13.  In Silico Investigation of Cancer Using Publicly Available Data

Cancer is a very complex disease, far more multifaceted than the traditional views rooted in the thinking that cancer is a genomic disease, at least for solid tumors as discussed in the previous chapters. The disease is a rapidly evolving biological system drifting away from normal cellular metabolism and homeostasis to adapt to the also evolving, increasingly more challenging and unfamiliar microenvironment. It may start from some, in and of itself, seemingly harmless metabolic changes in response to a stressful local condition such as persistent hypoxia and/or elevated ROS, which leads to gradual and continuing changes in the microenvironment, hence producing pressure for the underlying cells to evolve. The observed cell proliferation may represent a feasible and efficient route for the affected cells to escape from these pressures. The similar growth patterns and other common characteristics across different cancer types, referred to as hallmark activities, strongly suggest that the survival pathway of the affected cells is a well-coordinated process, possibly guided by signaling instructions manifested by hyaluronic acid and fragments as discussed in Chaps. 6 and 9. The continuous coadaptation and coevolution between the changing microenvironment and the altered cellular metabolism may drive the evolving cells to utilize whatever cellular capabilities encoded in their genomes via the increasingly more relaxed epigenomic regulations or random mutations confer for their survival.