These authors contributed equally to this work
Preventive Evolutionary Medicine of Cancers
Article first published online: 5 DEC 2012
© 2012 The Authors. Evolutionary Applications published by Blackwell Publishing Ltd.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Special Issue: Evolution and Cancer
Volume 6, Issue 1, pages 134–143, January 2013
How to Cite
Hochberg, M. E., Thomas, F., Assenat, E. and Hibner, U. (2013), Preventive Evolutionary Medicine of Cancers. Evolutionary Applications, 6: 134–143. doi: 10.1111/eva.12033
- Issue published online: 21 JAN 2013
- Article first published online: 5 DEC 2012
- Manuscript Revised: 30 OCT 2012
- Manuscript Accepted: 30 OCT 2012
- evolutionary cell biology;
- preventative evolutionary medicine;
Evolutionary theory predicts that once an individual reaches an age of sufficiently low Darwinian fitness, (s)he will have reduced chances of keeping cancerous lesions in check. While we clearly need to better understand the emergence of precursor states and early malignancies as well as their mitigation by the microenvironment and tissue architecture, we argue that lifestyle changes and preventive therapies based in an evolutionary framework, applied to identified high-risk populations before incipient neoplasms become clinically detectable and chemoresistant lineages emerge, are currently the most reliable way to control or eliminate early tumours. Specifically, the relatively low levels of (epi)genetic heterogeneity characteristic of many if not most incipient lesions will mean a relatively limited set of possible adaptive traits and associated costs compared to more advanced cancers, and thus a more complete and predictable understanding of treatment options and outcomes. We propose a conceptual model for preventive treatments and discuss the many associated challenges.