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.
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