Cancer is a micro-evolutionary process at the cellular level. Our guest lecturers next week will show you how the application of evolutionary theory to cancer has potential for a future Nobel prize. It will also illustrate why every medical student needs to understand evolution. (You are the lucky ones!) Cancer evolution has many parallels with the evolution of antimicrobial resistance. Many antibiotic resistance concepts apply here too, especially for the evolution of chemotherapy resistant cancer clones.

Athena Aktipis and Carlo Maley are two extremely talented evolutionary medicine researchers who have launched the Center for Evolution and Cancer at UCSF and are currently at the Center for Evolutionary Medicine at Arizona State University.

Athena Aktipis PhD

Athena Aktipis is the Director of Human and Social Evolution and co-founder of the Center for Evolution and Cancer at the University of California, San Francisco, and a Research Scientist in the Psychology Department at Arizona State University.  She is a theoretical evolutionary biologist, cancer biologist and cooperation theorist who now works at the intersection of these fields.  Dr. Aktipis is the author of the forthcoming book from Princeton University Press “Evolution in the flesh: Cancer and the transformation of life.”

Carlo Maley PhD

Carlo C. Maley is the director of the Center for Evolution and Cancer at the University of California, San Francisco. Dr. Maley is interested in the evolution of cancer, both at the level of cells evolving in neoplasms and at the level of the effects of cancer as a selective pressure on multicellular organisms. The Maley laboratory is exploring fundamental concepts in neoplastic progression, the process by which normal tissue becomes cancerous, and the evolution of therapeutic resistance, for purposes of developing better methods for cancer prevention and therapy. Carlo studies the evolution of clones during neoplastic progression of Barrett’s esophagus as well as the selective effects of therapy in acute myeloid leukemia (AML) and esophageal adenocarcinoma. It is also developing the comparative biology of cancer to determine how large, long-lived organisms like whales are able to suppress cancer 1000-fold better than humans.

You can read more about Athena and Carlo here and here.

Required Reading:

1. Life history tradeoffs in cancer

Optional extras:

2. 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.

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.  Merlo et al. Cancer as an evolutionary process

Assignment for November 4th: There is no writing project this week. But, I do want you to do some online research for this week. Try to find an article about the pros and cons of widespread screening for cancer. Should we be testing everybody for cancer, at younger and younger ages? If it is true that the earliest cancers are treatable, and finding them makes treatment possible, shouldn’t we screen everybody every year for every cancer? Why or why not?

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Joe Alcock

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