A HRW OR:BIT Book Club Review

At the start of my PhD, in which I researched the role of the Phosphoinositide 3-kinase (PI3K) isoform, p110δ, in cancer cell signalling (you can see why I hated the question “So, what is you PhD in, then?” from someone just making polite conversation), my supervisor gave me the book ‘One Renegade Cell’ to read…

Some 15+ years later (not wanting to give too much away!), it has been wonderful to revisit the book that helped lay the foundation of my oncology-focused career.

Although the book was published in 1998, and there have been significant developments in our understanding of cancer over the last 20+ years, ‘One Renegade Cell’ still provides a solid basis for anyone with an interest in oncology. For me, after moving away from academic oncology research into market research, the book served as a great refresher of the key events leading to cancer development…and also highlighted to me just how much progress has since been made in our understanding of both cancer development and in the approaches used to treat the disease.

The author, Robert A. Weinberg, a founding member of the Whitehead Institute (a non-profit research institution dedicated to improving human health through basic biomedical research), has been a pioneer in cancer research. Weinberg takes the reader on the cell’s journey; from a ‘normal’ state to a modified state that ultimately leads to the development of cancer. While the book breaks down the complexity of cancer development, using a multitude of every-day analogies and metaphors, there is still a fair amount of technical information that I feel may be a little heavy for readers without any scientific background. I found the first chapters easier to digest, although the early introduction of DNA, its composition and structure (critical information to understand the premise of cancer development) may be a bit of hurdle for readers without any background knowledge to overcome.

The book cleverly describes the pieces of the puzzle that have come together to shed light on how cancer develops. From epidemiological observations (e.g., scrotal cancers linked to men who had worked as chimney sweeps), the identification and cataloguing of carcinogens (cancer-causing agents), the discovery of proto-oncogenes and the changes (e.g., genetic mutations) that subvert these proto-oncogenes to oncogenes that ultimately disrupt cell growth, and the identification of tumour suppressor genes.

The book paints a complex picture of the multiple factors and contributors to cancer development, shining a spotlight on it being a multistep process. Weinberg highlights the involvement of genes, other than oncogenes and tumour suppressor genes, in this complex process – such as genes involved in DNA repair, in cellular signal transduction, angiogenesis, and controllers of the ‘cell cycle clock’ to name a few.

The final chapter, focuses on how we can use the knowledge of cancer development, as described throughout the 15 previous chapters, to develop treatments and ultimately a cure for cancer. There has been a huge amount of progress that has been made in cancer drug development since publication of the book, and if written today, I have no doubt that more time would have been spent outlining how our knowledge has been exploited to develop new cancer therapies and to design screening programs to prevent cancer and/or detect cancer early.

Overall, although not exactly a light read and becoming very ‘science-heavy’ in the latter chapters, I found revisiting the book a useful and interesting exercise, in refreshing my oncology knowledge. The read also served to highlight the great strides that have been made in cancer drug development, where theories of promising drug targets mentioned have since become a reality.

For those looking for more detail on the contents of the book…such the debate between the ‘chemical’ theory and the ‘viral’ theory of cancer development, (but aren’t looking to read 164 pages!), you can find a brief chapter-by-chapter summary here.



By Gemma McConnell

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