Question ID: WS-111
Submitted by: Kazufumi Suzuki
July 16, 2011
Is cancer is disease of cells or cell-cell interactions? Background Traditionally, it is thought that cancers arise from single cell which has received some damage in its genome. It seems to be true. UV, replication error or other numerous factors which can be cause DNA damage may be initial step of carcinogenesis. But it cannot explain tumor maintenance mechanism. When we study bulk tumor, cancer genome project tell us complicated genetic and epigenetic changes of cancer cells, for example driver mutations and passenger mutations. It is very hard to interpret cause (genetic and epigenetic alternation) and result (bulk tumor behavior, that is growth, metastasis, recurrence and so on). Feasibility We need new concept of cancer. In generally, cancer cannot be exist in single cell. We cannot pursue the nature of cancer in single cancer cell. In human body, like the other organism, any cell’s nature cannot determined by itself. It can only be determined in the context of cell-cell interactions. Cell-cell interaction consists of two way of interaction. One is direct contact, that is signals transmitted directly one cell membrane to the other (junctions). The other type is remote interaction, signals transmitted by cytokines, hormones and other proteins or small molecules. These signaling network end up to make morphogenic field within tissue level. That makes order of tissue. We don’t need to discover morphogen in human. Hypothetical morphogen can be derived from morphogenic fields. Morphogenic fields determine the nature of cells within the field. Genetic alteration of cancer display huge diversity, so we cannot distinguish cause and effect. Cell-cell interaction determines stability of genome, so most of passenger mutations are the effect of aberrant morphogenic field. But there is room that reductionism, that is the assumption of cancer is the disease of cell, explain the phenomenon clearly. For example, cancer metastasis can explain one cancer cell of primary tumor moves to the other organ and expands. Implications for public health We need to establish integrated cancer science which includes traditional methods like genetics which are based on reductionism and systemic approach of cancer which interpret phenomenon by multi-dimensional interactions. That may drive completely new way of research for public health.
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