribing DNA into RNA as all living cells do, they transcribe their RNA into DNA. This viral DNA is then spliced into the host’s genome, where the cell’s synthetic machinery is co-opted to make new virus particles. The 100,000 pieces of retroviral DNA in the human genome are remnants from multiple invasions of our ancestors’ “germline” cells—the cells that allow a host organism to reproduce. Most of these bits of retroviral DNA are degenerated fossils, but some have been exploited during evolution, with profound effects on our physiology.
Some present-day circulating retroviruses cause cancers in humans and other animals. Others, like HIV, cause severe immunodeficiencies. But retroviruses also hold clues to innovative approaches that can prevent and treat these diseases. In laboratories around the world, retroviruses continue to shed light on future possibilities that are anything but “retro.”
Although chemotherapy harms the immune system and is increasingly demonstrated to be an ineffective long-term cure for the vast majority of cancers, it remains the standard treatment for most cancer patients. Ruzic, a former scientific magazine publisher and originator of a science center, refused to accept this status quo, and instead plunged into the world of cutting-edge treatments, exploring the frontiers of cancer science with revolutionary results.
Ruzic went on the offensive: visiting scores of laboratories, gathering information, talking to researchers, and effectively becoming his own patient-care advocate. This book presents his findings. A scathing critique of the chemotherapy culture as well as unscientific "alternative" therapies, the book endorses state-of-the-art molecularly based technologies, making it an illuminating and necessary read for anyone interested in cancer research, especially patients and their families and physicians.
Neil Ruzic was expected to die within two years of his initial diagnosis. Five years later he has been declared cancer-free and considers himself cured.
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