Cancer has plagued humans throughout history. Although it's not a uniquely human affliction, it can be found lurking in virtually every living creature going as far back as the dinosaurs.
Cancer arises when well-behaved cells go rogue and start to grow and divide uncontrollably. Whether it's triggered by an external factor, like smoking, or an 'inside job', like errors caused by our own DNA repair machinery, cancer cells take advantage of the natural forces of evolution and the genes essential for multicellular life to wreak havoc.
This is why cancer is so difficult to eradicate - it's simply the price we pay for life. If we didn't have the genes or selection pressures to drive one cell to become many, we'd still be single-celled organisms swimming around the primordial soup.
Over the last century researchers and clinicians have made significant progress in understanding cancer and developing treatments, but all too often the drugs don't work.
In her latest book 'Rebel Cell: Cancer, evolution and the science of life', Dr Kat Arney, award-winning science writer and geneticist, explores the origins of cancer and the radical approaches that might one day help overcome it. If you look beyond the textbook-like title and cover, you're in for a thrilling piece of science storytelling.
The book opens with a whistle stop tour of the history and biology of cancer, starting from the origins of life over 4 billion years ago to the present day. Along the way, Dr Arney introduces some obscure creatures, such as comb jellies and sea sponges and tells some grisly tales about horned rabbits, soot warts and devil facial tumours. We also learn that cancer cells are capable of having sex, which worryingly enhances their ability to resist treatment. These stories are not only hard to forget but they also bring the science to life.
Dr Arney uses humour, analogies and metaphors to make technical concepts easier to digest. She compares telomeres to shoe laces, describes Dictyostelium mucoroides as 'asshole amoebas!' and explains how genetic mutations accumulate like 'typos in the genetic recipe book within our cells.'
The middle section of the book has a more sombre tone as Dr Arney explains why the majority of current treatments fail and whether anything can be done about it. She uncovers flaws in the pharmaceutical industry, describes current treatments as a game of whack-a-mole and explores why 'cancer is unavoidable for some and maybe inevitable for all of us.'
Although it may feel a little bleak compared to the first half of the book, it's notable that Dr Arney doesn't shy away from difficult topics. Her use of personal experiences, interviews with famous scientists and in-depth understanding of the scientific literature also add a sense of intimacy and authority.
Towards the end of the book there's a greater sense of optimism as Dr Arney puts forward solutions for deciphering the cancer cell's 'playbook' in order to beat it at its own game.
Using data from clinical trials and research that spans almost every scientific discipline, Dr Arney shows how understanding the evolutionary journey that these cells are on could help us to predict where they're going and steer them towards an evolutionary dead end or, at the very least, create a diversion.
She asks us to imagine cancer as an ecosystem. To think of tissues like miniature habitats of the body and tumours as populations of genetically diverse individuals roaming around these habitats subject to the rules and whims of natural selection. Even metastasis is cleverly described like a migrating population going in search of resources – risking their lives for the hope of making a better life for them and their offspring.
Dr Arney ends by telling us that cancer is not something alien, but an intrinsic part of multicellular life. And understanding it as an evolving entity could potentially help us find successful therapeutic approaches.
This book really gets to the heart of the question 'what is cancer?' and offers some new ways of thinking about it and overcoming it. The conversational and lively tone makes it easy to read, which is great for non-experts. Also, for those working in the field, there are plenty of thought-provoking ideas and further reading to keep you interested.
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