Cancer—a degenerative disorder?

Cancer is primarily a disease of ageing epithelia, and of ageing individuals. We now possess detailed insights into the changes in cell regulatory genes and DNA repair systems which accumulate with time and which manifest in malignancy. These demonstrate how cancer is frequently characterized by degenerative change in the genotype, from the most subtle base pair mutations to gross aneuploidy, and by deterioration in cell and tissue regulatory control, be it of proliferation, programmed cell death or signalling. Cancer may thus be as much a phenomenon of loss or deterioration of normal genomic control as of the acquisition of new, neoplastic functions. This distinction may be more than semantic, not least because it governs our approach to the search for therapeutic strategies. This essay considers the concept of cancer as a degenerative disease and its implications, and proposes the neologism aldoplasia to describe this phenomenon of cancer biology.