I am sure many of us have attended a talk where a molecular biologist puts up what looks like the wiring diagram of the flight deck of a jumbo, but is in fact a cartoon of the various intracellular signaling pathways of a cancer cell. This is often done to portray the dazzling complexity of all the possible ways in which cell growth is regulated, how it can go wrong, as well as which pathways are or may be targets for new therapeutics. But it also provides a slightly unsettling moment when we realise that the more we learn, the less we seem to know. It is also often met with the uneasy smile we also use when confronted with complex mathematical formulae, one inspired by gratitude that we don’t have to know or understand the details to get on with our lives.
However, it is going to become increasingly difficult to be engaged in modern oncology practice without the rudiments of a molecular viewpoint of cancer cell behaviour. So it is a relief that a book like The molecular basis of cancer exists that allows us to delve in an accessible manner into the intricacies of the cell and how it may go wrong.
The book, now in its 3rd edition, is presented as 59 chapters within five sections that cover the breadth of our molecular understanding of cancer and how this may be applied in clinical practice. Since cancer is understood to be a genetic disorder, it is no surprise that the very first chapter sets the scene through an excellent summary written by the eminent Robert Weinberg. The subsequent chapters of section 1 further explore the way in mutations arise, what causes them and examines the way in which animal models have been used to elucidate these. The second section takes the rather broad title of “Cancer Biology” which could be applied to just about any part of this book. However, here it relates to the cellular basis of cancer, encompassing cell cycle regulation, apoptosis and cancer stem cells. The third section on molecular pathology and diagnostics is an important bridge that links the basic science underpinning molecular biology to clinical practice. It contains a series of excellent chapters exemplified by those on cancer genomics and bioinformatics. These chapters provide an excellent review of the tools that exist, with references and weblinks that the interested reader may follow up should they wish to.
The penultimate section deals with the molecular basis of cancers that arise in specific organs and is a logical approach, since most readers will wish to turn directly to the disease group they are interested in. As is stated in the preface, this book is not intended to simply detail the clinical manifestations of cancer and its management. However, a basic outline of all the molecular changes known to underlie the diseases they cause are useful, as they give a context to the concepts presented earlier in the book.
The final section is perhaps the part that most closely fulfils what is the stated intent of the book, to enable those engaged in cancer management to better understand the disease and its therapy. Again, each chapter is necessarily brief, but like the chapter on monoclonal antibody therapy of cancer, they provide an excellent summary of the concepts and applications of novel anti-cancer agents.
The chapters in this book do not attempt to be exhaustive about the topic they address, however instead provide sufficient information that fulfils the stated intent of the editors “…to describe the scientific underpinnings that will enable clinicians and other professionals who manage cancer patients to better understand the disease and its therapy”. Unfortunately, there are a few exceptions, such as the chapter on “Regulation of the cell cycle”, which is written in such a technically challenging manner that it is hard to reconcile that it fits the editors’ intent. But on the whole one may pick up this book and turn to any chapter at random and not find oneself hopelessly lost in jargon.
The illustrations provided are helpful and well laid out and will no doubt find their way into presentations (with permission, of course) by those of us wanting to show others the relevance of the molecular workings of cancer cells in our work. This is facilitated through a useful additional feature of this text, which is online access to the full text provided through the publisher’s website. This also brings to life the various embedded weblinks in the text and has very user-friendly features, such as searches for images and links to these within the text. Since this book is quite heavy (some 757 pages and nearly 2kg) the online access is likely to be a boon to those wishing to access this text when hunting for an explanation to something they have just heard in a lecture.
I would thoroughly recommend this book as a starting point for anyone interested in the molecular basis of cancer (a particularly apt title) and suggest it ought to be on the shelves of any person or organisation engaged in the treatment of cancer.
Nikolajs Zeps, St John of God Pathology, Wembley, Western Australia.