2009
DOI: 10.1038/sj.bjc.6605171
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The mysterious steps in carcinogenesis

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Cited by 28 publications
(23 citation statements)
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“…Because the SMT relies on DNA mutations in the founder cell that would become cancerous, in carcinomas this cell is an epithelial one 3 . Thus, while the core narrative of the SMT has remained intact, increasingly pointed criticisms due to the difficulties in fitting data within the premises of the theory are addressed by ad hoc additions or become labeled as “mysterious steps” [9]. More specifically, Brash and Cairns state: “The prime mystery in carcinogenesis remains the very first step, because it is hard to imagine how the numerous genetic changes found in cancer cells could have been produced in any cell as the result of a single exposure to a DNA-damaging agent, or why months or years should have to elapse before the effect of these changes is observed”.…”
Section: Failings Of the Smtmentioning
confidence: 99%
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“…Because the SMT relies on DNA mutations in the founder cell that would become cancerous, in carcinomas this cell is an epithelial one 3 . Thus, while the core narrative of the SMT has remained intact, increasingly pointed criticisms due to the difficulties in fitting data within the premises of the theory are addressed by ad hoc additions or become labeled as “mysterious steps” [9]. More specifically, Brash and Cairns state: “The prime mystery in carcinogenesis remains the very first step, because it is hard to imagine how the numerous genetic changes found in cancer cells could have been produced in any cell as the result of a single exposure to a DNA-damaging agent, or why months or years should have to elapse before the effect of these changes is observed”.…”
Section: Failings Of the Smtmentioning
confidence: 99%
“…This latter interpretation, as well as the competing SMT, has faced many challenges over the years due to the lack of an agreed comprehensive explanation of how cancer fits within biology at large. Faced with the complexity of human cancer, some have suggested that “…a new idea seems to be needed… to start to clarify what is going on during carcinogenesis” [9]. Based on this suggestion, an evaluation of the usefulness of the SMT and of alternative approaches to it is due.…”
mentioning
confidence: 99%
“…The low growth-promoting activity of interstitial fluids would also account for the relatively large increase in cancer with prolonged increases in growth-stimulating hormones [35]. Given the evidence that selection is the driving force in human carcinogenesis [28,29], and the strong promoting effect of increased saturation density evident here, the driving force of increased cell division would not be increased mutation [35][36][37], but increased opportunities for selection of existing mutations [25,27,38,39]. Evidence for field effects in carcinogenesis of the lung, colon, breast, and other cancers have been cited by Braakhuis et al [7], and the general rules developed here should be applicable with appropriate modification to each special case.…”
Section: Discussionmentioning
confidence: 96%
“…Despite having acquired massive amounts of data about epithelial cancers at the molecular and cellular level, little is known about how carcinogenesis occurs (Brash and Cairns 2009). Mainstream thought claims that cancer is a problem of regulatory control of cell proliferation due to the genetic/epigenetic mutation within one or several initiating cells (Dalerba et al 2007).…”
Section: Introductionmentioning
confidence: 98%