How Cancer Cells Play the Winning Game
Mel F Greaves · Cancer · 2000
Abstract To generate a fully-fledged or dominant cancer clone, a cell has to subvert multiple rules of engagement and negotiate major evolutionary bottlenecks. For most types of cancer, this is only possible by the accumulation of a set of mutations in genes exercising different, but complementary or interlocking, functions. Because of the statistical rarity of DNA damage creating one of these mutations and because accrual of a set of mutations is only possible by sequential addition, the process can only operate in single cells, or clonally and over an extended period of time. This makes the whole process probabilistic and pervaded by chance (Fig. 8.1).