In our first post, we described Peter Nowell’s “Clonal Evolution of Tumor Cell Populations” as having shaped subsequent theory on cancer as a disease of evolutionary development. In this post, we refer to a recent article by Mel Greaves, Professor of Cell Biology at the Institute of Cancer Research in London, as exemplary of his prolific work (e.g., Cancer: the evolutionary legacy, Oxford University Press, 2000) that has built on Nowell’s theory.
“A pragmatic focus on immediate, or proximate, causal mechanisms in cancer has been very productive” (213). In other words, Greaves has nothing but praise and appreciation for the work of cancer epidemiologists and of oncologists in determining underlying causes for various cancers. However, “Any engineer confronted with a recurring fault in a complex machine or plant would look not only at the immediate source and cause of the fault, but at system design, its compromises and limitations. The engineer will resort to a blueprint; we have evolutionary biology” (214). What does this blueprint reveal? “Underlying the prevalence of cancer in human societies, there is an inherent vulnerability acquired as a legacy of our evolutionary history” (219). Greaves describes that for which he has provided detail elsewhere: the “cancer lottery” with two major mechanisms: “evolutionary mismatches” of lifestyle and the “inherent vulnerability” resulting from genetic mutations.
We recommend this article for its clear exposition of cancer and evolution.