"THAT'S the thing about cancer; it's all yours – it's entirely, perfectly personalised." So says Kit, a character in The Quarry, the final novel by the Scottish writer Iain Banks – who himself died earlier this month from cancer. "An unwilled suicide where... one small part of the body has taken a decision which will lead to the death of the rest."
Kit is right. Outside the lab, or hospital, we continue to talk about "a cure for cancer" as though it was a single disease, with a single cure. But it's an understatement even to say that every case is different: individual tumours in the same person can be quite different, each carrying enormous numbers of distinct genomes (see "Rapid evolution of tumours may be their Achilles' heel").
That may be why cancer is so difficult to treat. Current treatments are based on the bulk, brute removal of cells – but miss even a few, and evolution will see to it that the cancer returns in a new, often more resistant, form.
Bacteriologists and virologists have long employed evolutionary biology to develop therapies aimed at thwarting adaptation. Now it seems cancer researchers must do the same if we are to find cures for our cancers.
This article appeared in print under the headline "An evolving battle"
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