Cancer through the lens of evolution

Cancer is generally regarded as uncontrolled cell proliferation, propelled by mutant genes and resulting, all too often, in invasion of our tissues and hijacking of essential body functions.  Some regard this process as a ‘disease of the genome’.  What has been missing from the narrative has been a coherent framework that makes sense of all the complexity and uncertainties: why are we so vulnerable to cancer, why is there so much diversity between different cancers and even within single cancer types?  And why does treatment so often fail or only temporarily succeed?

 A new view of cancer sees it as a classical Darwinian process of natural selection, not of animals or plants, but of our cells, evolving, over years or decades as robust and highly adaptable mutants within the ecosystem habitats of the body.  Cancer therapies inadvertently contribute to this process by providing selective pressures encouraging the emergence of resistant cells - as with bacteria and antibiotic use.  Evolutionary principles derived from ecology and the study of human evolution can change the way we think about the big question in cancer research and provide new avenues to explore for more effective control.

 A few references:

 Greaves M (2007)  Darwinian medicine: a case for cancer.  Nat Rev Cancer, 7: 213-221.

Greaves M, Maley CC (2012)  Clonal evolution in cancer.  Nature, 481: 306-313.

 Greaves M (2014)  An evolutionary foundation for cancer control.  World Cancer Report 2014 (eds Stewart BW, Wild CP).  International Agency for Research on Cancer (IARC), Lyon, pp 337-345.

Host: Professor Bob White