1 The size of the challenge

In 1962 President Kennedy launched the ‘race to the moon’ in an effort for the United States to overtake Soviet space capabilities pledging the US would put a man on the moon within the decade. This clearly was a big technological challenge but on the 20 June 1969 Apollo 11 was launched and John Amstrong became the first man to set foot on the moon.

In 1971 President Nixon suggested that the concentrated efforts that allowed ‘splitting the atom and taking a man to the moon’ should be harnessed for the ‘war on cancer.’ In the intervening decades this war has not been won but it has triggered a huge scientific research effort and an explosion of knowledge that has not only helped to better understand the challenges of cancer therapy but has also to elucidate some of the fundamental mechanisms underpinning the understanding of the molecular biology of the cell we have today. Today, over 150,000 scientific papers associated with the term ‘cancer’ are published each year based on a search on the database ‘Pubmed’ (Figure 1.1).

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Number of cancer-related articles published each year according to the Pubmed database

Figure 1.1: Number of cancer-related articles published each year according to the Pubmed database

This explosion of knowledge continues to accelerate with many of the important concepts that shape our understanding of cancer development only having started to attract significant research interest a decade ago. This poses a two-fold challenge in creating a compact book on cancer:

  • Completeness - the vast amount of knowledge accumulated on each and any given sub-topic would easily fill a substantial book,
  • Timeliness - our understanding of cancer continues to evolve and more detail is added to the picture on a daily basis.

These considerations have led us to focus on putting together a basic framework that provides the reader with an overarching view of key concepts that shape the way we view cancer to date. This will mean that many of the highly significant individual contributions as well as the gradual evolution of our understanding of cancer will move into the background although these are historically important and provide a fascinating insight into how the science of cancer has been shaped by inspiring individuals as well as increasingly by multi-disciplinary and multi-national teams.

The aim of this compact introduction to cancer is therefore not completeness but rather to provide a paradigm of cancer which helps the reader to frame knowledge in a way that explains why cancer develops in the way it does and which allows us to develop effective and safe therapies that target the underlying biology of cancer.

Paradigms

  • Frame the way we understand a problem
  • Help us to organise knowledge
  • Drive the way we strive for solutions