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August 11, 1989

Is Cancer Adaptation Gone Awry?

JAMA. 1989;262(6):733-734. doi:10.1001/jama.1989.03430060013002

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GENES ARE NOT THE MASTERS but the servants of the cell.

That was the heretical word from Emmanuel Farber, MD, one of a handful of speakers at the recent 80th annual meeting of the American Association for Cancer Research (AACR) in San Francisco, Calif. It emanated from a symposium entitled "The Epigenetics of Cancer," sandwiched among scores of presentations on the molecular genetics of cancer.

For a better part of the decade, the prevailing wisdom of the AACR, whose membership is heavily weighted with basic investigators, has been that cancer is a genetic disease, which can be traced to a succession of DNA mutations and the influences of the resultant gene products. The epigeneticists are challenging this notion, declaring that genetic alterations alone are not sufficient to cause cancer; they need to occur in hostile extracellular environments. Their declarations have fallen on deaf ears. "Epigenetics is the stepchild of cancer