Cancer can be thought of as a micro-evolutionary process at the cellular level.

I will show you how the application of evolutionary theory to cancer evolution, dispersal, and relapse has potential for a future Nobel prize. It will also illustrate why every medical student needs to understand evolution.

Cancer evolution has many parallels with the evolution of antimicrobial resistance. Many of the concepts we learned for that earlier topic will apply here too, especially as they relate to evolution of chemotherapy resistant cancer clones.

Athena Aktipis and Carlo Maley are authors of some of this week’s readings. They are two extremely talented evolutionary medicine researchers who have launched the Center for Evolution and Cancer at UCSF. You can read more about them here and here.

1. Merlo et al. Cancer as an evolutionary process

2.Pepper and Maley

3. Aktipis, Maley, and Pepper. Dispersal Evolution in Neoplasms: The Role of Disregulated Metabolism in the Evolution of Cell Motility. Cancer Prevention Research, Feb 2012.

4. Aktipis Kwan et al Overlooking Evolution: A Systematic Analysis of Cancer Relapse and Therapeutic Resistance Research. PLoS One. 2011;6(11):e26100. Epub 2011 Nov 17.

Writing project:

Researchers have discovered that aggressive screening and treatment of many cancers can be ineffective and counterproductive. We will discuss several examples of this in class, including breast cancer and prostate cancer. What are some of the reasons why chemotherapy (anti-cancer drugs) can sometimes result in worse outcomes, including metastatic disease and shorter lives? Use the readings to explain your answer.

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Joe Alcock

Emergency Physician, Educator, Researcher, interested in the microbiome, evolution, and medicine