1. Basic Cancer Biology

Cancer has been recognized since early times, but treatment protocols and medications have lagged, by millennia, the initial observations of the disease. The tragic cases of childhood and teenage cancer notwithstanding, most cancers develop in the aging population, consistent with the nature of metabolic, genetic and other alterations discussed below and in various chapters. Epidemiological data show that, behind heart disease, cancer is the second leading cause of death worldwide, and many expect that in time cancer will overtake heart disease as the leading cause of mortality. Some 150 years ago it was demonstrated that cancer is composed of cells with morphology differing from that of normal cells. With information becoming available from numerous areas in biology and medicine, and capitalizing on major advances in technology, great strides were made in the twentieth century in unraveling many of the complexities of cancer, work that is continuing at an accelerating pace in the twenty-first century. It is now recognized that by far the majority of all cancers arises from environmental factors, metabolic disturbances, somatic mutations, and other pathophysiological processes (discussed throughout the book), while the remaining ones are attributable to germline mutations and are thus inheritable (familial).