A hard cell to subvert

One of the major success stories of the application of the tools of molecular and cell biology to the study of human disease was the discovery that cancer is a genetic disease. This is not to say that it is inherited from our parents' germ cells and can be traced through families as reflecting the action of a single defective gene. While a few forms of cancer are inherited this way, most appear to result from defects in our genes that we acquire in our lifetime.

We are constantly exposed to noxious chemicals with the potential to damage our DNA. As well as environmental agents such as tobacco smoke, there are the many by-products of our normal body chemistry.

To counter them, we have evolved a complex series of repair systems. If they fail as the result of ageing or other factors, permanent changes (mutations) may occur in the DNA of our cells, which are passed on to their progeny. If these changes provide cells with a proliferative advantage, a cancerous growth may result.

The genes involved in the genesis of cancer were rather unfortunately termed "oncogenes" - unfortunate because they are the normal housekeeping genes of our cells, ensuring that they divide in an orderly manner and interact appropriately with their fellow cells to allow regulated growth and development. Many common cancers require mutations in several oncogenes, some involving these regulatory functions, others making it more likely that the cancerous cell will spread and form secondary deposits elsewhere in the body.

The current view has it, therefore, that cancer reflects the development of an appropriate pattern of oncogene damage; previous exposure to endogenous and exogenous carcinogens to cause this damage; defective repair systems; and chance.

This lively new textbook provides a bird's-eye view of this remarkable story. After outlining the fundamentals of normal cell biology and the regulation of gene expression, Lauren Pecorino describes the mode of action of different oncogenes and tumour suppressor genes and how their various mutations result in malignant transformation of cells. The ways in which carcinogens might act are discussed together with how therapeutic agents are being designed, directed specifically against the action of different forms of oncogene mutation. She rounds off with a look into the future at how cancer diagnostics and immunotherapy may evolve.

The author's infectious enthusiasm as a teacher comes across on every page of this beautifully illustrated book. To guide her readers through this increasingly complex field, she introduces some novel features, including "Special interest" boxes, sections labelled "Pause to think", well-designed chapter highlights and aids to "Memory refreshment". Given the speed of development of this field, the book is remarkably up to date.

As is clear from the section on careers in cancer research, this book is directed primarily at science students who might wish to develop such a career, either in academia or in the pharmaceutical industry. Although it lacks the overall breadth required for medical students, they, too, will find much of value in what is one of the best student texts on the molecular and cellular aspects of cancer available.

Sir David Weatherall is emeritus regius professor of medicine, Oxford University.