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Good Reads  Evolutionary Biology  Evolution

The Cheating Cell How Evolution Helps Us Understand and Treat Cancer

Popular Science
By: Athena Aktipis(Author), Alex Cagan(Illustrator)
238 pages, 19 b/w illustrations
Brimming with thought-provoking questions, The Cheating Cell looks at cancer through an evolutionary lens and forces the reader to radically reconsider cancer; not as a bug, but as a feature of life.
The Cheating Cell
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  • The Cheating Cell ISBN: 9780691212197 Paperback Sep 2021 Not in stock: Usually dispatched within 6 days
  • The Cheating Cell ISBN: 9780691163840 Hardback Mar 2020 Not in stock: Usually dispatched within 6 days
Selected version: £14.99
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About this book

When we think of the forces driving cancer, we don't necessarily think of evolution. But evolution and cancer are closely linked, for the historical processes that created life also created cancer. The Cheating Cell delves into this extraordinary relationship, and shows that by understanding cancer's evolutionary origins, researchers can come up with more effective, revolutionary treatments.

Athena Aktipis goes back billions of years to explore when unicellular forms became multicellular organisms. Within these bodies of cooperating cells, cheating ones arose, overusing resources and replicating out of control, giving rise to cancer. Aktipis illustrates how evolution has paved the way for cancer's ubiquity, and why it will exist as long as multicellular life does. Even so, she argues, this doesn't mean we should give up on treating cancer – in fact evolutionary approaches offer new and promising options for the disease's prevention and treatments that aim at long-term management rather than simple eradication. Looking across species – from sponges and cacti to dogs and elephants – we are discovering new mechanisms of tumor suppression and the many ways that multicellular life-forms have evolved to keep cancer under control. By accepting that cancer is a part of our biological past, present, and future – and that we cannot win a war against evolution – treatments can become smarter, more strategic, and more humane.

Unifying the latest research from biology, ecology, medicine, and social science, The Cheating Cell challenges us to rethink cancer's fundamental nature and our relationship to it.

Customer Reviews (1)

  • Forces you to reconsider cancer
    By Leon (NHBS Catalogue Editor) 23 Aug 2021 Written for Paperback

    Fifty years ago, US President Richard Nixon declared a "war on cancer" when he signed the National Cancer Act. Despite fantastic progress on some fronts, overall it is clear that we are not winning this battle. Cancer remains one of the leading causes of human mortality. But what if the tired war-metaphor is getting it all wrong? Brimming with thought-provoking questions, The Cheating Cell looks at cancer through an evolutionary lens and forces the reader to radically reconsider cancer; not as a bug, but as a feature of life.

    Athena Aktipis came to the research field of cancer evolution in the mid-2000s, just as it was getting a boost from various researchers who started to apply ideas from evolutionary biology to cancer research. She describes herself as working at the interface of cooperation theory, theoretical evolutionary biology, and cancer biology. Her background in psychology, with a specific interest in cooperation and conflict, might seem little relevant to cancer research but turns out to be highly appropriate.

    The basic premise of this book is that cancer is an evolutionary phenomenon that has been with us for as long as life has been multicellular and is best thought of as cellular cheating. If that seems like a lot to take in, I am trying to distil into one sentence what Aktipis spends the first three chapters developing. Let us go through these in reverse order.

    First, this notion of cheating. The hallmarks of cancer in humans is unchecked cell division, frequently forming tumours in the most unwelcome of places and, in some forms, spreading throughout the body in a process known as metastasis. But this is rather a narrow definition for understanding cancer's deep evolutionary history. To compare organisms with a very different underlying biology, such as plants and animals, you need to think at a more fundamental level. What cancer cells are ultimately doing is cheating on the pact that cells form when cooperating to form a multicellular organism. They divide out of control, they refuse to self-destruct via programmed cell death (apoptosis), they hog the body's resources, they do not stick to their assigned job, and they trash their environment, damaging and destroying the host's body as they go.

    Second, this notion of its deep history. The option for some cells to go rogue and cheat became available as soon as life evolved multicellularity. As also further explored in chapter 5, some form of cancer is found in almost all animal groups and even in plants, where it is known as fasciation. This chapter also explores Peto's Paradox: how larger body size is associated with increased cancer risk within, but not between species. Large and long-lived species consisting of many cells, such as elephants and whales, are very resistant to cancer.

    Third, this notion of an evolutionary phenomenon. Individual cancer cells reproduce rapidly and, just like organisms, are subject to natural selection. Populations of cancer cells show variation, heritability, and differential fitness – this is how they thwart our medical interventions, developing resistance to drugs and chemotherapy. Even if the time-scale is short and cancer ultimately kills its host, until then the calculus of evolution through natural selection still applies. Furthermore, selection is happening simultaneously at multiple levels. There is an arms race between rapidly evolving cancer cells and the body that, through division of labour, can draw on more complex defence strategies. Aktipis introduces you to three mechanisms that offer a certain redundancy in keeping cells from misbehaving, all of which can be broken or hijacked by cancer.

    Probably the biggest eye-opener for me was what I mentioned first: cancer being a feature, not a bug. In chapter 4, Aktipis outlines how cancer is with us from "womb to tomb". The reason evolution has not overcome cancer is trade-offs. The very processes that, when they malfunction, cause cancer are the basic mechanisms that, when they function, allow us to exist as multicellular organisms in the first place. "Many important systems that help us survive and thrive require cells to do things that are "cancer-like" including proliferating rapidly, moving around the body, and invading tissues" (p. 55). Think of wound healing and tissue regeneration, for example. Aktipis introduces the metaphor of life walking a tightrope: there needs to be enough cellular freedom to allow an organism to grow and develop, but not so much that cell division runs rampant. This, here, is why the war metaphor is unhelpful: "We can't completely eradicate something that is fundamentally a part of us" (p. 10).

    Aktipis has many more arrows to her bow. A long sixth chapter probes the frontiers of cancer research by asking what lesson from ecology we can apply to the tumour's microenvironment. Can disersal theory be applied to metastasis? Is the cooperation seen amongst cancer cells an adaptation, a by-product of other processes, or a transitory, random process? Can we draw lessons from kin selection theory or social insect colonies? What of the interaction between cancer and the microbiome? And can selfish genetic elements such as transposons influence our susceptibility to cancer?

    All of the above should force us to rethink how we treat cancer, leading to seemingly counterintuitive treatments. Our current strategies of radiation and chemotherapy rain down fire and brimstone but often lead to drug resistance. Rather than total eradication, adaptive therapies would aim for coexistence with tumours at a level that is not too damaging for the patient. For other cancers, feeding tumours and providing a comfy, stable environment could prevent the more disruptive result of metastasis. These are but some of the options and ideas considered here.

    Aktipis is very interested in science communication and has enlisted Alex Cagan to provide infographics. I found her writing a tad repetitive in places, saying something in one paragraph and then repeating it in slightly different words in the next paragraph. Hopefully, the flipside of this particular quirk is that few people will be left feeling they did not understand concepts. And this is, in a way, a good thing: The Cheating Cell bristles with fascinating ideas, there are many other tangents and questions Aktipis raises that I have not mentioned. All of this forces a radical reconsideration of what cancer is and how we should deal with it.
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Athena Aktipis is assistant professor in the Department of Psychology and in the Arizona Cancer Evolution Center at Arizona State University and co-founder of the International Society for Evolution, Ecology and Cancer. She is also the host of the science podcast Zombified. She lives in Tempe, Arizona.

Popular Science
By: Athena Aktipis(Author), Alex Cagan(Illustrator)
238 pages, 19 b/w illustrations
Brimming with thought-provoking questions, The Cheating Cell looks at cancer through an evolutionary lens and forces the reader to radically reconsider cancer; not as a bug, but as a feature of life.
Media reviews

"Aktipis takes an evolutionary approach to cancer, tracing the ways cells 'cheat' natural selection and showing how the human body evolved to outsmart many of those threats. She invites readers to put themselves in the role of a cancer cell and learn about the ways in which the disease and the history of human existence are intertangled."
– Erin Blakemore, Washington Post

"The Cheating Cell is a fascinating book on a subject that's gaining the prominence it deserves: cancer as an evolutionary phenomenon. Athena Aktipis works in the heart of this field and she deftly illuminates the subject for both scientists and general readers. The implications – for cancer treatment and for the understanding of our existence as multicellular creatures – are huge."
– David Quammen, author of The Tangled Tree

"The Cheating Cell is an instant classic – a book that will transform how physicians and their patients understand cancer, how investigators develop therapies, and how we as a society can work together to reduce the global burden of this disease. Masterful, powerful, and absolutely essential reading for anyone who truly wants to understand the nature of cancer, The Cheating Cell is a tour de force."
– Barbara Natterson-Horowitz, MD, coauthor of Zoobiquity

"This wise, erudite, and engaging book will change how we think about cancer and life itself. Brilliantly illuminating how cancer is a form of evolution gone awry within our bodies, Athena Aktipis shows that we need an evolutionary approach to not only fighting the disease but also living with it."
– Daniel E. Lieberman, author of The Story of the Human Body

"This insightful and long-overdue book views cancer as a disease that results from the evolutionary and ecological dynamics of all multicellular organisms, from birth to death. Athena Aktipis does a masterful job of capturing the many threads of evolution and evolutionary theory that promise to enable a fundamental understanding of cancer and portend a new era of innovative prevention and treatment strategies."
– Anna D. Barker, Arizona State University and former deputy director of the National Cancer Institute

"Cancer is more than a source of dread and tragedy – it is entwined with the nature of life and the forces that shaped it. Athena Aktipis has thought deeply about evolution and cancer, and provides an engaging and insightful explanation of why we are cursed with this malady."
– Steven Pinker, author of Enlightenment Now

"Trying to keep cheating cells at bay is a problem that connects humans, elephants, Tasmanian devils, and cacti alike. In The Cheating Cell, Athena Aktipis uses clear explanations and riveting examples to show how viewing cancer through an ecological and evolutionary lens allows us to better understand the disease, and can lead to more effective ways of lengthening lifespans in our ongoing battle with this most ancient of foes."
– Kelly Weinersmith, coauthor of Soonish

"The one book to read for a true understanding of cancer and its control."
– David Sloan Wilson, author of This View of Life

"The Cheating Cell turned my understanding of cancer on its head and you should read it."
– Hank Green, New York Times bestselling author of An Absolutely Remarkable Thing and A Beautifully Foolish Endeavor

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