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Brief Reviews - Medicine
by Jeanette Bayduza

To explain the complex subject of the cause of cancer in comprehensible terms to those not involved in this type of science is the purpose of Robert A. Weinberg's One Renegade Cell: How Cancer Begins (Basic Books, 170 pages, $30 cloth). The book accomplishes this task superbly. The author, a molecular biologist and director of one of the world's leading cancer research centres in the United States, enthusiastically leads the reader step-by-step through an explanation of normal cell component functions and how disruptions in these basic cell components may be one of the multitude of events finally leading to the production of a cancerous cell. The topic is complicated; the narrative, however, is easy to follow. And while a prior basic knowledge of cell biology is an asset, it is not a prerequisite.

Weinberg follows the evolution in cancer research from some of the earliest observations, such as Pott's correlation of scrotal cancer and chimney sweeps in 1775, Mandel's work in organismic heredity in the mid-nineteenth century, through the work of countless other researchers toiling in laboratories worldwide and Watson and Cricks' 1953 watershed discovery relating to gene structure, to the tenuous advances by molecular biologists beginning in the early 1970s, and the explosion of knowledge in the last two decades.

He gives examples of false clues, scientific debates as to possible future research paths, sheer luck, and gradually more fruitful work as analytical methods become increasingly reliable. Above all, he illustrates the irreplaceable contribution of a multitude of disciplines working in concert with a worldwide sharing of discoveries, finally melding into the solid scientific facts known today. The importance of basic research is reaffirmed-governments take note. And the final chapter ends on an optimistic note: because cancer's basic cause is from outside the cell, factors such as environment, air, food, and smoke can be modified by the individual and society, leading to a reduction in cancer deaths as opposed to the discovery of new cures. Undoubtedly, this will occur, but the path will take many turns, orchestrated as before by multitudes of researchers working in their respective fields.

This is not a reference book on specific cancers. The basic science of a few (e.g., colon, retinoblastoma, breast) is given, but only to support the text and correlate these cancers with clinical observations. The book does not have to be read in its entirety; a detailed index is included. But even reading the first few chapters will provide readers with a foundation to understand words which are being used with increasing frequency in the media: cloning, hybridization, genetic engineering, terminator seeds, target genes, bullet virus, gene therapy, drug resistance. Specifically, the book will help the reader to grasp the monumental significance of the Human Genome Project, which is scheduled to be completed within the next two years. (The Human Genome Project is a worldwide cooperative undertaking to catalogue the entire gene library carried in human cells; the base sequences of these genes will often provide the broad hints as to their roles in the life of the cell.)

In the future, society will be called upon to decide which research routes should continue and which should stop. For example, Iceland's parliament passed The Health Sector Database Bill in 1998, allowing the medical records, family trees, and assorted genetic information of all Icelanders to be combined in a single, computerized database. Campaigns for and against the bill have been heating up ever since.

I would give this book to young high-school, college, and university students. Many are searching for a path; some will find inspiration here.

Jeanette Bayduza


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