β Scribed by Samuel Hellman
No coin nor oath required. For personal study only.
E volution is the dominant fact of biology,'' stated Nobel laureate and codiscoverer of the structure of DNA, James D. Watson 1 at a recent meeting at the University of Chicago. Although there has been a great deal of interest in the evolution of cancer, it has been focused primarily on preclinical events; however, these concepts apply as well to the clinical manifestations of cancer. To design a strategy for cancer management, one must have a model of the disease. For such a model to be useful it must be consistent with what we already know, especially with what Watson describes as ''the dominant fact of biology.'' We must understand what evolutionary theory both states and implies before we can apply it in the clinic. What follows is a discussion of the clinical relevance of evolutionary concepts as they bear on the development of a cancer, its natural history and prognosis, and to determining appropriate therapeutic strategies.
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